Both NCCN and ESMO, for example, recommend anti-PD-1/PD-L1 as first-line monotherapy for metastatic NSCLC with PD-L1 TPS ≥ 50% in the absence of targetable mutations, and in combination with chemotherapy for PD-L1 TPS 1%–49% (43, 44). This evidence concerns the gene CD274 and non-small cell lung carcinoma.