Thirdly, although our nomogram was internally validated using bootstrapping validation, other models proposed by external validation are required for future exploration.More importantly, relying solely on clinical variables may inadequately reflect the molecular heterogeneity of lung cancer.In the current era of precision medicine, driver gene status (e.g., EGFR mutations, ALK rearrangements) directly influences responses to targeted therapies, while PD-L1 expression levels serve as crucial predictive biomarkers for immune checkpoint inhibitor efficacy. The gene discussed is ALK; the disease is lung cancer.