The decision to initiate adjuvant pembrolizumab in this case of PD-L1-negative early-stage NSCLC was supported by emerging evidence from the phase III PEARLS/KEYNOTE-091 trial, which demonstrated a disease-free survival benefit in patients with complete resection in stages IB-IIIA, regardless of PD-L1 expression [23]. Here, CD274 is linked to non-small cell lung carcinoma.