In a 2018 phase III trial of pembrolizumab combined with pemetrexed and platinum chemotherapy in metastatic non-squamous NSCLC without sensitizing EGFR or ALK mutations, improvements in overall survival (OS) and PFS were reported in the overall population, with PFS improvement observed in both never-smokers and smokers [121]. This evidence concerns the gene ALK and non-small cell lung carcinoma.