PD-L1-high non-small-cell lung cancer without a driver mutation: lines of therapy
4 standard-of-care settings across 3 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| PD-L1 | Advanced, first line, PD-L1 50 percent or more | Pembrolizumab alone (KEYNOTE-024, KEYNOTE-042), cemiplimab alone (EMPOWER-Lung 1) or atezolizumab alone; pembrolizumab plus platinum doublet for bulky or symptomatic disease; nivolumab plus ipilimumab as a chemotherapy-free alternative. | NCCN Guidelines: Non-Small Cell Lung Cancer | 98 | |
| PD-L1 | Advanced, first line, PD-L1 1 to 49 percent | Pembrolizumab plus platinum doublet (KEYNOTE-189, KEYNOTE-407); monotherapy is not recommended below 50 percent. | NCCN Guidelines: Non-Small Cell Lung Cancer | 98 |
Second line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Advanced, after progression on immunotherapy | Platinum doublet if not yet given; docetaxel with or without ramucirumab; clinical trials of antibody-drug conjugates and bispecifics. | NCCN Guidelines: Non-Small Cell Lung Cancer | 86 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Duration and stopping | Two years of immunotherapy for patients in response, with retreatment at relapse; management of immune-related adverse events by organ. | NCCN Guidelines: Non-Small Cell Lung Cancer | 99 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.