8
Treatment
Figure 1. First-Line Treatment Options for Patients with
Stage IV NSCLC Without Driver Alterations
Patients with stage IV NSCLC,
PS 0–1
a
EGFR/ALK/ROS-1/BRAF negative
Negative (TPS 0%) and low
positive PD-L1 (TPS 1%–49%)
High PD-L1 (TPS ≥50%)
Non-SCC
Single-agent pembrolizumab
S
Single-agent atezolizumab
S
Single-agent cemiplimab
S
Single-agent pembrolizumab
W
Atezolizumab/carboplatin/
paclitaxel/bevacizumab
M
Pembrolizumab/carboplatin/
permetrexed
S
Atezolizumab/carboplatin/
nab-paclitaxel
M
Nivolumab/ipilimumab ±
chemotherapy
W
Standard chemotherapy with
platinum-based two-drug
combinations
S
Standard chemotherapy with
non-platinum-based two-drug
combinations
W
Atezolizumab/carboplatin/
paclitaxel/bevacizumab
M
Atezolizumab/carboplatin/
nab-paclitaxel
W
Nivolumab/ipilimumab ±
chemotherapy
W
Pembrolizumab/carboplatin/
permetrexed
S
Treatment options Treatment options
For patients with contraindications to
immunotherapy
For patients with contraindications
to immunotherapy and are not
candidates for platinum-based therapy
For patients with low positive PD-L1
expression who are ineligible for
doublet platinum ± pembrolizumab
