9
Negative (TPS 0%) and low
positive PD-L1 (TPS 1%–49%)
High PD-L1
(TPS ≥50%)
SCC
a
is does not apply to patients with stage IV NSCLC with rarer histologies, e.g., large cell
neuroendocrine.
Single-agent pembrolizumab
S
Single-agent atezolizumab
S
Single-agent cemiplimab
S
Single-agent pembrolizumab
W
Pembrolizumab/carboplatin/
paclitaxel or nab-paclitaxel
S
Nivolumab/ipililumab ±
chemotherapy
W
Standard chemotherapy with
platinum-based two-drug
combinations
S
Standard chemotherapy with
non-platinum-based two-drug
combinations
W
Nivolumab/ipilimumab ±
chemotherapy
W
Pembrolizumab/carboplatin/
paclitaxel or nab-paclitaxel
M
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
EGFR/ALK/ROS-1/BRAF
positive
Refer to algorithm for
Stage IV NSCLC with
Driver Alterations
Strength of
Recommendation
W
Strong
Moderate
Weak
M
S
