Chemoimmunotherapy vs Immunotherapy Monotherapy Receipt in Advanced Non-Small Cell Lung Cancer

In driver mutation-negative advanced non–small cell lung cancer (aNSCLC), chemotherapy with anti–programmed cell death 1 (PD1) or its ligand (PD-L1) immune checkpoint inhibitor therapy (ICI) is standard of care for patients with PD-L1 expression (ie, tumor proportion score) of less than 50% (PD-L1 low). When PD-L1 expression is 50% or higher (PD-L1 high), ICI monotherapy and chemoimmunotherapy show similar outcomes in the US Food and Drug Administration pooled analyses.1,2 Except for scenarios, such as high tumor burden or advanced age, clinical guidelines do not recommend 1 treatment over another, and it is unclear what factors influence prescribing of each treatment in the clinical setting.