In first-line treatment of metastatic non-small-cell lung cancer without a targetable driver mutation, treatment selection is stratified by tumor PD-L1 expression level and by broad-panel molecular (driver mutation) testing, reflecting the field of precision oncology's use of predictive biomarkers to choose between checkpoint-inhibitor monotherapy, checkpoint inhibitor plus chemotherapy combinations, and targeted small-molecule inhibitors. The underlying principle is that biomarker status (PD-L1 percentage, presence of an actionable driver alteration such as MET exon 14 skipping or RET fusion) predicts differential response to immunotherapy versus targeted therapy versus chemotherapy, and that tissue- versus plasma-based (liquid biopsy) molecular diagnostics trade off turnaround time, sensitivity, and tissue availability. This sits within medical oncology's broader shift toward biomarker-driven, individualized systemic therapy selection rather than uniform treatment of a histologic cancer type.
In first-line treatment of metastatic non-small-cell lung cancer without a targetable driver mutation, treatment selection is stratified by tumor PD-L1 expression level and by broad-panel molecular (…