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One of the most important things to measure with a stage four metastatic non-small cell lung cancer is what is called PDL1. This percentage, or sometimes referred to a CPS or combined score in some cancer types and immune therapy drugs, gives us an idea on how well you’ll respond to immune therapy. So if you have a non-small cell lung cancer and your PDL1 expression is over 50%, you could get away with doing just immune therapy by itself because the data suggests the chance of good control are high. If it’s below 50%, but still greater than 1%, oftentimes if you need quick reduction in your tumor, they will combine it with chemotherapy. But it is reasonable to use immune therapy alone if somebody is not in good enough health to tolerate the more intense cytotoxic chemotherapy. If your PDL1 percentage is zero or not even 1%, then unfortunately chemotherapy is probably the better way to go, and you likely won’t have a response to immune therapy by itself. However, you can talk to your doctor about data if immune therapy may still need to be tried if you are not a candidate for chemotherapy,
