NEOPLASMS OF THE LUNG: Edited by Alan M. Fein and David E. OstApproach to stage IV non-small-cell lung cancer: how to select among first-line therapy options?Pacheco, Jose M.Author Information Division of Medical Oncology, Department of Internal Medicine, University of Colorado Cancer Center, Aurora, Colorado, USA Correspondence to Jose M. Pacheco, MD, Assistant Professor, Thoracic Oncology and Developmental Therapeutics, 1665 Aurora Court, Room 5309, Mail Stop F704, Aurora, CO 80045, USA. Tel: +1 720 848 5463; e-mail: [email protected] Current Opinion in Pulmonary Medicine: July 2020 - Volume 26 - Issue 4 - p 311-320 doi: 10.1097/MCP.0000000000000659 Buy Metrics Abstract Purpose of review There are several first-line systemic therapy options for patients with newly diagnosed stage IV non-small-cell lung cancer. Targeted therapy with tyrosine kinase inhibitors provide a good first option for some. Unfortunately, most patients do not have an alteration for which there is an available tyrosine kinase inhibitor. For these patients there are immunotherapy and chemoimmunotherapy options; however, there is debate about how to choose amongst these treatments for a given individual. This review attempts to simplify this decision-making process. Recent findings The data on first-line immunotherapy and chemoimmunotherapy regimens is highlighted. Programed death ligand-1 cut-points and how these may influence therapy decision making are discussed. Molecular markers that may help predict benefit or lack thereof in patients treated with immunotherapy regimens are touched upon. Summary Provided is a guide for the practicing clinician to help them select amongst immunotherapy and chemoimmunotherapy options for a given patient. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.