Figure 1.

Main algorithms for the treatment of late stage non-epidermoid non-small lung cancer at diagnosis and strategies for biomarker testing. The first step concerns assessment of different genomic alterations among currently recommended genes. If the genes are wild-type (A) no targeted therapy is administered and patients receive immunotherapy alone (if PD-L1 is expressed in more than 50% of tumor cells) or in association with chemotherapy (if PD-L1 is expressed in less than 50% of tumor cells). If one active driver genomic alteration is detected on one of the currently recommended genes (B), no immunotherapy alone or in combination with chemotherapy should be administered since the patient should be treated with a targeted therapy. (C) List of the currently recommended and future molecular biomarkers for assessment at baseline.