Several phase III trials on immune checkpoint inhibitor therapy in non-small cell lung cancer were recently published and changed the clinical practice Here, non-small cell lung cancer has to be categorized first according to the presence of activating mutations and second according to the programmed cell death ligand 1 (PDL1) expression. Approximately 25% of patients present with a driver mutation and should be treated with tyrosine kinase inhibitors as the first line treatment strategy for metastatic non-small cell lung cancer. Approximately 75% of patients do not present with a driver mutation and should be treated according to the presence of PDL1 expression. Patients with high PDL1 (≥ 50% of tumor cells) expression are candidates for immune checkpoint inhibitor monotherapy, although a combination with chemotherapy can be suggested in patients with high tumor load and fast progressing disease. Patients with intermediate (1-49% of tumor cells) PDL1 expression are on the other hand candidates for the combination of chemotherapy with immune checkpoint inhibitor therapy according to the recently published data. Further, combination of immune checkpoint inhibitor-based therapy with chemotherapy and bevacizumab could be an option in patients with a driver mutation after the failure of available tyrosine kinase inhibitors.Listen to the podcast with Professor Johan Vansteenkiste, MD (Respiratory Oncology Unit and Trial Unit; Department of Respiratory Diseases

University Hospitals KU Leuven; Catholic University Leuven, Belgium) and read the full Abstract on the ESMO Open website.