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Lung cancer with no driver mutation (PD-L1 guides treatment)

If no driver was found, you still have strong options, and immunotherapy has helped many people live longer and feel well. Here's how your plan is chosen.

ℹ️ General information to help you and your loved ones talk with your care team, not medical advice. Read our disclaimer.

The quick guide

What it means: No targetable gene change was found, so treatment is guided by PD-L1 and the cancer's type (squamous or non-squamous).

How it's found: PD-L1 is checked with a stain on tumor tissue.

How common it is: This is the case for many people with non-small cell lung cancer, especially those who smoked.

How treatment works

🌱 Early-stage

  • Surgery with chemo plus immunotherapy before and/or after, or chemoradiation followed by immunotherapy (durvalumab) for stage III.

🔁 Advanced or metastatic

  • PD-L1 50% or higher: immunotherapy alone (like Keytruda) may be an option.
  • Otherwise, immunotherapy plus chemo, such as carboplatin + pemetrexed + Keytruda for non-squamous cancer.
  • Later: other chemo, docetaxel, or clinical trials.

Approvals depend on stage and prior treatment. Your care team will decide what fits you.

Drug guides

Biomarker tests that matter

Side effects you may notice

❓ Questions you and your loved ones can ask

Back to Lung cancer overview. Other types: EGFR-positive lung cancer, ALK-positive lung cancer, KRAS-positive lung cancer (including G12C), Lung cancer with ROS1, BRAF, MET, RET, NTRK, HER2 or NRG1 changes, Small cell lung cancer (SCLC).

Written by the Cancer Side Effects Guide team from FDA labels and leading cancer centers. Not medical advice. · Last updated: October 15, 2026 · How we write

Not medical advice. This page is general information to help you talk with your care team. It can't replace advice from your doctor or nurse. If you have a fever of 100.4°F (38°C) or higher during treatment, or any symptom that worries you, call your care team now. In an emergency, call 911.

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