Efficacy of Platinum-based Chemotherapy Plus Immune Checkpoint Inhibitors for EGFR/ALK/ROS1 Mutant Lung Cancer

Inclusion Criteria:

1. Understand the requirements and contents of the clinical trial, and provide a signedand dated informed consent form.

2. Age ≥ 18 years.

3. Histologically or cytologically confirmed, Stage IV NSCLC.

4. EGFR/ALK/ROS1-sensitive mutations confirmed by an accredited local laboratory,progressed from first line systematic therapy.

5. ECOG 0-1.

6. Predicted survival ≥ 12 weeks.

7. Adequate bone marrow hematopoiesis and organ function

8. Presence of measurable lesions according to RECIST 1.1.

Exclusion Criteria:

Cancer-Specific Exclusions:

• Active or untreated central nervous system metastases.

• Malignancies other than NSCLC within 5 years prior to randomization, with theexception of those with a negligible risk of metastasis or death treated withexpected curative outcome.

General Medical Exclusions:

• Pregnant or lactating women.

• History of autoimmune disease.

• History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-inducedpneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screeningchest computed tomography scan. History of radiation pneumonitis in the radiationfield (fibrosis) is permitted.

• Positive test for human immunodeficiency virus.

• Active hepatitis B or hepatitis C.

• Severe infection within 4 weeks prior to randomization.

• Significant cardiovascular disease.

• Illness or condition that interferes with the participant's capacity to understand,follow and/or comply with study procedures.

Exclusion Criteria Related to Medications:

• Prior treatment with cluster of differentiation 137 agonists or immune checkpoint blockade therapies, anti-programmed death-1, and anti-PD-L1 therapeutic antibodies.