Abstract
Nowadays we can see a significant improvement and changes in the treatment of the patients with lung cancer. The current recommendations for the treatment are constantly being changed. New schemes and medicines are coming to the clinical practice. However, there are a group of patients outside of guidelines: patients with ECOG‑2 status, clinically rapidly progressing, with severe anxiety. Such patients are not including in clinical trials. Apparently, it is not quite right to transfer the current standard recommendations for the treatment to this group of patients. This review discusses various aspects related to the choice of a first line treatment in patients with metastatic non-small cell lung cancer in the situation of time absence and luck of molecular status of the patient. Is there a place for the starting with chemotherapy or immunochemotherapy, switching to targeted therapy or immunotherapy in the process of treatment.
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