Plasma-Adapted First-Line Pembro In NSCLC

Inclusion Criteria: \- Participants must have histologically or cytologically confirmed stage IV NSCLC (AJCC 8th edition). \- Participants must have evaluable disease on imaging per RECIST (measurable disease is not required). * No prior treatment with a systemic anti-cancer therapy of any kind for the treatment of stage IV NSCLC. Prior definitive chemoradiation for locally advanced disease, or prior adjuvant or neoadjuvant therapy for early stage disease is permitted if completed ≥6 months prior to initiating study treatment. * Age ≥18 years. * ECOG performance status 0-2 (see Appendix A) * Candidate for combination chemoimmunotherapy per physician assessment. * Participants must have normal organ and marrow function as defined below: \-- absolute neutrophil count ≥1000/mcL * platelets ≥100,000/mcL * total bilirubin \<1.3 mg/dL * creatinine \<1.6 mg/dL * PD-L1 tumor proportion score (TPS) ≥1%, as determined by a CLIA-laboratory. * The effects of pembrolizumab on the developing human fetus are unknown. For this reason and because immune checkpoint blockade agents as well as other therapeutic agents used in this trial are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she…