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46.5% (153) had a PD-L1 tumor proportion score (TPS>¼50%). Eighty six percent (283) of patients had a known date of test, with 95% (n¼269) tested before the start of 1LT. Among those tested before start of 1LT (N¼269), 47% (146) had a TPS 50%, of which majority 82% received 1L anti-PD-1 inhibitor pembrolizumab monotherapy, followed by 14% received a TKI monotherapy. Patients with TPS <50% (n¼123), majority (60%) received platinum doublet +/-bevacizumab. Among the TPS50% and <50%, approx. 71% and 54% did not have EGFR/ALK aberrations. Of those not tested for PD-L1 before the start of 1L treatment (n¼60), 46.6% were EGFR and ALK negative with majority (68%) receiving platinum doublet +/bevacizumab. Among the untested (n¼81), 19% were EGFR/ALK negative with majority receiving TKI inhibitor therapy (49%), followed by platinum doublet +/-bevacizumab (37%) [Table -1]. Conclusion:A fast uptake of PD-L1 testing was seen since its introduction in the Israel's health services list in early 2017. Predominant use of immune checkpoint inhibitors as 1L treatment for PD-L1 positive patients shows high adherence to guidelines.