Thirty-six patients diagnosed with advanced-stage NSCLC without actionable driver mutation and received pembrolizumab in the first line setting were included in this study...low SPARC expression was a significant predictive factor for the first-line pembrolizumab treatment response (p = 0.04, OR:0.11, 95%CI 0.01-0.92) in NSLC patients....Our study lightened a new area in the literature that SPARC expression might predict the pembrolizumab response...