Other than part of a clinical trial or for its FDA-approved indication (second-line therapy for metastatic squamous-cell NSCLC), when do you offer nivolumab to your patients with NSCLC?   

For example, should nivolumab be considered standard second-line therapy for adenocarcinoma patients?   Can it be considered for first-line therapy in NSCLC patients with a performance status too poor for traditional chemotherapy?