ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2023
Clinicopathologic and Genomic Factors Impacting Efficacy of First-Line Chemoimmunotherapy in Advanced NSCLC.
Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 1 of them a synthesis that pooled it.
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Who cites it
67 citing papers in PubMed, 1 synthesis or guideline pooled it, 82 citations in OpenAlex.
- A Systematic Review and Meta-Analysis of the Impact of Tumour Mutation Burden on Survival Outcomes in Solid Tumours.Cancer medicine · 2026Pooled it
- Influence of oncogenic drivers and signaling pathways on immune checkpoint inhibitor efficacy in NSCLC.Genes & diseases · 2027Review
- Article
- Targeted therapeutic strategies forTranslational lung cancer research · 2026Review
- Tumor-Derived Complement C3 Overexpression in STK11-Mutant Lung Adenocarcinoma Drives Tumor Growth and Immune Checkpoint Inhibitor Resistance.Cancer immunology research · 2026Article
- Next-generation sequencing elucidates the distinct mutational landscape of SMARCA4-deficient lung cancer.Oncology letters · 2026Article
- Article
- Somatic copy number alterations profiling in non-small cell lung cancer and their correlation with clinical efficacy in first-line treatment.Genome medicine · 2026Article
- Dual PD-1/IL-2Rα targeting restores CD8Cell reports. Medicine · 2026Article
- SMARCA4-deficient non-small cell lung cancer and immunotherapy resistance: mechanisms and novel strategies-a mini-review.Discover oncology · 2026Review
- The efficacy and predictive factors of first-line immune checkpoint inhibitors for advanced non-small cell lung cancer with driver or non-driver gene alterations: a retrospective cohort study.Journal of thoracic disease · 2026Article
- Dissecting the impact of Controlling Nutritional Status (CONUT) score on survival outcomes and immune-inflammatory profiles in patients with advanced NSCLC undergoing first-line immunotherapy.Journal for immunotherapy of cancer · 2026Article
- Emerging Predictive Biomarkers of Immunotherapy Sensitivity in Patients with Non-Small Cell Lung Cancer.ImmunoTargets and therapy · 2026Review
- Immune checkpoint inhibitors in resectable non-small cell lung cancer: recent successes and ongoing challenges.Frontiers in oncology · 2026Review
- Immunotherapy plus chemotherapy improves survival in SMARCA4-deficient NSCLC: a real-world cohort study.Frontiers in immunology · 2026Article
- Development and validation of a circulating tumor DNA-based machine learning model for predicting immunotherapy response in non-small cell lung cancer.Translational cancer research · 2025Article
- Peripheral blood inflammatory markers as predictive and prognostic indicators in neoadjuvant immunotherapy for non-small cell lung cancer.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2025Article
- Multi-omics analysis reveals differential benefits of immunotherapy±chemotherapy based on detailed smoking history in advanced non-small cell lung cancer.Journal for immunotherapy of cancer · 2025Article
- First-line treatments for KRAS-mutant non-small cell lung cancer: current state and future perspectives.Cancer biology & therapy · 2025Review
- Prognostic Implications of SMARCA4, ARID1A, and Other BAF Mutations in Non-Small Cell Lung Cancer.Cancer medicine · 2025Review
7 more citing papers are in PubMed but not listed here.
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Authors and funding
28 authors at 7 institutions in 3 countries.
Funding
Abstract
introductionAlthough programmed cell death protein 1 and programmed death-ligand 1 (PD-L1) blockade in combination with platinum-doublet chemotherapy has become a mainstay of first-line treatment for advanced NSCLC, factors associated with efficacy of chemoimmunotherapy (CIT) are not well characterized.
methodsIn this multicenter retrospective analysis, clinicopathologic and genomic data were collected from patients with advanced NSCLC (lacking sensitizing genomic alterations in EGFR and ALK) and evaluated with clinical outcomes to first-line CIT.
resultsAmong 1285 patients treated with CIT, a worsening performance status and increasing derived neutrophil-to-lymphocyte ratio in the blood were associated with a significantly reduced objective response rate (ORR), median progression-free survival (mPFS), and median overall survival (mOS). With increasing PD-L1 tumor proportion scores of less than 1%, 1% to 49%, 50% to 89%, and greater than or equal to 90%, there was a progressive improvement in ORR (32.7% versus 37.5% versus 51.6% versus 61.7%, p < 0.001), mPFS (5.0 versus 6.1 versus 6.8 versus 13.0 mo, p < 0.001), and generally mOS (12.9 versus 14.6 versus 34.7 versus 23.1 mo, p = 0.009), respectively. Of 789 NSCLCs with comprehensive genomic data, NSCLCs with a tumor mutational burden (TMB) greater than or equal to the 90th percentile had an improved ORR (53.5% versus 36.4%, p = 0.004), mPFS (10.8 versus 5.5 mo, p < 0.001), and mOS (29.2 versus 13.1 mo, p < 0.001), compared with those with a TMB less than the 90th percentile. In all-comers with nonsquamous NSCLC, the presence of an STK11, KEAP1, or SMARCA4 mutation was associated with significantly worse ORR, mPFS, and mOS to CIT (all p < 0.05); this was also observed in the KRAS-mutant subgroup of NSCLCs with co-occurring mutations in STK11, KEAP1, or SMARCA4 (all p < 0.05). In KRAS wild-type NSCLC, KEAP1 and SMARCA4 mutations were associated with a significantly shorter mPFS and mOS to CIT (all p < 0.05), but STK11 mutation status had no significant impact on mPFS (p = 0.16) or mOS (p = 0.38).
conclusionsIn advanced NSCLC, better patient performance status, low derived neutrophil-to-lymphocyte ratio, increasing PD-L1 expression, a very high TMB, and STK11/KEAP1/SMARCA4 wild-type status are associated with improved clinical outcomes to first-line CIT.
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