Evidence map›Paper›PMID 40866864›Full record

Trial reportBMC cancer2025

Baseline tumor burden predicts the efficacy of first-line chemoimmunotherapy in patients with advanced non-small cell lung cancer: results from 2 phase 3 randomized placebo-controlled trials.

Xinyi He, Mengting Shi, Lin Zhang, Jianhua Zhan, Jiaqing Liu, Dongchen Sun, Zihong Chen, Shaodong Hong, Yaxiong Zhang, Gang Chen and 9 more

Abstract readRandomized Controlled TrialClinical Trial, Phase III
In one paragraph

Trial report in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Xinyi He *Department of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Mengting Shi *Department of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Lin Zhang *Department of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Jianhua Zhan *Department of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Jiaqing Liu *Department of Intensive Care Unit, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Dongchen SunDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Zihong ChenDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Shaodong HongDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Yaxiong ZhangDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Gang ChenDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Shen ZhaoDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Ting ZhouDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Wenfeng FangDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Yuanyuan ZhaoDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Yan HuangDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Caicun ZhouDepartment of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Yunpeng YangDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China. yangyp@sysucc.org.cn.
Li ZhangDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China. zhangli@sysucc.org.cn.
Huaqiang ZhouDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China. zhouhq@sysucc.org.cn.

Funding

Guangzhou Basic and Applied Basic Research Foundation 2024A04J4082National Natural Science Foundation of China 82102864National Natural Science Foundation of China 82241232Young Talents Program of Sun Yat-sen University Cancer Center YTP-SYSUCC-0096
6 · The paper itself

Abstract

backgroundBaseline tumor burden (TB), measured radiographically, has emerged as a potential biomarker for stratifying survival outcomes with immune checkpoint inhibitors (ICI) across solid tumors. However, the predictive value for ICI plus chemotherapy (chemoimmunotherapy) in NSCLC has not been confirmed with large cohorts that include a chemotherapy-only control group.

methodsThis post hoc analysis utilized data from ORIENT-11 trial, a phase III, randomized clinical trial of advanced NSCLC patients who were administered with either chemoimmunotherapy or chemotherapy alone. TB was measured as the sum of the diameters of target lesions at baseline following RECIST 1.1 criteria. The relationships between baseline TB and outcomes were assessed using the Cox proportional hazards model. Validation was conducted using data from ORIENT-12 trial.

resultsIn chemoimmunotherapy arm, patients with low TB demonstrated longer progression-free survival (PFS: 11.60 vs. 7.20 months, hazard ratio [HR] = 0.625, p = 0.004) and overall survival (OS: 28.77 vs. 20.10 months, HR = 0.683, p = 0.020) compared to those with high TB. In the chemotherapy-only arm, no significant survival differences were observed based on TB levels. Multivariate analyses confirmed that regardless of tumoral PD-L1 expression, low TB as an independent marker of improved survival with chemoimmunotherapy. Patients with high TB and low PD-L1 expression had the shortest survival, deriving minimal benefit from chemoimmunotherapy over chemotherapy alone (PFS: 5.53 vs. 5.07 months; OS: 10.52 vs. 13.80 months). These findings were validated in ORIENT-12 cohort.

conclusionsBaseline TB is a predictive, rather than prognostic, clinical biomarker for survival outcomes in advanced NSCLC patients treated with chemoimmunotherapy. TB assessment, integrated with PD-L1 status evaluation, may improve patient stratification for first-line chemoimmunotherapy in clinical practice and provide valuable insight for the clinical trials designs.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Non-Small-Cell LungImmune Checkpoint InhibitorsImmunotherapyLung NeoplasmsTumor BurdenAgedFemaleHumansMaleMiddle AgedPrognosisTreatment OutcomeImmune Checkpoint InhibitorsBaseline tumor burdenChemoimmunotherapyNon-small cell lung cancerPD-L1 expression

Identifiers

PMID40866864
PMCPMC12382186

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.