Evidence map›Paper›PMID 41549296›Full record

ArticleRespiratory research2026

Impact of concurrent systemic and inhaled corticosteroid use on clinical outcomes in advanced lung cancer patients receiving immune checkpoint inhibitors.

Yi Liu, Jiarui Zhang, Linhui Yang, Jiadi Gan, Qi Qi, Wanqin Fang, Huohuo Zhang, Rui Xu, Sha Liu, Jun Yang and 2 more

Abstract read
In one paragraph

Article in Respiratory research, 2026. 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

12 authors.

Yi Liu *Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Jiarui Zhang *Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Linhui YangDepartment of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Jiadi GanDepartment of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Qi QiDepartment of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Wanqin FangDepartment of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Huohuo ZhangDepartment of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Rui XuDepartment of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Sha LiuDepartment of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Jun YangDepartment of Pulmonary and Critical Care Medicine, Langzhong People's Hospital, Langzhong, Sichuan, 637400, China.
Weimin LiDepartment of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Dan LiuDepartment of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China. liudan10965@wchscu.cn.

Funding

Chengdu Science and Technology Project 2023-YF09-00039-SNNational Natural Science Foundation of China 82173182Science and Technology Program of Sichuan 2023NSFSC1939
6 · The paper itself

Abstract

backgroundCorticosteroids are frequently used during immune checkpoint inhibitor (ICI) treatment, especially in lung cancer patients with comorbidities. Previous studies suggest that systemic corticosteroids (SCS) hinder the effectiveness of ICIs, while the impact of inhaled corticosteroids (ICS) remains unclear. We aimed to examine the association between concurrent SCS and ICS on clinical outcomes in advanced lung cancer patients treated with ICIs.

methodsThis retrospective cohort study enrolled adults with advanced lung cancer who initiated ICIs between September 1 2016 and September 30 2023 at West China Hospital of Sichuan University. Exposure included concurrent SCS, ICS versus no steroid treatment. Clinical outcomes including overall survival (OS), progression-free survival (PFS), and tumor response were assessed. Time-dependent Cox regression models (treating SCS and ICS use as time-varying covariates) were applied to account for immortal-time bias.

resultsAmong 368 patients, 122 were SCS users, 51 were ICS users and 195 did not receive corticosteroids. SCS use was associated with inferior PFS (hazard ratio [HR] 1.99; 95% confidence interval [CI], 1.40–2.84; p value < 0.001) and OS (HR 1.77; 95% CI, 1.25–2.51; p value = 0.001), whereas ICS use was not significantly associated with PFS (HR 1.35; 95% CI, 0.66–2.80; p value = 0.412) or OS (HR 1.48; 95% CI, 0.74–2.97; p value = 0.269). Subgroup and sensitivity analyses generally supported the robustness of these findings. In exploratory analyses restricted to SCS users, initiation of SCS within 2 months after ICI start was associated with worse survival.

conclusionsThis study suggests that concurrent SCS use may adversely affect the clinical outcomes of advanced lung cancer patients receiving immunotherapy, whereas ICS use did not appear to compromise ICI efficacy. These findings highlight the critical need for cautious consideration when combining ICIs with systemic corticosteroids and emphasize the importance of treating both cancer and lung comorbidity simultaneously.

Indexed as

Adrenal Cortex HormonesImmune Checkpoint InhibitorsLung NeoplasmsAdministration, InhalationAgedCohort StudiesFemaleHumansMaleMiddle AgedProgression-Free SurvivalRetrospective StudiesTreatment OutcomeAdrenal Cortex HormonesImmune Checkpoint InhibitorsAdvanced lung cancerEfficacy.Immune checkpoint inhibitorsInhaled corticosteroidsSystemic corticosteroids

Identifiers

PMID41549296
PMCPMC12896340

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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.