Evidence map›Paper›PMID 41839643›Full record

ArticleThoracic cancer2026

Association of Immune-Related Adverse Events and the Efficacy of Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer: Adjusting for Immortal Time Bias.

Yoshiki Kuwabara, Hiroyuki Ohya, Maiko Osawa, Kota Shiraishi, Itsuka Matsumoto, Shigeru Ishii, Shin Yokosuka, Masatoshi Abe, Tomoyuki Takahashi, Yuichiro Kawano and 11 more

Abstract read
In one paragraph

Article in Thoracic cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Article
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

21 authors.

Yoshiki KuwabaraDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.ORCID https://orcid.org/0009-0009-7036-0021
Hiroyuki OhyaDepartment of Pharmacy, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Maiko OsawaDepartment of Biostatistics, Graduate School of Medicine, Saitama Medical University, Saitama, Japan.
Kota ShiraishiDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Itsuka MatsumotoDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Shigeru IshiiDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Shin YokosukaDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Masatoshi AbeDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Tomoyuki TakahashiDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Yuichiro KawanoDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Hiroaki NishimuraDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Maiko Toda-SasakiDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Yumiko Kobayashi-OgawaDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Satoshi KikuchiDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Yusuke HirataDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Kosuke SakaiDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.ORCID https://orcid.org/0000-0003-3138-0360
Hiroyuki KyoyamaDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Gaku MoriyamaDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Yohei KawasakiDepartment of Biostatistics, Graduate School of Medicine, Saitama Medical University, Saitama, Japan.
Nobuyuki KoyamaDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.ORCID https://orcid.org/0000-0002-3989-2275
Kazutsugu UematsuDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.ORCID https://orcid.org/0000-0003-0014-295X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAssociations between immune-related adverse events (irAEs) and survival outcomes in non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs) remain controversial, partly due to inconsistencies in dealing with immortal time bias (ITB). To address this, we adjusted for ITB in this single-center retrospective study.

methodsWe included 129 patients with advanced NSCLC receiving ICIs as first-line therapy and assessed associations between irAE development and progression-free survival (PFS) and overall survival (OS). To mitigate ITB, we performed landmark analyses at 30, 42, and 75 days and used multivariable Cox models with irAEs as a time-dependent covariate.

resultsDuring a median follow-up of 9.7 months, 58 (45.0%) patients developed irAEs. Unadjusted analyses showed a significant association between irAEs and longer PFS (hazard ratio [HR] 0.55; p < 0.01) and OS (HR 0.42; p < 0.01), but this was no longer evident after adjusting for ITB. Specifically, landmark analyses revealed no significant survival differences, except for PFS at the 42-day landmark. The time-dependent Cox model confirmed no significant association between irAE occurrence and PFS (HR 1.16) or OS (HR 0.93). In contrast, good Eastern Cooperative Oncology Group performance status at baseline was an independent predictor of improved survival.

conclusionAfter appropriate adjustment for ITB, irAE development was not associated with improved survival in NSCLC patients treated with ICIs. Baseline performance status, rather than irAE occurrence, remains a more critical prognostic factor for these patients. The relationship between irAE development and clinical outcome should be evaluated with consideration of ITB.

Indexed as

Carcinoma, Non-Small-Cell LungDrug-Related Side Effects and Adverse ReactionsImmune Checkpoint InhibitorsLung NeoplasmsAgedFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesImmune Checkpoint Inhibitorsimmortal time biasimmune checkpoint inhibitorsimmune‐related adverse eventsnonsmall cell lung cancer

Identifiers

PMID41839643
PMCPMC13097447

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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.