ArticleBritish journal of cancer2026
Real-world outcomes of immunotherapy in advanced NSCLC patients with comorbidities.
Article in British journal of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
backgroundComorbidities are common in advanced non-small cell lung cancer (NSCLC) patients, yet their impact on systemic anti-cancer treatment (SACT) and survival in the era of immune checkpoint inhibitors (ICIs) remains unclear due to limited representation in clinical trials.
methodsThis nationwide registry-based study included 9178 patients with stage IIIB-IV NSCLC diagnosed before and after ICI introduction. Kaplan-Meier and multivariable Cox models were applied to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).
resultsCommon comorbidities included chronic obstructive pulmonary disease (COPD: 22%), cardiovascular disease (CVD: 21%), type 2 diabetes (T2D: 10%), and rheumatic and musculoskeletal diseases (RMD: 6%). Patients with comorbidities were less likely to receive SACT. Following ICI introduction, SACT use increased across all comorbidity groups and 2-year OS improved up to threefold. CVD patients had better 2-year OS when treated with ICI alone than ICI plus chemotherapy (38 vs 22%). Patients with CVD, T2D and RMD had higher risk of death when treated with ICI plus chemotherapy compared to patients without these comorbidities (HR = 1.36 (1.07-1.73), HR = 1.33 (0.99-1.78) and HR = 1.38 (0.97-1.95), respectively).
conclusionsSurvival among patients with comorbidities improved following ICI introduction, however the benefit varied by comorbidity and treatment modality, supporting more individualised treatment strategies.
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