Immunotherapy With Programmed Cell Death 1 Versus Programmed Cell Death Ligand 1 Inhibitors in Patients With Advanced Non–Small Cell Lung Cancers: A Multicenter, Retrospective Analysis

Abstract

This multicenter retrospective study analyzed data from 1266 patients with advanced non–small cell lung cancer (NSCLC) across five leading hospitals in China. The aim was to evaluate survival outcomes and safety profiles of programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors. The main outcomes included overall survival (OS) and progression-free survival (PFS), while the secondary endpoint was adverse events. Kaplan–Meier survival analysis, univariate and multivariate Cox regression modeling, and propensity score matching (PSM) analyses were performed to compare the real-world efficacies of PD-1 and PD-L1. Patients receiving PD-1 inhibitors had significantly longer median OS compared with those treated with PD-L1 inhibitors (28.2 versus [vs.] 24.6 months; hazard ratio [HR] 0.74 [95% confidence interval (CI) 0.59–0.93]; p = 0.0099), with consistent effects after PSM analysis (HR 0.70 [95% CI 0.12–0.91]; p = 0.005) and multivariable, adjusted Cox regression model with HR of 0.74 ([95% CI 0.59–0.93]; p = 0.01). Further analysis indicated that body mass index ≥ 24 kg/m² (HR 0.72 [95% CI 0.75–0.93]; p = 0.014) and history of hypertension (HR 1.35 [95% CI 1.01–1.79]; p = 0.037) may interfere with the therapeutic effects of PD-1 with comparable safety profiles, which renewed personalized immunotherapy options for NSCLC patients in clinical settings.

Keywords

immunotherapy / lung cancer / programmed cell death 1 / programmed cell death ligand 1

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