{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T18:53:24Z","timestamp":1778957604077,"version":"3.51.4"},"reference-count":43,"publisher":"Wiley","issue":"14","license":[{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite promising outcomes of first\u2010line immunotherapy with or without chemotherapy in advanced non\u2010small cell lung cancer (NSCLC), limited accessibility due to reimbursement was remain the problem in low to middle income countries. This study aimed to evaluate real\u2010world effectiveness of immunotherapy in patients with advanced NSCLC in Northern Thailand.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective, single\u2010centered cohort, was conducted. Patients with advanced NSCLC who underwent PD\u2010L1 testing (excluding EGFR and ALK mutations) and were treated with immunotherapy or without chemotherapy or chemotherapy alone were included. The primary end point was progression\u2010free survival (PFS). The secondary endpoints were overall survival (OS), objective response rate (ORR), and adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 123 patients, of which 21 patients received immunotherapy\u2010based regimen and 102 patients received chemotherapy alone. The median PFS was 11.9\u2009months in immunotherapy\u2010based group compared to 5.93\u2009months in the chemotherapy group, with a. hazard ratio (HR) of 0.4 (95% confidence interval [CI], 0.23 to 0.68; <jats:italic>p<\/jats:italic>\u2009=\u20090.001). Similarly, the median OS was 26.68\u2009months in the immunotherapy\u2010based group and 11.21\u2009months in the chemotherapy group, with HR of 0.42 (95% CI 0.22\u20130.8; <jats:italic>p<\/jats:italic>\u2009=\u20090.009). ORRs were significantly higher in the immunotherapy\u2010based group, with 65% of patients showing a response compared to 32% in the chemotherapy group (<jats:italic>p<\/jats:italic>\u2009=\u20090.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The result of this real\u2010world study in patients with advanced stage NSCLC indicate that first\u2010line immunotherapy\u2010based regimen was associated with significantly greater PFS, OS, and ORR with a safety profile consistent with pivotal studies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.70007","type":"journal-article","created":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T04:34:50Z","timestamp":1721363690000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of treatment outcome between first\u2010line combination immunotherapy (anti\u2010<scp>PD<\/scp>\u2010<scp>L1<\/scp> or anti\u2010<scp>PD1<\/scp>) with or without chemotherapy and chemotherapy alone in advanced non\u2010small cell lung cancer patients in tertiary care hospital"],"prefix":"10.1002","volume":"13","author":[{"given":"Danainut","family":"Naratornsirakul","sequence":"first","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine Chiang Mai University  Chiang Mai Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4052-5728","authenticated-orcid":false,"given":"Busyamas","family":"Chewaskulyong","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine Chiang Mai University  Chiang Mai Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarawut","family":"Kongkarnka","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine Chiang Mai University  Chiang Mai 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