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This study aimed to investigate the clinical impact of COPD on the treatment response to ICIs in a large number of patients with NSCLC. In total, 133 patients with spirometry test results were retrospectively identified among those who received palliative pembrolizumab for NSCLC. COPD was defined as pre\u2010bronchodilator forced expiratory volume in 1 s\/forced vital capacity &lt;0.7. Overall survival (OS), progression\u2010free survival (PFS), and objective response rate were analyzed according to the presence of COPD. Spirometry\u2010based COPD was present in 59 (44%) patients. Patients with COPD had better OS (hazard ratio [HR] for death, 0.45; 95% confidence interval [CI], 0.26\u20130.78) and PFS (HR for disease progression or death, 0.50; 95% CI, 0.31\u20130.79) than those without COPD. These associations persisted after adjusting for potential confounders including smoking history. The response rate was also higher in patients with COPD than in those without COPD (38.2% <jats:italic>vs<\/jats:italic>. 20.5%, <jats:italic>p<\/jats:italic>\u2009=\u20090.028). Spirometry\u2010defined COPD was associated with a significantly longer OS and PFS in patients with NSCLC treated with palliative pembrolizumab. Identifying coexisting COPD could predict favorable treatment outcomes in patients with NSCLC treated with pembrolizumab.<\/jats:p>","DOI":"10.1002\/ijc.32235","type":"journal-article","created":{"date-parts":[[2019,2,26]],"date-time":"2019-02-26T20:24:40Z","timestamp":1551212680000},"page":"2433-2439","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Improved treatment outcome of pembrolizumab in patients with nonsmall cell lung cancer and chronic obstructive pulmonary disease"],"prefix":"10.1002","volume":"145","author":[{"given":"Sun Hye","family":"Shin","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Yun","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunjoo","family":"Im","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Ae","family":"Jung","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong\u2010Mu","family":"Sun","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Seok","family":"Ahn","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myung\u2010Ju","family":"Ahn","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4846-7449","authenticated-orcid":false,"given":"Keunchil","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Yun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9219-3350","authenticated-orcid":false,"given":"Se\u2010Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"},{"name":"Department of Health Sciences and Technology, Samsung Advanced Institute of Health Science and Technology Sungkyunkwan University  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,25]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"GLOBOCAN 2012 v1.0: cancer incidence and mortality worldwide: IARC CancerBase no. 11. 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