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In this study, data of patients with unresectable TC diagnosed from January 2017 were retrospectively collected from multiple centers. Treatment response, progression\u2010free survival (PFS), overall survival (OS), survival\u2010independent prognostic factor, and adverse events (AEs) were further analyzed. As a result, a total of 93 patients with unresectable TC were enrolled, of which 54 received first\u2010line chemotherapy, and 39 received chemotherapy plus immune checkpoint inhibitors (ICIs). The objective response rate was 50% (27\/54) in the chemotherapy group and 76.9% (30\/39) in the chemotherapy plus ICIs group. The chemotherapy plus ICIs group achieved significant median PFS benefit (8.8 vs. 34.9\u2009months, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and median OS benefit (41.8\u2009months vs. not reached, <jats:italic>p<\/jats:italic>\u2009=\u2009.025). Multivariate analysis showed that ICIs and local therapy were independent prognostic factors for PFS. In addition, 17 patients developed immune\u2010related AEs (IRAEs), of which 15 (38.5%) had Grade 1 or 2 IRAEs and 2 (5.1%) had Grade 3 IRAEs in the chemotherapy plus ICIs group. In conclusion, the efficacy of chemotherapy plus ICIs is superior to chemotherapy, and the adverse effects are manageable in patients with unresectable TC.<\/jats:p>","DOI":"10.1002\/ijc.34948","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T19:03:36Z","timestamp":1712948616000},"page":"710-718","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Chemotherapy versus chemotherapy plus immune checkpoint inhibitors for the first\u2010line treatment of unresectable thymic carcinoma: A multicenter retrospective study"],"prefix":"10.1002","volume":"155","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9222-4882","authenticated-orcid":false,"given":"Baishen","family":"Zhang","sequence":"first","affiliation":[{"name":"Sun Yat\u2010Sen University Cancer Center State Key Laboratory of Oncology in South China; Guangdong Provincial Clinical Research Center for Cancer  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiting","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Oncology, Nanfang Hospital Southern Medical University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Sun Yat\u2010Sen University Cancer Center; 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