{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T19:27:11Z","timestamp":1786562831358,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2022MH288"],"award-info":[{"award-number":["ZR2022MH288"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020196","name":"Shandong Provincial Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["SDCX\u2010ZG\u2010202303064"],"award-info":[{"award-number":["SDCX\u2010ZG\u2010202303064"]}],"id":[{"id":"10.13039\/501100020196","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2022M721446"],"award-info":[{"award-number":["2022M721446"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007452","name":"Wu Jieping Medical Foundation","doi-asserted-by":"publisher","award":["320.6750.2023\u201017\u201026)"],"award-info":[{"award-number":["320.6750.2023\u201017\u201026)"]}],"id":[{"id":"10.13039\/100007452","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Coronavirus disease 2019 (COVID\u201019) remains a global health threat, particularly for patients with cancer, who experience greater susceptibility and worse outcomes. Epidermal growth factor receptor (EGFR)\u2010tyrosine kinase inhibitor (TKI) is standard first\u2010line therapy for advanced EGFR\u2010mutated non\u2010small cell lung carcinoma (NSCLC). However, the impact of COVID\u201019 on TKI efficacy remains unclear. This multicenter retrospective study included patients with stage IV EGFR\u2010mutated NSCLC who received first\u2010line EGFR\u2010TKI treatment at four Chinese hospitals. Leveraging China's policy change (December 2022), we compared a pre\u2010pandemic COVID\u201019\u2010negative cohort (January 2019\u2013November 2022) with a COVID\u201019\u2010positive cohort (January\u2013June 2023). After 1:1 propensity score matching (PSM), Kaplan\u2013Meier and Cox regression analyses evaluated progression\u2010free survival (PFS) and prognostic factors. Among 711 patients (median follow\u2010up, 37.90\u2009months), the COVID\u201019\u2010negative group had significantly longer median PFS (18.17 vs. 12.89\u2009months;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.001). After PSM, we analyzed 426 well\u2010matched patients (213\/cohort). Before and after matching, COVID\u201019\u2010negative patients exhibited better PFS with all EGFR\u2010TKI generations (unmatched:\n                    <jats:italic>p<\/jats:italic>\n                    <jats:sub>1st<\/jats:sub>\n                    \u2009&lt;.001,\n                    <jats:italic>p<\/jats:italic>\n                    <jats:sub>2nd<\/jats:sub>\n                    \u2009=\u2009.030, and\n                    <jats:italic>p<\/jats:italic>\n                    <jats:sub>3rd<\/jats:sub>\n                    \u2009=\u2009.001; matched:\n                    <jats:italic>p<\/jats:italic>\n                    <jats:sub>1st<\/jats:sub>\n                    \u2009&lt;.001,\n                    <jats:italic>p<\/jats:italic>\n                    <jats:sub>2nd<\/jats:sub>\n                    \u2009=\u2009.049, and\n                    <jats:italic>p<\/jats:italic>\n                    <jats:sub>3rd<\/jats:sub>\n                    \u2009=\u2009.015). COVID\u201019 infection worsened outcomes in both monotherapy and combination therapy. Multivariable analysis identified COVID\u201019 infection as an independent predictor of worse PFS (hazard ratio 1.650, 95% confidence interval: 1.286\u20132.116;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.001). Adenocarcinoma, \u22643 metastatic organs, smoking index &gt;570, concurrent systemic therapy, and third\u2010generation TKI were also prognostic. COVID\u201019 infection markedly reduces EGFR\u2010TKI efficacy in patients with advanced NSCLC, warranting closer monitoring during and after infection and supporting adaptive management strategies.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70444","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T05:10:12Z","timestamp":1774069812000},"page":"699-708","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>Coronavirus disease 2019<\/scp>\n                    infection reduces\n                    <scp>EGFR<\/scp>\n                    \u2010\n                    <scp>TKI<\/scp>\n                    efficacy in non\u2010small cell lung carcinoma: Real\u2010world evidence from a multicenter propensity\u2010matched cohort"],"prefix":"10.1002","volume":"159","author":[{"given":"Wenjie","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"},{"name":"Medical Integration and Practice Center Shandong University  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxuan","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China  Hefei Anhui China"},{"name":"Department of Radiation Oncology Anhui Provincial Cancer Hospital  Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanxi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyong","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanqi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Science and Education, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohui","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhu","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Oncology Affiliated Hospital of Jining Medical University  Jining Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanliang","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Yantai Yuhuangding Hospital  Yantai Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingwei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Shandong Provincial Hospital Affiliated to Shandong First Medical University  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7235-3230","authenticated-orcid":false,"given":"Peng","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1099314"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040938"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0810699"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.77.2293"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(17)30729\u20105"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411817"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(16)30508\u20103"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1612674"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.3724\/abbs.2022147"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.20892\/j.issn.2095\u20103941.2020.0559"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc\u20102023\u2010004743"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pro6.70025"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fct.2020.111769"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12943\u2010021\u201001363\u20101"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.01580"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010020\u20102008\u20103"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)30183\u20105"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/imr.12977"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(12)61144\u20101"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature01322"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molcel.2020.08.006"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41422\u2010020\u201000460\u2010y"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2021.102242"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41422\u2010021\u201000578\u20107"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41418\u2010020\u201000633\u20107"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.00182\u201017"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1021\/acsptsci.0c00112"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078\u20100432.CCR\u201022\u20100192"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.18502\/ijhoscr.v16i2.9205"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1001099"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.virol.2018.05.009"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/03000605241281907"}],"container-title":["International Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.70444","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijc.70444","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.70444","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T18:29:53Z","timestamp":1786559393000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ijc.70444"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,20]]},"references-count":32,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,8,1]]}},"alternative-id":["10.1002\/ijc.70444"],"URL":"https:\/\/doi.org\/10.1002\/ijc.70444","archive":["Portico"],"relation":{},"ISSN":["0020-7136","1097-0215"],"issn-type":[{"value":"0020-7136","type":"print"},{"value":"1097-0215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,20]]},"assertion":[{"value":"2025-09-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}