{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:34:34Z","timestamp":1791549274121,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"20","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018537","name":"National Science and Technology Major Project","doi-asserted-by":"publisher","award":["2023ZD0502804"],"award-info":[{"award-number":["2023ZD0502804"]}],"id":[{"id":"10.13039\/501100018537","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In metastatic non\u2010small cell lung cancer (NSCLC) patients receiving first\u2010line immune checkpoint inhibitors (ICIs), the real\u2010world progression patterns and subsequent treatment outcomes remain controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed patients with stage IV NSCLCs treated with first\u2010line immunotherapy between January 2017 and June 2023. Clinico\u2010demographic and treatment data were obtained from an electronic medical record system. Progression patterns were categorized by: (1) Progression in different organs; (2) Progression in existing or new lesions; and (3) Oligoprogression versus systemic progression. Survival was assessed using the Kaplan\u2013Meier method and Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 157 patients, 67.5% experienced systemic progression, and 49.0% had progression in existing lesions. The most common organs with progression were the lung (81.5%), lymph nodes (35.0%), and pleural effusion (24.2%). Median post\u2010progression survival (PPS) was superior in oligoprogression versus systemic progression (22.4 vs. 10.9\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012). Patients with extrapulmonary progression (8.2 vs. 22.9\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) or progression in new lesions (9.6 vs. 25.3\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029) showed decreased PPS. In multivariate Cox regression, ECOG PS of 2\u20134 (HR: 2.26,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), tumor stage of IVB (HR: 1.74,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), and extrapulmonary progression (HR: 2.05,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) were associated with decreased PPS. Subsequent treatments containing ICIs improved survival compared to regimens without ICIs (29.0 vs. 11.3\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), particularly in patients with systemic progression (19.3 vs. 9.2\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most metastatic NSCLCs on first\u2010line immunotherapy experienced systemic progression. Oligoprogression and progression only in existing lesions showed better prognoses, whereas extrapulmonary progression indicated worse survival. Subsequent ICI\u2010containing treatments had improved survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1759-7714.70173","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T19:44:24Z","timestamp":1760557464000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Progression Patterns and Subsequent Treatments of First\u2010Line Immunotherapy in Advanced Non\u2010Small Cell Lung Cancer: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"16","author":[{"given":"Qi","family":"He","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010bei","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010rou","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010xing","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min\u2010jiang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2832-2664","authenticated-orcid":false,"given":"Yan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9226-5393","authenticated-orcid":false,"given":"Meng\u2010zhao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing 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