{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T10:01:41Z","timestamp":1779962501433,"version":"3.53.1"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Anti\u2010inflammatory agents including acetaminophen (APAP) and non\u2010steroidal anti\u2010inflammatory drugs (NSAIDs) may blunt anti\u2010tumor immunity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a patient\u2010level cross\u2010trial analysis of five randomized controlled studies (IMpower110, IMpower130, IMpower131, IMpower132, and IMpower150) that assessed the efficacy of first\u2010line atezolizumab therapy in advanced non\u2010small cell lung cancer (NSCLC). We investigated whether APAP\/NSAIDs exposure influenced progression\u2010free survival (PFS) and overall survival (OS) in both atezolizumab\u2010treated and non\u2010atezolizumab\u2010treated cohorts using forest plot analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 3781 patients, APAP exposure was 15.4% (583\/3781) and NSAIDs use was 33.9% (1282\/3781). APAP use was associated with worse PFS and OS in both the atezolizumab and non\u2010atezolizumab groups (PFS with atezolizumab: hazard ratio [HR]\u2009=\u20091.18, 95% confidence interval [CI]: 0.97\u20131.43; PFS without atezolizumab: HR\u2009=\u20091.23, 95% CI: 1.05\u20131.43; OS with atezolizumab: HR\u2009=\u20091.13, 95% CI: 0.98\u20131.30; OS without atezolizumab: HR\u2009=\u20091.31, 95% CI: 1.04\u20131.65). NSAIDs use was not associated with differences in PFS or OS in the atezolizumab group but was linked to worse PFS and OS in the non\u2010atezolizumab group (PFS with atezolizumab: HR\u2009=\u20090.98, 95% CI: 0.89\u20131.08; PFS without atezolizumab: HR\u2009=\u20091.18, 95% CI: 1.03\u20131.34; OS with atezolizumab: HR\u2009=\u20091.01, 95% CI: 0.91\u20131.13; OS without atezolizumab: HR\u2009=\u20091.27, 95% CI: 1.10\u20131.46). After excluding patients on baseline proton pump inhibitors, a significant interaction between NSAIDs use and treatment modality was observed in the multivariable analysis of OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0140), with no interaction for APAP use (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.6707).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Neither APAP nor NSAIDs exposure influenced atezolizumab efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1759-7714.70300","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T11:46:42Z","timestamp":1778845602000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Anti\u2010Inflammatory Drug Therapy on the Efficacy of First\u2010Line Atezolizumab Treatment in Patients With Advanced Non\u2010Small Cell Lung Cancer: An Integrated Analysis of Five Randomized Controlled Trials"],"prefix":"10.1111","volume":"17","author":[{"given":"Kazuki","family":"Takada","sequence":"first","affiliation":[{"name":"Department of Surgery Saiseikai Fukuoka General Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Cortellini","sequence":"additional","affiliation":[{"name":"Department of Surgery &amp; Cancer Imperial College London, Hammersmith Hospital  London UK"},{"name":"Operative Research Unit of Medical Oncology Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"},{"name":"Department of Medicine and Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8175-6798","authenticated-orcid":false,"given":"Shinkichi","family":"Takamori","sequence":"additional","affiliation":[{"name":"Department of Surgery and Science Graduate School of Medical Sciences, Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumitaka","family":"Mizuki","sequence":"additional","affiliation":[{"name":"Center for Clinical Research, Yamaguchi University Hospital  Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Pinato","sequence":"additional","affiliation":[{"name":"Department of Surgery &amp; Cancer Imperial College London, Hammersmith Hospital  London UK"},{"name":"Division of Oncology, Department of Translational Medicine University of Piemonte Orientale  Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mototsugu","family":"Shimokawa","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Yamaguchi University Graduate School of Medicine  Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21654"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1716948"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30167-6"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1917346"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1016\/j.jtho.2020.03.028","article-title":"Atezolizumab in Combination With Carboplatin and Nab\u2010Paclitaxel in Advanced Squamous NSCLC (IMpower131): Results From a Randomized Phase III Trial","volume":"15","author":"Jotte R.","year":"2020","journal-title":"Journal of Thoracic Oncology: Official Publication of the International Association for the Study of Lung Cancer"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2020.11.025"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.01.006"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2022.02.003"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-021-01606-4"},{"key":"e_1_2_12_11_1","first-page":"11","article-title":"Prognostic Associations of Concomitant Antibiotic Use in Patients With Advanced NSCLC Treated With Atezolizumab: Sensitivity Analysis of a Pooled Investigation of Five Randomised Control Trials","volume":"11","author":"Manning\u2010Bennett A. T.","year":"2023","journal-title":"Biomedicine"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.05.010"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtocrr.2023.100556"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2020-000889"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2022.12.013"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-020-06882-6"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.14001"},{"key":"e_1_2_12_18_1","article-title":"Inflammatory Cytokine: An Attractive Target for Cancer Treatment","volume":"10","author":"Lee H. 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