{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:39:21Z","timestamp":1791639561413,"version":"4.3.4"},"reference-count":33,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"unspecified","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"James A. Fieber Lung Cancer Research Fund","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014735","name":"Royal College of Physicians and Surgeons of Canada","doi-asserted-by":"publisher","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/100014735","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001368","name":"V Foundation","doi-asserted-by":"crossref","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/100001368","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Elva J. and Clayton L. McLaughlin Fund for Lung Cancer Research","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"name":"Grants from John and Georgia DallePezze","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"name":"Henry R. Shibata Fellowship","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30CA008748"],"award-info":[{"award-number":["P30CA008748"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01CA209414"],"award-info":[{"award-number":["U01CA209414"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Ning Zhao & Ge Li Family Initiative for Lung Cancer Research and New Therapies","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2023,6,28]]},"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Single-agent PD-(L)1 blockade (IO) alone or in combination with chemotherapy (Chemotherapy-IO) is approved first-line therapies in patients with advanced lung adenocarcinomas (LUADs) with PD-L1 expression \u22651%. These regimens have not been compared prospectively. The primary objective was to compare first-line efficacies of single-agent IO to Chemotherapy-IO in patients with advanced LUADs. Secondary objectives were to explore if clinical, pathological, and genomic features were associated with differential response to Chemotherapy-IO versus IO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a multicenter retrospective cohort study. Inclusion criteria were patients with advanced LUADs with tumor PD-L1 \u22651% treated with first-line Chemotherapy-IO or IO. To compare the first-line efficacies of single-agent IO to Chemotherapy-IO, we conducted inverse probability weighted Cox proportional hazards models using estimated propensity scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort analyzed included 866 patients. Relative to IO, Chemotherapy-IO was associated with improved objective response rate (ORR) (44% vs 35%, p=0.007) and progression-free survival (PFS) in patients with tumor PD-L1\u22651% (HR 0.84, 95%\u2009CI 0.72 to 0.97, p=0.021) or PD-L1\u226550% (ORR 55% vs 38%, p&lt;0.001; PFS HR 0.68, 95%\u2009CI 0.53 to 0.87, p=0.002). Using propensity-adjusted analyses, only never-smokers in the PD-L1\u226550% subgroup derived a differential survival benefit from Chemotherapy-IO vs IO (p=0.013). Among patients with very high tumor PD-L1 expression (\u226590%), there were no differences in outcome between treatment groups. No genomic factors conferred differential survival benefit to Chemotherapy-IO versus IO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While the addition of chemotherapy to PD-(L)1 blockade increases the probability of initial response, never-smokers with tumor PD-L1\u226550% comprise the only population identified that derived an apparent survival benefit with treatment intensification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jitc-2023-006994","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T12:35:54Z","timestamp":1690202154000},"page":"e006994","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Efficacy of PD-(L)1 blockade monotherapy compared with PD-(L)1 blockade plus chemotherapy in first-line PD-L1-positive advanced lung adenocarcinomas: a cohort study"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct03793179","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04547504","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1981-1535","authenticated-orcid":false,"given":"Arielle","family":"Elkrief","sequence":"first","affiliation":[{"name":"Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA"},{"name":"Human Oncology & Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA"},{"name":"Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8072-5946","authenticated-orcid":false,"given":"Joao M Victor","family":"Alessi","sequence":"additional","affiliation":[{"name":"Lowe Center for Thoracic Oncology, Dana 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R","family":"Preeshagul","sequence":"additional","affiliation":[{"name":"Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinan","family":"Wang","sequence":"additional","affiliation":[{"name":"Environmental Health, Harvard University, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Pecci","sequence":"additional","affiliation":[{"name":"Lowe Center for Thoracic Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Di Federico","sequence":"additional","affiliation":[{"name":"Lowe Center for Thoracic Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, 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