{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:46:53Z","timestamp":1787021213932,"version":"build-2736575974"},"reference-count":44,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Precis Oncol"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>\n                      The efficacy and safety of combination strategies involving immune checkpoint inhibitors (ICIs) in patients with advanced epidermal growth factor receptor (\n                      <jats:italic toggle=\"yes\">EGFR<\/jats:italic>\n                      )\u2013mutant non\u2013small cell lung cancer (NSCLC) who have developed resistance to EGFR-tyrosine kinase inhibitors (TKIs) remains uncertain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing ICIs combined with chemotherapy with or without antiangiogenic therapy (C\/A) versus C\/A alone in the treatment of advanced NSCLC after resistance to EGFR-TKIs. We searched databases, including PubMed, Cochrane Library, Embase, Web of Science, and meeting abstracts. Hazard ratios (HRs) and 95% CI for median overall survival (OS) and median progression-free survival (PFS) were calculated. Risk ratios (RRs) and 95% CI were used as indicators of objective response rate (ORR) and adverse events (AEs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Eight RCTs involving 10 cohorts and 2,269 patients were included. Adding ICIs to C\/A significantly improved PFS (HR, 0.67 [95% CI, 0.57 to 0.80];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), OS (HR, 0.89 [95% CI, 0.79 to 0.99];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .031), and ORR (RR, 0.80 [95% CI, 0.74 to 0.88];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) comparedwith C\/A alone. Subgroup analyses showed that the benefits were more pronounced in patients with PD-L1 expression \u226550%, specific\n                      <jats:italic toggle=\"yes\">EGFR<\/jats:italic>\n                      mutations (Leu858Arg), absence of Thr790Met mutation, and treatment with pemetrexed-platinum. No significant increase in grade 3 or higher AEs was observed, but rates of discontinuation and specific AEs (rash, hypothyroidism, and hypertension) were significantly higher in the ICI+C\/A group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      This meta-analysis suggests that the addition of ICIs to C\/A may improve survival outcomes in patients with advanced NSCLC after resistance to EGFR-TKIs, particularly in selected subpopulations such as those with high PD-L1 expression or specific\n                      <jats:italic toggle=\"yes\">EGFR<\/jats:italic>\n                      mutations. However, careful monitoring for specific AEs is warranted.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/po-24-00907","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T19:59:08Z","timestamp":1752177548000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":7,"title":["Immune Checkpoint Inhibitors in Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor\u2013Resistant Chemotherapy-Na\u00efve Advanced Non\u2013Small Cell Lung Cancer: A Meta-Analysis Based on Eight Randomized Trials"],"prefix":"10.1200","author":[{"given":"Letian","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuling","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jietao","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8391-6134","authenticated-orcid":true,"given":"Chengbo","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_6_2_2","article-title":"Global cancer observatory","author":"International Agency for Research on Cancer","year":"2025","unstructured":"International Agency for Research on Cancer. 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