{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T06:28:22Z","timestamp":1786429702811,"version":"build-2736575974"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Granulocyte colony-stimulating factor (G-CSF) is routinely used to manage chemotherapy-induced neutropenia in patients receiving chemoimmunotherapy for advanced non-small cell lung cancer (NSCLC). However, its potential to promote immunosuppressive tumor-associated neutrophils (TANs) has raised theoretical concerns about compromising the efficacy of immune checkpoint inhibitors (ICIs). We aimed to evaluate the real-world association between G-CSF use and survival outcomes in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study, we analyzed data from patients with unresectable, locally advanced or metastatic NSCLC who initiated first- or later-line chemoimmunotherapy at a tertiary academic center between 2018 and 2021. Multivariable Cox regression and inverse probability of treatment weighting (IPTW) were used to adjust for key prognostic confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 120 enrolled patients, 57 (47.5%) received G-CSF during treatment. With a median follow-up of 22.6 months, the median progression-free survival (PFS) was 12.9 months in the G-CSF group versus 9.6 months in the non-G-CSF group (hazard ratio [HR] = 0.97, 95% CI: 0.60\u20131.58; P = 0.92). The median overall survival (OS) was 17.6 versus 15.3 months, respectively (HR = 0.99, 95% CI: 0.50\u20131.98; P = 0.99). In multivariable analysis, G-CSF administration was not independently associated with PFS (adjusted HR [aHR] = 1.08, 95% CI: 0.60\u20131.93; P = 0.80) or OS (aHR = 1.96, 95% CI: 0.80\u20134.78; P = 0.14). IPTW-adjusted analyses confirmed these null associations (PFS: HR = 1.30, P = 0.85; OS: HR = 1.00, P = 0.95).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this real-world cohort, no statistically significant association between G-CSF use and survival outcomes was observed among patients with advanced NSCLC treated with chemoimmunotherapy. Further prospective studies are warranted to better define the potential risks and benefits of G-CSF in this setting, particularly regarding its long-term association with survival outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1886001","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:40:49Z","timestamp":1786426849000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Granulocyte colony-stimulating factor use does not impair efficacy of chemoimmunotherapy in advanced non-small cell lung cancer: a real-world retrospective study"],"prefix":"10.3389","volume":"17","author":[{"given":"Rui","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Oncology, The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]},{"name":"Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Handai","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinchun","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ni","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingzhen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Basic Medical Sciences, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuwen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanguo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University","place":["Jinan, Shandong, China"]},{"name":"Department of Oncology, Qilu Hospital of Shandong University Dezhou Hospital","place":["Dezhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.jncc.2024.01.006","article-title":"Cancer incidence and mortality in China, 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