{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:16:01Z","timestamp":1788185761228,"version":"build-2803163510"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"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. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Chemo-immunotherapy has demonstrated significant survival benefits in non-small cell lung cancer. However, real-world data on its effectiveness and safety in patients with unresectable stage III\u2013IV disease remain insufficient. Furthermore, whether the addition of anti-angiogenic agents provides additional benefit beyond chemo-immunotherapy remains unclear. This study aimed to evaluate the real-world effectiveness and safety of adding immune checkpoint inhibitors to chemotherapy, and to further explore the added value of anti-angiogenic therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 260 patients with unresectable stage III\/IV NSCLC treated at two centers (2018\u20132025) were enrolled. Patients were divided into a chemotherapy-based immunotherapy group (n=162) and a non-immunotherapy chemotherapy group (n=98); the former was further stratified by the addition of anti-angiogenic therapy (n=71) or not (n=91). To address baseline imbalances between groups, propensity score matching (PSM) (1:1 nearest-neighbor, caliper=0.2 SD) was performed using key covariates. Progression-free survival and overall survival were assessed using Kaplan-Meier analysis and Cox regression. Adverse events were graded per CTCAE 5.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Chemotherapy-based immunotherapy significantly prolonged median PFS (9.0 vs 6.8 months, P&amp;lt;0.001) and OS (22 vs 14.2 months, P\u00a0=\u00a00.028) compared with non-immunotherapy chemotherapy regimens. This regimen was independently associated with improved PFS (HR\u00a0=\u00a00.56, P&amp;lt;0.001) and OS (HR\u00a0=\u00a00.65, P\u00a0=\u00a00.018). Conversely, ECOG PS 2 was a strong independent predictor of worse prognosis (PFS: HR\u00a0=\u00a06.45; OS: HR\u00a0=\u00a05.50, both P&amp;lt;0.001). Among recipients of chemotherapy\u2011based immunotherapy, adding anti-angiogenic therapy further improved PFS (9.1 vs 6.8 months, P\u00a0=\u00a00.044; HR\u00a0=\u00a00.69, P\u00a0=\u00a00.060), with no significant increase in adverse events (P &amp;gt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Chemoimmunotherapy significantly improved PFS and OS in unresectable stage III\/IV NSCLC. The addition of anti-angiogenic agents to this backbone further prolonged PFS without increasing adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1897228","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:33:08Z","timestamp":1788183188000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of chemotherapy plus immunotherapy in unresectable stage III\u2013IV non-small cell lung cancer, with analysis of the additional role of anti-angiogenic agents"],"prefix":"10.3389","volume":"16","author":[{"given":"Xifen","family":"Qin","sequence":"first","affiliation":[{"name":"The Fourth Affiliated Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiguo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care 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