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Related Concept Videos

Treatment Resistant Cancers02:56

Treatment Resistant Cancers

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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
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Updated: Jan 7, 2026

Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
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Multicenter Real-World Data on First-Line Chemoimmunotherapy in Patients With Advanced Non-Small Cell Lung Cancer and

Shunichi Kataoka1, Takehito Shukuya1, Hiroshi Ohtsu2

  • 1Department of Respiratory Medicine, Juntendo University, Graduate School of Medicine, Tokyo, Japan.

Clinical Lung Cancer
|January 3, 2026
PubMed
Summary

Chemotherapy with immune checkpoint inhibitors (Chemo-ICIs) significantly improved progression-free survival and response rates in advanced non-small cell lung cancer patients with performance status 2, without increasing toxicity.

Keywords:
First-line therapyImmune checkpoint inhibitorsPlatinum-doublet chemotherapyPoor performance statusReal-world evidence

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Area of Science:

  • Oncology
  • Immunotherapy
  • Clinical Trials

Background:

  • Standard treatment for advanced non-small cell lung cancer (NSCLC) involves chemotherapy with immune checkpoint inhibitors (Chemo-ICIs) for patients with performance status (PS) 0-1.
  • Patients with PS2 are often excluded from clinical trials, creating an evidence gap for optimal treatment selection.
  • The efficacy and safety of first-line Chemo-ICIs in PS2 patients remain unclear.

Purpose of the Study:

  • To evaluate the efficacy and safety of first-line Chemo-ICIs compared to chemotherapy (Chemo) alone in patients with advanced NSCLC and PS2.
  • To address the evidence gap regarding treatment strategies for NSCLC patients with PS2.

Main Methods:

  • Multicenter retrospective cohort study of 2425 patients with stage IV NSCLC and PS0-2 without driver oncogenes.
  • Propensity score matching to compare outcomes between Chemo-ICIs and Chemo groups.
  • Primary endpoints: progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and grade ≥ 3 adverse events.

Main Results:

  • Among 424 PS2 patients, 56 received Chemo-ICIs and 117 received Chemo. After matching, Chemo-ICIs significantly improved median PFS (5.7 vs. 2.3 months; P=.025) and ORR (43% vs. 21%; P=.02).
  • OS showed a non-significant trend toward improvement with Chemo-ICIs (8.0 vs. 6.0 months; P=.219).
  • Rates of grade ≥ 3 adverse events were comparable between the groups (50.0% vs. 43.6%; P=.514).

Conclusions:

  • Chemo-ICIs significantly improved PFS and ORR compared to Chemo in NSCLC patients with PS2, without increased toxicity.
  • These findings support the clinical relevance of chemoimmunotherapy in PS2 patients.
  • The results may help bridge the evidence gap in current treatment guidelines for NSCLC with PS2.