Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2026 Jan 5;7(4):100952.
doi: 10.1016/j.jtocrr.2026.100952. eCollection 2026 Apr.

Immune Checkpoint Inhibitor Outcomes in NSCLC Across Populations and Practice Settings

Matthew Lee  1 , Jialing Liu  2 , Kari J Teigen  3 , Krishti Sabloak  4 , Melissa Howell  5 , Mario Gonzalez  6 , Bassam Ghabach  6   7 , David E Gerber  2   8   9 , Kalyani Narra  6   7 , Mitchell S von Itzstein  2   9
Affiliations

Immune Checkpoint Inhibitor Outcomes in NSCLC Across Populations and Practice Settings

Matthew Lee et al. JTO Clin Res Rep. .

Abstract

Introduction: Immune checkpoint inhibitor (ICI) clinical trials generally enroll non-Hispanic White patients at academic or private practice settings. ICI outcomes at safety-net settings and across diverse populations remain limited.

Methods: We conducted a retrospective study of patients with advanced NSCLC treated in a safety-net health care system and at an academic cancer center. We obtained clinical and demographic data from the electronic medical record. Kaplan-Meier estimates and Cox proportional hazards model were used to assess variables associated with survival.

Results: A total of 408 patients were included. Compared with the academic center cohort (n = 213), the safety-net cohort (n = 195) was younger (35% versus 75% ≥ 65 y old; p < 0.001), had more racial and ethnic diversity (48% versus 73% non-Hispanic White; p < 0.001), and had more disadvantaged socioeconomic score (61 versus 24 median socioeconomic index; p < 0.001). After multivariable adjustment, patients receiving ICI as part of their treatment had improved survival compared with patients receiving chemotherapy alone (chemoradiation and ICI: adjusted hazard ratio [aHR] = 0.54; 95% confidence interval [CI]: 0.31-0.93; p = 0.03; chemotherapy and ICI: aHR = 0.44; 95% CI: 0.28-0.68; p < 0.001; ICI alone: aHR = 0.53; 95% CI: 0.30-0.91; p = 0.02). There was a near significant association with improved survival at academic practice setting (HR = 0.77; CI = 0.58-1.03; p = 0.08). There were no differences in survival according to race and ethnicity or socioeconomic status.

Conclusion: In a diverse cohort across practice settings, receipt of ICI was associated with improved survival, regardless of facility type, race and ethnicity, or socioeconomic status. Efforts to provide ICI access to all eligible patients may improve outcomes.

Keywords: ICI; Non–small cell lung cancer; Real-world; Safety-net.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Overall survival in ICI-treated patients in the overall cohort (n = 138) (A) according to race and ethnicity and (B) according to practice setting. HR, hazard ratio; ICI, immune checkpoint inhibitor; JPS, JPS Health Network; UTSW, University of Texas Southwestern Medical Center.
Figure 2
Figure 2
Overall survival according to race and ethnicity in the overall cohort. HR, hazard ratio.
See this image and copyright information in PMC

References

    1. Bray F., Laversanne M., Sung H., et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74:229–263. - PubMed
    1. Kratzer T.B., Bandi P., Freedman N.D., et al. Lung cancer statistics, 2023. Cancer. 2024;130:1330–1348. - PubMed
    1. Garon E.B., Hellmann M.D., Rizvi N.A., et al. Five-year overall survival for patients with advanced non‒small-cell lung cancer treated with pembrolizumab: results from the Phase I KEYNOTE-001 study. J Clin Oncol. 2019;37:2518–2527. - PMC - PubMed
    1. Reck M., Remon J., Hellmann M.D. First-line immunotherapy for non-small-cell lung cancer. J Clin Oncol. 2022;40:586–597. - PubMed
    1. Gandhi L., Garassino M.C. Pembrolizumab plus chemotherapy in lung cancer. N Engl J Med. 2018;379:e18. - PubMed