PhD Scientific Days 2026

Poster Session 1.S - Conservative Medicine

Real-world comparison of first-line platinum-based chemotherapy and chemo-immunotherapy in metastatic non-small cell lung cancer

Name of the presenter

Fésü, Dorottya

Institute/workplace of the presenter

Semmelweis University, Department of Pulmonology

Authors

Dorottya Fésü, MD, PhD¹, Balázs Csoma, MD, PhD¹, Alexandra Nagy, MD, PhD¹, Lőrinc Polivka, MD, PhD¹, Veronika Müller MD; DSc¹, Lilla Tamási, MD, DSc¹
1: Semmelweis University, Department of Pulmonology

Text of the abstract

Introduction: Metastatic non-small cell lung cancer (NSCLC) is one of the most malignant neoplastic diseases. Therapeutic options in target-negative NSCLC include chemotherapy (CHT) and chemo-immunotherapy (CH-IM); however real-world data are scarce about the effect of these therapies.
Aims: The objective of this study was to evaluate the impact of chemotherapy and chemo-immunotherapy on progression-free survival (PFS) in NSCLC patients.
Methods: We retrospectively analysed all newly diagnosed advanced NSCLC patients presented the first time on our Multidisciplinary oncology team (MDT) between January 2020-December 2021 and January-June 2025. Patients with stage IV squamous-cell carcinoma/adenocarcinoma were included if treated with CHT or CH-IM in first line (N=130; CHT: N=59; CH-IM: N=71)). Patients who had been lost to follow-up; refused therapy; treated with best supportive care/targeted/mono-immunotherapy; had concomitant/previous malignant diseases; or previously underwent surgical procedure due to lung-cancer were excluded from the analysis. PFS was estimated using Kaplan–Meier curves and compared by log-rank test and Cox proportional hazards regression. To control for potential confounding we conducted a multivariable Cox proportional hazards regression model (co-variables: age, sex, smoking history, comorbidity of chronic obstructive pulmonary disease, ECOG status and cancer histology type). P value < 0.05 was defined as statistically significant.
Results: There was no significant difference between CHT and CH-IM treated groups regarding sex distribution, ECOG status; history of COPD and histology type; however in the CHT group patients were older (68.8±6.7 vs 65.5±8.8, p=0.02) and active smoking was more common (59% vs 32%, p=0.005). Significantly better PFS outcome was associated with CH-IM (HR=0.288; CI= 0.17 - 0.48; p<0.001), which remained significant after adjustment for confounders (aHR=0.288; CI= 0.16 - 0.50; p<0.001).
Conclusion: In this real-world retrospective cohort of metastatic NSCLC patients first-line chemo-immunotherapy demonstrated a significant PFS advantage over platinum-based chemotherapy, even after controlling for potential confounders. These findings suggest that combined chemo-immunotherapy has beneficial effect on PFS, prolonging time until progression.
Funding: Semmelweis Doctoral School, Pre-doctorate scholarship