Clinical characteristics and survival outcomes of long-term responders for advanced nonsmall cell lung cancer patients with first-line PD-1/PD-L1 inhibitors: a multicenter retrospective study

Nonsquamous cell carcinoma, bone metastasis, and liver metastasis were significant predictors of LTR. LTR patients showed a higher proportion of PD-L1 expression. Compared to Sintilimab-chemotherapy, Pembrolizumab-chemotherapy may be more promising for long-term survival of lung squamous cell carcinoma patients. Key messages What is already known on this topic - Immunotherapy (IO) has demonstrated long-term survival benefits in advanced nonsmall cell lung cancer (NSCLC). However, the clinical characteristics, prognosis, and optimal treatment strategies for long-term responders (LTR) to first-line programmed cell death protein-1/programmed cell death ligand-1 inhibitors remain unclear, necessitating further investigation. What this study adds - This study identifies nonsquamous cell carcinoma, absence of bone metastasis, and absence of liver metastasis as significant predictors of LTR in NSCLC patients. LTR patients exhibit a higher proportion of programmed cell death ligand-1 expression (≥50%). Additionally, Pembrolizumab-chemotherapy shows superior overall survival outcomes for LTR with lung squamous cell carcinoma compared to Sintilimab-chemotherapy. How this study might affect research, practice, or policy - These findings provide critical insights for patient stratification and therapy optimization in NSCLC. The identification of predictive factors and superior therapeutic combinations can guide clinical decision-making, personalized treatment strategies, and inform future research on IO in NSCLC.