165eP Not only histology: The role of chemotherapy backbone in immunotherapy outcomes in advanced lung cancer – A network meta-analysis

immune function, potentially attenuating the therapeutic effects of immune checkpoint inhibitors (ICI's). Methods:We retrospectively analyzed NSCLC patients treated with ICI's, alone or in combination with chemotherapy.Patients were stratified by histology (adenocarcinoma and squamous cell carcinoma) and treatment modality.Glycemic status was assessed, and survival outcomes were evaluated using Kaplan-Meier methods.Progression-free survival (PFS) and overall survival (OS) were compared across groups, with statistical significance set at p < 0.05.We retrospectively analyzed NSCLC patients treated with ICI's, alone or in combination with chemotherapy.Patients were stratified by histology (adenocarcinoma and squamous cell carcinoma) and treatment modality.Glycemic status was assessed, and survival outcomes were evaluated using Kaplan-Meier methods.PFS and OS were compared across groups, with statistical significance set at p < 0.05. Results:We identified 234, both PFS and OS were significantly improved across the entire cohort.In which patients with balanced glucose levels showed significantly better outcomes, with median PFS of 22.43 vs. 17.25 months and OS of 28.66 vs. 23.44 months (p=0.01).The benefit was consistent across subtypes and treatments.In adenocarcinoma, balanced glucose improved PFS (22.21 vs. 13.5) and OS (26.6 vs. 15.37 months).In squamous carcinoma, PFS was 26.7 vs. 14.4 and OS 29.3 vs. 23.6 months (p=0.01).For chemo-immunotherapy, PFS improved (15 vs. 11 months, p=0.05) with a trend for OS (22 vs. 13, p=0.07).With immunotherapy alone, balanced glucose yielded markedly longer PFS (25 vs. 15) and OS (43 vs. 19 months, p=0.01). Conclusions:Our findings support the role of glucose control as a modifiable host factor that may enhance the effectiveness of ICI's in NSCLC.Integration of metabolic management into oncologic care could maximize survival outcomes.