Immunotherapy (IO) + chemotherapy ± anti-angiogenics comprise FDA-approved 1L regimens for metastatic non-small cell lung cancer (NSCLC), with IO-only therapy approved only for PD-L1+ NSCLC. Patients with PD-L1 scores from 1%-49% have many therapeutic options, but little is known about how subgroups of patients experience benefit across treatment regimens. To explore this, a recent study pooled data from eight randomized controlled trials investigating anti-PD-(L)1 therapy as IO-only or in chemo-IO regimens for the 1L treatment of patients with advanced NSCLC. Overall survival (OS) and progression-free survival (PFS) were compared between chemo-IO and IO alone via a pooled analysis. A total of 2,108 patients with NSCLC and PD-L1 score from 1%-49% were identified. Baseline characteristics were: 37% aged 65-74 years and 12% aged ≥75; 67% male; 79% White; 65% ECOG ≥ 1; and 85% smokers. The pooled analysis showed that patients receiving chemo-IO (n = 639) had longer PFS and OS compared to patients treated with IO alone (n = 529), with median PFS 7.7 versus 4.2 months and median OS 21.4 versus 14.5 months.  

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Outcomes of anti-PD-(L1) therapy in combination with chemotherapy versus immunotherapy (IO) alone for first-line (1L) treatment of advanced non-small cell lung cancer (NSCLC) with PD-L1 score 1-49%: FDA pooled analysis.