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Prognostic stratification through smoking status and cumulative smoking dose in advanced non-small cell lung cancer immunotherapy: a dose-dependent real-world analysis

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资源类型：
Pubmed体系：
作者：
Yang Lan[1,2] * ; Wang Haoyu[1,2] * ; Tian Panwen[1,2,3] ; Li Weimin[1,2] ;
机构： [1]Department of Pulmonary and Critical Care Medicine State Key Laboratory of Respiratory Health and Multimorbidity West China Hospital of Sichuan University, Precision Medicine Key Laboratory of Sichuan Province, Chengdu, Sichuan,China. [2]Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan,China. [3]Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu,China.
出处：
DOI： 10.3389/fonc.2025.1590825
ISSN：

关键词： non-small cell lung cancer immune checkpoint inhibitors smoking hygiene cumulative smoking dose real-world evidence

摘要：
The association between smoking status, cumulative smoking dose, and immunotherapy efficacy in non-small cell lung cancer (NSCLC) remains controversial. We sought to integrate the lifetime pack-years with smoking cessation status to identify optimal immunotherapy beneficiaries.A total of 1,192 immunotherapy-treated NSCLC patients treated between November 2015 and April 2024 were enrolled. Data on demographics, clinical characteristics, pathologic characteristics, treatments, and clinical outcomes were collected. The objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS) were compared across different smoking statuses (never, current, and former smokers) and cumulative smoking doses (never smokers, non-heavy smokers: <20 pack-years, and heavy smokers: ≥20 pack-years). Multivariate logistic regression and Cox proportional hazards models were used to analyze ORR and PFS, respectively.Among the 1,192 patients, 377 were never smokers, 499 were current smokers, and 316 were former smokers. In terms of smoking status, former smokers exhibited the longest median PFS (17.0 months, P < 0.001), with the highest ORR (46.8%, P < 0.001) and DCR (86.7%, P = 0.008). Regarding cumulative smoking dose, the heavy smoker group demonstrated the longest median PFS (15.9 months, P = 0.001), with the highest ORR (46.6%, P < 0.001) and DCR (85.2%, P = 0.012). Notably, further multivariate analysis identified former heavy smokers as independent favorable predictors of ORR (OR = 1.93, 95% CI = 1.25-2.99, P = 0.003) and PFS (HR = 0.75, 95% CI = 0.57-0.99, P = 0.04) in advanced NSCLC patients receiving immunotherapy.This real-world cohort analysis establishes a clinical stratification combining smoking cessation status with cumulative smoking dose, identifying former heavy smokers as optimal immunotherapy beneficiaries. These findings advocate integrated smoking history documentation and emphasize clinical prioritization of cessation interventions to enhance treatment efficacy in NSCLC.Copyright © 2025 Yang, Wang, Tian and Li.

基金：
This work was supported by the Noncommunicable Chronic Diseases-National Science and Technology Major Project (2023ZD0506105/2023ZD0506100 to Weimin Li), Noncommunicable Chronic Diseases-National Science and Technology Major Project (2024ZD0522806/ 2024ZD0522800 to Panwen Tian), Sichuan Science and Technology Program (2024NSFSC1528 to Lan Yang), and National Natural Science Foundation of China (No. 92159302 to Weimin Li).
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2025]版：
大类 | 3 区 医学
小类 | 4 区 肿瘤学
最新[2025]版：
大类 | 3 区 医学
小类 | 4 区 肿瘤学
第一作者：
第一作者机构： [1]Department of Pulmonary and Critical Care Medicine State Key Laboratory of Respiratory Health and Multimorbidity West China Hospital of Sichuan University, Precision Medicine Key Laboratory of Sichuan Province, Chengdu, Sichuan,China. [2]Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan,China.
共同第一作者：
通讯作者：
通讯机构： [1]Department of Pulmonary and Critical Care Medicine State Key Laboratory of Respiratory Health and Multimorbidity West China Hospital of Sichuan University, Precision Medicine Key Laboratory of Sichuan Province, Chengdu, Sichuan,China. [2]Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan,China. [3]Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu,China.
推荐引用方式(GB/T 7714)：
Yang Lan,Wang Haoyu,Tian Panwen,et al.Prognostic stratification through smoking status and cumulative smoking dose in advanced non-small cell lung cancer immunotherapy: a dose-dependent real-world analysis[J].Frontiers In Oncology.2025,15:1590825.doi:10.3389/fonc.2025.1590825.
APA：
Yang Lan,Wang Haoyu,Tian Panwen&Li Weimin.(2025).Prognostic stratification through smoking status and cumulative smoking dose in advanced non-small cell lung cancer immunotherapy: a dose-dependent real-world analysis.Frontiers In Oncology,15,
MLA：
Yang Lan,et al."Prognostic stratification through smoking status and cumulative smoking dose in advanced non-small cell lung cancer immunotherapy: a dose-dependent real-world analysis".Frontiers In Oncology 15.(2025):1590825

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