Association between smoking history and overall survival in patients receiving first-line pembrolizumab for advanced NSCLC

There is a need to tailor treatments to patients who are most likely to derive the greatest benefit from them to improve patient outcomes and enhance cost-effectiveness. A retrospective cohort study of adult patients receiving first-line pembrolizumab for advanced NSCLC selected from a US nationwide real-world database originating for more than 280 cancer clinics compared overall survival of ever-smokers and never-smokers. After adjustment for baseline covariates, ever-smokers had significantly prolonged OS compared with never-smokers. Among patients starting first-line platinum chemotherapy for advanced NSCLC, ever-smokers had significantly shorter OS compared with never-smokers. The authors conclude that these findings suggests that in never-smoking advanced NSCLC, first-line pembrolizumab monotherapy may not be the optimal therapy selection.