Efficacy of PD-1/PD-L1 plus CTLA-4 inhibitors in advanced/metastatic NSCLC: a meta-analysis based on RCTs.

Front Immunol · 2026 · PMC13199360 · PMID 42199400

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highly significantno p-value reported

Highly significant interactions were also identified for Smoking status (Yes vs No: P-interaction<0.0001), the presence of Brain metastasis (Yes vs No: P-interaction=0.0124), and consistently across TMB subgroups (TMB<10 vs TMB≥10: P-interaction = 0.0330; TMB<20 vs TMB≥20: P-interaction = 0.0192).

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failed to reach statistical significanceno p-value reported

Notably, although subgroup analyses indicated potential differences in treatment efficacy based on histology, sex, ECOG status, PD-L1 expression, and liver metastasis, formal interaction tests failed to reach statistical significance.

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showed a trendno p-value reported

Smokers experienced a significant improvement in OS, while non-smokers did not benefit even showed a trend towards deterioration.

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