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Comparison of the 3 Most Commonly Used Modified PD-1 Inhibitors Plus Chemotherapy in Inoperable Wild-Type Non-Small Cell Lung Cancer

Oncology (Williston Park). 2026 Mar 16;40(2):123-133. doi: 10.46883/2026.25921065.

ABSTRACT

OBJECTIVE: Immunotherapy combined with chemotherapy is a standard treatment for advanced non-small cell lung cancer (NSCLC). However, the comparative efficacy and safety of cost-efficient modified PD-1 inhibitors remain incompletely characterized. This study aimed to determine the optimal choice for the 3 most commonly used modified PD-1 inhibitors-tislelizumab, sintilimab, and camrelizumab-combined with chemotherapy in locally advanced or metastatic NSCLC.

MATERIALS AND METHODS: We conducted a retrospective study of patients with NSCLC who received chemotherapy plus 1 of the modified PD-1 inhibitors. The primary objective was to compare survival and therapeutic responses across groups. The secondary objective was to analyze adverse events in each group.

RESULTS: No significant differences were observed in median progression-free survival (PFS) or overall survival across the 3 groups. However, PD-L1-positive patients (tumor proportion score ≥ 1%) demonstrated significantly prolonged PFS with tislelizumab ( P = .038) and sintilimab ( P = .031) vs camrelizumab. The incidence of immune-related adverse events did not differ statistically across treatments.

CONCLUSION: Although survival outcomes were comparable among the 3 PD-1 inhibitors in the overall cohort, tislelizumab and sintilimab showed superior PFS in PD-L1-positive subgroups, suggesting biomarker-driven therapeutic selection. These findings underscore the importance of PD-L1 status in optimizing immunotherapy regimens for advanced NSCLC, offering clinical insights for personalized treatment strategies.

PMID:41931642 | DOI:10.46883/2026.25921065

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