编程死亡配体-1（PD-L1）表达已被认为是非小细胞肺癌（NSCLC）免疫治疗反应的预测生物标志物。然而，PD-L1并不总是一个可靠的预测性生物标志物。在本研究中，我们旨在比较接受免疫治疗的NSCLC患者在吸烟状况下的治疗反应，包括二线或进一步线治疗。我们使用了韩国首尔天主教医疗中心的肺癌登记数据库。符合以下条件的患者有资格参与本研究：确诊为组织学确认的NSCLC，并在2017年1月至2021年12月期间接受免疫检查点抑制剂（ICIs）作为二线或进一步线治疗。总共有220名接受ICIs治疗的NSCLC患者参与了本研究。其中有40名从不吸烟者，73名过去吸烟者，和107名现在吸烟者。多变量分析显示，吸烟状况、病理类型和PD-L1表达是影响无进展生存期（PFS）的重要因素。性别、ECOG体能状态、病理类型和PD-L1表达是影响总生存期（OS）的重要因素。肺癌诊断时的吸烟状况可能是预测ICIs治疗反应的生物标志物在晚期NSCLC患者中。版权所有2023，国际抗癌研究院（乔治·J·德里纳西奥斯博士），保留所有权利。

Programmed death ligand-1 (PD-L1) expression is known to be a predictive biomarker for response to immunotherapy in non-small cell lung cancer (NSCLC). However, PD-L1 is not always a reliable predictive biomarker. In the present study, we aimed to compare responses to immunotherapy according to smoking status in NSCLC patients receiving immunotherapy in second line or further line treatment.The lung cancer registry database of the Catholic Medical Center, Seoul, Republic of Korea was used. Patients were eligible for this study if they were diagnosed with histologically confirmed NSCLC and received immune checkpoint inhibitors (ICIs) as second-line or further line therapy from January 2017 to December 2021.Overall, 220 patients with NSCLC treated with ICIs were enrolled. There were 40 never smokers, 73 former smokers, and 107 current smokers. In multivariate analysis, smoking status, pathologic type, and PD-L1 expression were significant factors affecting PFS. Sex, ECOG performance status, pathologic type, and PD-L1 expression were significant factors affecting OS.Smoking status at diagnosis of lung cancer could be a predictive biomarker for response to ICIs in patients with advanced NSCLC.Copyright © 2023, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.