关于程序性细胞死亡配体使用免疫检查点抑制剂 (ICIs) 治疗无主要驱动突变 [表皮生长因子受体 (EGFR) 突变或间变性淋巴瘤激酶 (ALK) 重排] 的术后复发性非小细胞肺癌 (NSCLC) 的报道有限1 (PD-L1) 在现实环境中表达。本研究的目的是评估 ICI 对这些 NSCLC 的效果。我们招募了 255 名术后复发 NSCLC 患者，这些患者缺乏 EGFR 突变或 ALK 重排，他们在 2012 年至 2021 年间接受了肺叶切除术或更广泛的切除术。与复发后生存相关的因素（ PRS）是使用 Cox 比例风险模型确定的。使用 Kaplan-Meier 曲线分析 PRS，并使用时序检验进行比较。多变量分析表明，鳞状细胞癌、病理分期 III 和东部肿瘤合作组 (ECOG) 表现状态≥2 与较差的 PRS 显着相关。相反，一线使用 ICI 与 PRS 改善相关。在一线和后续治疗期间使用 ICI 的患者比仅接受化疗的患者具有更好的 PRS。在使用ICIs的患者中，手术切除标本中PD-L1表达≥50%、1-49%和<1%的患者一线反应率和PRS均无显着差异。在现实世界中，无论 PD-L1 表达如何，任何治疗线均可改善 NSCLC 患者的 PRS，而无需主要驱动突变。2024 年《胸部疾病杂志》。版权所有。

Limited reports exist regarding postoperative recurrent non-small cell lung cancer (NSCLC) without major driver mutations [epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) rearrangements] treated with immune checkpoint inhibitors (ICIs) when programmed cell death ligand 1 (PD-L1) is expressed in a real-world setting. The aim of this study was to evaluate the effect of ICIs for those NSCLC.We enrolled 255 patients with postoperative recurrent NSCLC lacking EGFR mutations or ALK rearrangements who underwent lobectomy or more extensive resection between 2012 and 2021. Factors associated with post-recurrence survival (PRS) were determined using the Cox proportional hazards model. PRS was analyzed using Kaplan-Meier curves and compared using the log-rank test.Multivariable analysis demonstrated that squamous cell carcinoma, pathological stage III, and an Eastern Cooperative Oncology Group (ECOG) performance status ≥2 were significantly associated with worse PRS. Conversely, ICI use at first line was associated with improved PRS. Patients who used ICIs during the first line and subsequent therapies had better PRS than those who received chemotherapy alone. Among patients who used ICIs, there was no significant difference in response rate at the first line, nor in PRS among those with PD-L1 expression ≥50%, 1-49%, and <1% in surgically resected specimens.ICI use at any treatment line improved the PRS of NSCLC patients without major driver mutations, irrespective of PD-L1 expression, in a real-world setting.2024 Journal of Thoracic Disease. All rights reserved.