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Real-world data survival outcomes of first line immunotherapy with pembrolizumab in high expressers with stage IV non-small cell lung cancer Cover

Real-world data survival outcomes of first line immunotherapy with pembrolizumab in high expressers with stage IV non-small cell lung cancer

Open Access
|Sep 2026

Figures & Tables

TABLE 1.

Clinical characteristics of patients with NSCLC

CharacteristicsFrequencies N/(%)
Gender
 Male31 (60.2%)
 Female20 (39.8%)
Age (years)
 Average66.8
 Range50–84
Smoking status
 Non-smokers3 (5.9%)
 Active smokers39 (76.5%)
 Former smokers9 (17.6%)
Pack-year index
 Average48.5
 Range0–150
Body mass index (BMI)
 Average25.4
 < 18.53 (5.9%)
 18.5–24.922 (43.1%)
 25.0–29.923 (45.1%)
 30.0–34.91 (2.0%)
 > 40.02 (3.9%)
ECOG performance status
 01 (2.0%)
 150 (98.0%)

1 ECOG = Eastern Cooperative Oncology Group; NSCLC = non-small cell lung cancer

TABLE 2.

Pathological characteristics and TNM staging

Histological subtype of NSCLC
 Squamous22 (43.1%)
 Non-squamous (adenocarcinoma)29 (56.9%)
TNM classification
TNM
T1a1 (2.0%)010 (19.6%)1a20 (41.2%)
T1b3 (5.9%)13 (5.9%)1b16 (31.4%)
T1c3 (5.9%)220 (39.2%)1c15 (27.5%)
T2a2 (3.9%)318 (35.3%)
T2b6 (11.8%)
T37 (13.7%)
T429 (56.9%)
Stage
IVAIVB
36 (70.6%)15 (29.4%)

1 NSCLC = Non-Small Cell Lung Cancer; T = Tumor; N = Node; M = Metastasis

TABLE 3.

Levels of PD-L1 expression

PD-L1 expression N/(%)
50–59%5 (9.8%)
60–69%11 (21.6%)
70–79%9 (17.6%)
80–89%13 (25.5%)
90–100%13 (25.5%)

1 PD-L1 = Programmed Death-Ligand 1

TABLE 4.

Duration of treatment and number of cycles with pembrolizumab

DURATION OF TREATMENT (months)
Average18.3
Range2–60
NUMBER OF CYCLES WITH PEMBROLIZUMB
Average21.3 cycles
Range2–61 cycles
TABLE 5.

Radiological response to treatment according to the iRECIST criteria

(immuno) RADIOLOGICAL RESPONSE TO TRETMENT (iRECIST)
Complete response (CR)0 (0%)
Partial response (PR)19 (37.3%)
Stable disease (SD)26 (51.0%)
Progressive disease (PD)6 (11.8%)
Overall response rate (ORR)37.2%

1 iRECIST = (immuno) Response Evaluation Criteria In Solid Tumors

FIGURE 1.

Progression free survival (PFS) for all patients evaluated in the real-world data (RWD) analysis.

FIGURE 2.

Overall survival (OS) for all patients evaluated in the real-world data (RWD) analysis.

TABLE 6.

Multivariate analysis of patient characteristics in relation to PD-L1 expression

CharacteristicPD-L1 (50–79%)PD-L1 (80–100%)p value
Age (± SD)65.4 (7.9)68.2 (5.8)0.166
Gender, N (%)
Male19 (76.0)12 (46.2)0.029
Female6 (24.0)14 (53.8)
BMI
< 18.51 (4.0)2 (7.7)0.394
18.5–24.99 (36.0)13 (50.0)
25.0–29.912 (48.0)11 (42.3)
30.00–34.91 (4.0)0 (0.0)
35.00–39.90 (0.0)0 (0.0)
> 402 (8.0)0 (0.0)
Smoking status, N (%)
Nonsmokers0 (0.0)3 (11.5)0.099
Smokers22 (88.0)17 (65.4)
Former smokers3 (12.0)6 (23.1)
Type of NSCLC, N (%)
Squamous11 (44.0)11 (42.3)0.903
Non-squamous14 (56.0)15 (57.7)
Stage, N (%)
IVa21 (84.0)15 (57.7)0.039
IVb4 (16.0)11 (42.3)
Best response, N (%)
PR12 (48.0)7 (26.9)0.262
SD10 (40.0)16 (61.5)
PD3 (12.0)3 (11.5)
Progression, N (%)
No13 (52.0)11 (42.3)0.488
Yes12 (48.0)15 (57.7)
Outcome, N (%)
Alive12 (48.0)9 (34.6)0.332
Deceased13 (52.0)17 (65.4)

1 BMI = Body Mass Index; NSCLC = Non-Small Cell Lung Cancer; PD-L1 = Programmed Death-Ligand 1; PD = Progressive Disease; PR = Partial Response; SD = Stable Disease; ± SD = ± Standard Deviation

FIGURE 3.

Progression Free Survival (PFS) between PD-L1 ≥ 80% group and PD-L1 < 80%; p = 0.548.

FIGURE 4.

Overall Survival (OS) between PD-L1 ≥ 80% group and PD-L1 < 80%; p = 0.153

DOI: https://doi.org/10.2478/raon-2026-0050 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 450 - 458
Submitted on: Mar 23, 2026
Accepted on: May 22, 2026
Published on: Sep 7, 2026
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2026 Vladimir Stojsic, Bojan Zaric, Petar Simurdic, Tomi Kovacevic, Darijo Bokan, Jelena Djekic Malbasa, Tatjana Sarcev, Goran Stojanovic, Daliborka Bursac, Borislava Nikolin, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.