Surgery and OncologySurgery and OncologyХирургия и онкология2949-5857Publishing House ABV Press87710.17650/2949-5857-2026-16-2-81-87ORIGINAL REPORTОРИГИНАЛЬНОЕ ИССЛЕДОВАНИЕResearch ArticleLong-term real-world outcomes in patients with metastatic non-small cell lung cancer and immune-mediated adverse eventsОтдаленные результаты лечения пациентов с метастатическим немелкоклеточным раком легкого при развитии иммуноопосредованных нежелательных явлений в реальной клинической практикеhttps://orcid.org/0000-0002-0620-2696YudinD. I.ЮдинД. И.
Russian Federation
yudinden@mail.ruhttps://orcid.org/0000-0003-4469-502XLaktionovK. K.ЛактионовК. К.
Russian Federation
yudinden@mail.ruhttps://orcid.org/0000-0002-6323-511XDjanyanI. A.ДжанянИ. А.
Russian Federation
yudinden@mail.ruN. N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр онкологии им. Н. Н. Блохина» Минздрава России20062026162818712122025Copyright ©; 2026, ABV-pressCopyright ©; 2026, АБВ-пресс2026ABV-pressАБВ-прессhttps://creativecommons.org/licenses/by/4.0/https://onco-surgery.info/jour/article/view/877

Background. The negative side of immunotherapy with immune checkpoint inhibitors for patients with metastatic non-small cell lung cancer (NSCLC) is the development of immune-mediated adverse events (imAE).

Aim. To determine the association between imAE and overall survival (OS), progression-free survival (PFS) in patients with metastatic NSCLC receiving immunotherapy.

Materials and methods. The study included data on treatment of patients with metastatic NSCLC who received immunotherapy at the N. N. Blokhin National Medical Research Center of Oncology between 2015 and 2023. The patients were divided into two groups: those who developed any grade imAE and those who did not. The primary endpoints of the study were PFS and OS. Landmark analysis was performed to avoid immortal time bias.

Results. The study included 461 patients. Any grade imAE occurred in 138 patients, while 323 patients did not experience imAE. The median follow-up time was 60.7 months. For the patients with and without imAE in a 16-month landmark analysis, median OS was 70.0 months (95 % confidence interval (CI) 39.93–100.06) and 45.4 months (95 % CI 38.78–52.01) (p = 0.048), respectively. And in a 6.5-month landmark analysis, median PFS was 16.7 months (95 % CI 1.25–32.14) and 20.6 months (95 % CI 14.98–26.21) (p = 0.942) for patients with and without imAE, respectively.

Conclusion. Immune-mediated adverse events during immunotherapy in patients with metastatic NSCLC are associated with better overall survival when a landmark analysis was applied.

Введение. Негативная сторона лечения ингибиторами иммунных контрольных точек для пациентов с метастатическим немелкоклеточным раком легкого (НМРЛ) – развитие иммуноопосредованных нежелательных явлений (иоНЯ).

Цель исследования – определение взаимосвязи между развитием иоНЯ и общей выживаемостью (ОВ), выживаемостью без прогрессирования (ВБП) у пациентов с метастатическим НМРЛ, получающих иммунотерапию.

Материалы и методы. В исследование включены данные о лечении пациентов с метастатическим НМРЛ, получивших иммунотерапию в Национальном медицинском исследовательском центре онкологии им. Н. Н. Блохина с 2015 по 2023 г. Больные разделены на 2 группы: с развитием иоНЯ (1-я группа) и без них (2-я группа). Первичными конечными точками исследования стали ОВ и ВБП. С целью коррекции ошибки бессмертия выполнен лэндмарк-анализ.

Результаты. В исследование включен 461 пациент. У 138 больных развились иоНЯ разной степени тяжести (1-я группа), у 323 пациентов иоНЯ не отмечены (2-я группа). Медиана времени наблюдения составила 60,7 мес. При условии дожития до 16-го месяца от начала иммунотерапии медиана ОВ пациентов 1-й и 2-й групп составила 70 мес (95 % доверительный интервал (ДИ) 39,93–100,06) против 45,4 мес (95 % ДИ 38,78–52,01) соответственно (p = 0,048). При лэндмарк-анализе медиана ВБП при условии дожития до 6,5 мес в 1-й группе составила 16,7 мес (95 % ДИ 1,25–32,14) против 20,6 мес (95 % ДИ 14,98–26,21) во 2-й группе (р = 0,942).

Заключение. При выполнении лэндмарк-анализа выявлено, что развитие иоНЯ у пациентов с метастатическим НМРЛ на фоне иммунотерапии ассоциируется с лучшими показателями ОВ.

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