{
  "abstract": "Background Programmed death ligand-1 (PD-L1) is a crucial biomarker in non-small cell lung cancer (NSCLC). High PD-L1 expression correlates with improved responses to anti-PD-1/PD-L1 monotherapy, while the benefit of immunotherapy in PD-L1-negative tumors remains uncertain. Despite the use of chemoimmunotherapy combinations across PD-L1 levels, patients with PD-L1-negative disease form a clinically diverse group with poor prognosis. Standard treatments include dual agent chemoimmunotherapy (with anti-PD-1/PD-L1 and anti-CTLA4) and single agent chemoimmunotherapy (with anti-PD-1/PD-L1); however, direct comparisons of these regiments among patients with PD-L1-negative advanced NSCLC have not been conducted.Methods IPDfromKM is a computational tool that aids in extraction of individual patient data (IPD) from published Kaplan-Meir (KM) plots. We used a web-based application to extract coordinates which were then processed and reconstructed into IPD, making the IPD available for secondary analysis and comparisons with outcomes data from CheckMate9LA (nivolumab/ipilimumab/chemotherapy), against KEYNOTE-189, and KEYNOTE-407 (pembrolizumab/chemotherapy). We analyzed both the progression free survival (PFS) and overall survival (OS).Results In non-squamous NSCLC, CM9LA and KEYNOTE-189 demonstrated similar overall survival (OS): 18.5 months (95% CI: 14.0–22.9) vs. 17.7 months (95% CI: 14.2–23.8), respectively (HR: 1.10; p=0.503). Progression-free survival (PFS) showed similar outcomes with KEYNOTE-189, with a median of 6.28 months compared to 5.38 months with CM9LA (HR: 0.96; 0.77- 1.19, p=0.704). One-year survival rates showed KN189 27.7% in comparison to CM9LA 29.3%, but 5-year OS was double in CM9LA (8.4%) vs. KEYNOTE-189 (2.5%). In the squamous population, OS was nearly identical between CM9LA (18.5 months; 95% CI: 14.0–22.9) and KEYNOTE-407 (15.1 months; 95% CI: 13.4–19.8; HR: 1.17; p=0.274). PFS outcomes were also comparable (CM9LA 5.42 months; KN407: 6.22 months; HR:1.03;(0.74- 1.43) p=0.860). Notably, 5-year OS in CM9LA was more than double that of KEYNOTE-407 (20.7% vs. 10.8%), despite similar early survival metrics.Conclusions Our analysis provides a direct survival comparison of PD-L1-negative NSCLC patients across dual and single chemoimmunotherapy regimens. In non-squamous disease, CM9LA and KEYNOTE-189 showed similar short-term outcomes, but CM9LA demonstrated a stronger long-term survival signal. In squamous NSCLC, both regimens had comparable early outcomes, with CM9LA again showing a late survival advantage. These findings support histology-specific treatment strategies and highlight the potential long-term benefits of dual immunotherapy in PD-L1-negative patients. However, these observed differences need further confirmation in randomized prospective studies.",
  "authors": [
    {
      "affiliations": [
        "University of Alabama at Birmingham, Birmingham, AL, USA"
      ],
      "name": "Sanad Alhushki"
    },
    {
      "affiliations": [
        "Jordan University of Science and Technology, Irbid, Amman, Jordan"
      ],
      "name": "Mohammad Khaled Alhushki"
    },
    {
      "affiliations": [
        "University of Alabama at Birmingham, Birmingham, AL, USA"
      ],
      "name": "Ellen McNeeley"
    },
    {
      "affiliations": [
        "UAB Medicine, Birmingham, AL, USA"
      ],
      "name": "Aakash Desai"
    }
  ],
  "title": "1152 Comparing outcomes with single versus dual agent chemoimmunotherapy for patients with PD-L1 negative metastatic non-small cell lung cancer (NSCLC)",
  "uid": "338918d0-2b2e-5d86-a872-57504f1875c1"
}