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Item refines Preprint · not peer-reviewed Added

Real-world immune checkpoint inhibitor survival is often poorer than in pivotal trials

Of 2,514 Belgian metastatic patients on immune checkpoint inhibitors, 568 stopped without further therapy and survived a median 21.4 months.

This retrospective cohort study followed 3,231 adults given immune checkpoint inhibitors at four Belgian hospitals. Structured and free-text health records were harmonised with the OMOP common data model and natural language processing. Of 2,514 with metastatic disease, 568 (22.6%) stopped without further therapy, surviving a median 21.4 months. Melanoma median survival was 78 months, time on treatment 7 and time to next treatment 26. ECOG performance status of 2 or more was associated with poorer survival than 0-1 (adjusted HR 2.18, 95% CI 1.82-2.60). Real-world survival was often poorer than in pivotal trials, but this comparison was descriptive only.

Why it is interesting: Some patients survived for long periods after stopping immunotherapy without further treatment. In lung cancer treated with pembrolizumab plus chemotherapy, survival with ECOG 0-1 came closer to trial results than with ECOG 2 or more.

Source
medRxiv, 3 November 2026
Paper
Comprehensive real-world utilization, treatment trajectories, and outcomes of immune checkpoint inhibitors across cancer types: the multicenter FAIR-ICI cohort
Authors
Ha LT, Donck FV, Bassez I, Oeste CL, Vulsteke C, Delombaerde D et al.
DOI
10.64898/2026.11.02.26367076
Type
Preprint
Design
Retrospective multicentre EHR cohort, four Belgian hospitals, 3,231 adults treated with immune checkpoint inhibitors; OMOP-CDM harmonisation and NLP; years not stated
Verdict
Refines prior evidence
Driver
Cancer

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