Effectiveness and Safety of Immunotherapy in Advanced NSCLC with Pericardial Effusions: A Global Retrospective Multicenter Study

作者：Talal El Zarif, Sarah Abou Alaiwi, Amin H. Nassar, Eleonora Gariazzo, Valentina Santo, Edoardo Garbo, Mihaela Aldea, Francesco Paoloni, Sagal Pannu, Karl Semaan, Omar Chehab, Malak Hoballah, Vishal Navani, Gao Y, Daniel Meyers, Igor Stukalin, Arjun Mittra, MT Li, Nicholas Jones, Shirly Grynberg, Ronnie Shapira, Alexi Vasbinder, Salim S. Hayek, Elias Bou Farhat, Marc Eid, Eddy Saad, Dory Freeman, Kaushal Parikh, Aakash Desai, Smith Cd, Edward El-Am, Frank Aboubakar Nana, Simone Foderaro, Javier Baena-, Mercedes Herrera, Alessio Cortellini, David J Pinato, James Korolewicz, Chul Kim, Paul Sackstein, Ryan A Denu, Walid Macaron, Noha Abdel-wahab, Tomas G. Neilan, Joao A C Lima, Narjust Florez, Pasi Janne, Biagio Ricciuti, Federica Pecci, Toni K Choueiri, Jennifer M. Kwan, Abdul Rafeh Naqash · 发表于：The Oncologist · 年份：2026 · DOI：10.1093/oncolo/oyag277 · 研究领域：Cancer Immunotherapy and Biomarkers、Pericarditis and Cardiac Tamponade、Lung Cancer Diagnosis and Treatment

BACKGROUND: There is limited data on immune checkpoint inhibitor (ICI) use in patients with non-small cell lung cancer (NSCLC) and known pericardial effusions. METHODS: This international multi-center observational retrospective study included patients with advanced NSCLC with or without pericardial effusions receiving ICIs. Immune-related adverse events (irAEs) were graded per CTCAE v5.0. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method. Cox proportional hazards multivariable models assessed the association between survival outcomes and clinicopathologic variables, and an inverse probability of treatment weighting (IPTW) model compared outcomes between the two groups. RESULTS: A total of 1,248 patients with advanced NSCLC treated with ICIs across 13 institutions were included. Of these, 85 patients (6.8%) had pre-existing pericardial effusions. Compared to controls, patients with pericardial effusions were younger (median age 63 vs. 67 years, p=0.007), diagnosed more frequently with PD-L1 positive tumors (96% vs. 76%, p<0.001), and had a higher median number of baseline metastatic sites (3 vs. 1, p<0.001). IrAEs were similar between both groups (42% vs. 38%), and no cardiac irAEs occurred in patients with pericardial effusions. PFS (median 5.6 vs. 4.6 months, p=0.3) and OS (median 10.2 vs. 14.7 months, p=0.50) were not statistically different between patients with pericardial effusions and the controls, respectively. In both...