ArticleClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2026
Drug allergy history predicts early progression-free survival benefit from PD-(L)1 inhibitors in advanced non-small cell lung cancer: a retrospective cohort study.
Article in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlthough allergic predisposition may modulate antitumor immunity, its influence on immune checkpoint blockade remains unclear. We investigated whether a documented drug allergy history affects the outcomes of PD-(L)1 inhibitors in advanced non-small cell lung cancer (NSCLC).
methodsWe retrospectively analyzed 246 patients with stage III-IV NSCLC treated with PD-(L)1 inhibitors at West China Hospital from October 2019 to October 2024, with follow-up through May 2025. Patients were grouped according to drug allergy history. Baseline imbalances were corrected using 1:2 propensity score matching (caliper 0.2) and inverse probability of treatment weighting. The primary endpoint was progression-free survival (PFS); secondary endpoints included overall survival (OS), objective response rate (ORR), and immune-related adverse events (irAEs).
resultsBefore adjustment, allergy-positive patients (n = 49) showed higher 1-year PFS than controls (54.4% vs. 35.7%, p = 0.019). After matching, median PFS remained longer (13.6 vs. 6.6 months; hazard ratio 0.61, 95% CI 0.40-0.91, p = 0.017), and 1-year PFS improved (57.0% vs. 33.4%, p = 0.009), whereas 3-year PFS, OS, and ORR were comparable. Weighted analyses and multiple sensitivity tests corroborated these findings. Overall incidences of Grade ≥ 2 or ≥ 3 irAEs were similar; although Grade ≥ 2 gastrointestinal irAEs trended higher in the allergy cohort (6.1% vs. 1.0%, p = 0.054).
conclusionsA history of drug allergy predicts early clinical benefits, particularly superior 1-year PFS, from PD-(L)1 blockade in advanced NSCLC without increasing severe irAEs. Prospective multicenter studies are needed to confirm these findings and elucidate the underlying mechanisms.
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