WHAT’S NEW?
By expanding the sample size, we found that the PD-1 inhibitor showed an acceptable toxicity profile on NSCLC patients with chronic viral infection. There is no big difference between the adverse reaction spectrum and the incidence of adverse reactions in such patients and those of patients without infectious diseases, but it is worth observing that the proportion of hepatic transaminase elevating was increased. Hepatic transaminase increased in 26.7% (16/60) of hepatitis B patients. All five patients with reduced viral load received antiviral therapy. Of the 14 patients who did not receive antiviral therapy, 3 patients had grade 3 or 4 adverse events, but in all three patients, the adverse events were reversed with steroids and ICIs were not discontinued, so the side effects were considered acceptable. And immunotherapy combined with antiviral therapy can effectively improve safety. Therefore, we recommend close monitoring for such patients in consultation with a hepatologist and to treat those with active viral hepatitis with antiviral therapy prior to the immunotherapy. The efficacy of PD-1/PD-L1 immune checkpoint inhibitors on locally advanced and advanced NSCLC patients with a history of infectious diseases was acceptable and such patients can benefit from immunotherapy. In subgroup analysis, first-line treatment group, immunotherapy combined with radiotherapy group, immunotherapy combined with chemotherapy and antiangiogenic agents group showed better efficacy.