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Article History

Received: 25 March 2025

Accepted: 16 May 2025

First Online: 11 June 2025

Declarations

:

: Marina Garassino: personal financial interests: AstraZeneca, Abion, MSD International GmbH, Bayer, BMS, Boehringer Ingelheim Italia S.p.A, Celgene, Eli Lilly, Incyte, Novartis, Pfizer, Roche, Takeda, Seattle Genetics, Mirati, Daiichi Sankyo, Regeneron, Merck & Co., Inc., Rahway, NJ, USA, Blueprint, Janssen, Sanofi, AbbVie, BeiGenius, Oncohost, Medscape, Gilead, lo Biotech, and Revolution Medicines. Institutional financial interests: Eli Lilly, MSD, Pfizer (MISP), AstraZeneca, MSD International GmbH, BMS, Boehringer Ingelheim Italia S.p.A, Celgene, Eli Lilly, Ignyta, Incyte, MedImmune, Novartis, Pfizer, Roche, Takeda, Tiziana, Foundation Medicine, Glaxo Smith Kline GSK, and Spectrum Pharmaceuticals. Others: AIRC, AIFA, Italian Moh, TRANSCAN, research fundings, and Horizon 2020. Ying Cheng: received funding to their institutions from Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA to support study conduct. Delvys Rodriguez-Abreu: received personal fees/honoraria for consultancy and lectures from Roche, AstraZeneca, Bristol Myers Squibb, Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA; Eli Lilly, Pfizer, and Novartis; travel expenses from Roche, Bristol Myers Squibb, Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA; and Novartis; and grant support for institutional studies from Bristol Myers Squibb. Silvia Novello: personal fees for an invited speaker from Amgen, AstraZeneca, BeiGene, Eli Lilly, MSD, Novartis, Takeda, Pfizer, Roche, and Thermo Fisher; personal fees for advisory boards from Amgen, BI, Pfizer, Roche, Sanofi, Takeda, Janssen, and GSK; research funding to institution from BI and MSD; president of Women Against Lung Cancer Europe (WALCE). Julien Mazieres: personal fees from Roche, AstraZeneca, Pierre Fabre, Takeda, BMS, MSD, Pfizer, Jiangsu Hengruii, Blueprint, Daiichi, Novartis, and Amgen and grants from Roche, AstraZeneca, Pierre Fabre, and BMS. Andrew Robinson: received funding for clinical trials from AstraZeneca, MSD, Pfizer, and Roche and is an advisory board member for AstraZeneca and Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. Steven Powell: received study funding to the institution from Bristol Myers Squibb, Genentech, Incyte, Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA; Pfizer Inc, Novartis, Seattle Genetics, Actuate, Sorrento, Molecular Templates, Janssen Research and Development, LLC, Celgene Inc., and Vyriad; consulting support to the institution from Bristol Myers Squibb; and speaking fees to the institution from Alkermes. Balazs Halmos: received research funding from AbbVie, AstraZeneca, BMS, Boehringer Ingelheim, Eli Lilly, GSK, Guardant Health, Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, Mirati, Novartis, Pfizer, and Takeda and is a consultant for AstraZeneca, BMS, Boehringer Ingelheim, Genentech, Guardant Health, Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, Novartis, Pfizer, and Spectrum. Jhanelle Gray: consultant/advisor for AbbVie, Blueprint Medicines, Daiichi Sankyo, EMD Serono—Merck KGaA, Gilead Sciences, Inc., IDEOlogy Health, Janssen Scientific Affairs, LLC, Jazz Pharmaceuticals, Loxo Oncology Inc., Novartis, OncoCyte Biotechnology Company, Regeneron, Spectrum ODAC, Takeda Pharmaceuticals, and Triptych Health Partners; consultant for AstraZeneca and Merck & Co., Inc., Rahway, NJ, USA; and received research support from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, EMD Serono—Merck KgaA, Genentech, Gilead Sciences, Inc., G1 Therapeutics, Ludwig Institute of Cancer Research, Merck & Co., Inc., Rahway, NJ, USA, Novartis, Panbela Therapeutics, Inc, Pfizer, and Regeneron. Meihua Wang: former employee of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, and owns stock in Merck & Co., Inc., Rahway, NJ, USA; current employee of Eikon Therapeutics, Hayward, CA, USA. Cong Chen: employee of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, and owns stock in Merck & Co., Inc., Rahway, NJ, USA. Jing Yang: employee of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, and owns stock in Merck & Co., Inc., Rahway, NJ, USA. Fabricio Souza: former employee of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, and owns stock in Merck & Co., Inc., Rahway, NJ, USA; current employee of Daiichi Sankyo, Inc., Basking Ridge, NJ, USA. Paul Schwarzenberger: former employee of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, and owns stock in Merck & Co., Inc., Rahway, NJ, USA. Luis Paz-Ares: has a leadership role in ALTUM Sequencing and Genomica; served on speakers’ bureaus for AstraZeneca, BMS, Lilly, MSD Oncology, Merck Serono, Pfizer, and Roche/Genentech; received travel, accommodation, and expenses from AstraZeneca, BMS, MSD, Pfizer, Roche, and Takeda; honoraria from Amgen, AstraZeneca, Bayer, Blueprint Medicines Corporation, BMS, Celgene, Ipsen, Lilly, Merck Serono, Mirati Therapeutics, MSD, Novartis, Pfizer, PharmaMar, Roche/Genentech, Sanofi, Servier, and Takeda; research funding to their institution from AstraZeneca, BMS, Kura Oncology, MSD, Pfizer, and PharmaMar; other relationships with Roche; and an immediate family member has other relationships with Amgen, Ipsen, Merck Novartis, Pfizer, Sanofi, Servier, and Roche.

: This noninterventional analysis did not require ethics approval as it used anonymized data from two previously conducted trials, KEYNOTE-189 and KEYNOTE-407. Both trials were conducted in accordance with principles of Good Clinical Practice and the provisions of the Declaration of Helsinki of 1964 and its later amendments and were approved by the appropriate institutional review boards and regulatory agencies at each participating site. All participants provided written informed consent before enrolling. Study procedures were approved by an institutional review board/ethics committee.