Comparing nivolumab response between smokers and ex-smokers in advanced non-small cell lung cancer: It is never too late to quit smoking

Mustafa Ersoy

doi:10.18621/eurj.1733954

Comparing nivolumab response between smokers and ex-smokers in advanced non-small cell lung cancer: It is never too late to quit smoking

Abstract

Objectives: Lung cancer is most commonly caused by smoking, and unfortunately, a significant portion of patients continue to smoke even during their treatment. Our study aimed to investigate the impact of current smoking on the treatment response in patients receiving nivolumab.

Methods: This was a retrospective cohort study that compared the treatment responses of patients who continued to smoke during nivolumab therapy and those who had a history of smoking but had quit prior to nivolumab initiation. The study included 55 patients with advanced non-small cell lung cancer who received treatment between 2019 and 2025. All participants had stage 4 disease and had progressed after initial platinum-based combination chemotherapy. The treatment responses were categorized as progressive disease, stable disease, partial response, and complete response, and the differences between current smokers and ex-smokers were analyzed, with the response evaluation conducted according to the PET Response Criteria in Solid Tumors 1.0 guidelines.

Results: The analysis revealed a statistically significant difference in treatment response between ex-smokers and current smokers (P=0.039). Ex-smokers demonstrated superior Objective Response Rates (56.0% vs. 25.0%) and Disease Control Rates (76.0% vs. 33.3%) compared to current smokers, with the difference in Disease Control Rate reaching statistical significance (P=0.042). Furthermore, multivariate logistic regression indicated that current smokers were 3.64 times less likely to achieve an objective response to nivolumab than ex-smokers, a finding that, while borderline significant, suggests a clinically meaningful trend (P=0.084).

Conclusions: Our study demonstrated that continued smoking during nivolumab therapy may negatively impact the treatment response. While more prospective data is needed, the current results and existing literature suggest that smoking cessation is crucial for patients receiving nivolumab, and clinicians should be more vigilant in addressing this issue.

Keywords

Ethical Statement

This study was approved by the Kütahya Health Sciences University Non-Interventional Clinical Research Ethics Committee (Decision No: 2025/04-39; date: 11.03.2025). All procedures were conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments. Since this was a retrospective study, informed consent was not obtained from the participants.

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Details

Primary Language

English

Subjects

Clinical Oncology

Journal Section

Research Article

Authors

Mustafa Ersoy ^*
0000-0001-9035-4846
Türkiye

Early Pub Date

August 26, 2025

Publication Date

November 4, 2025

Submission Date

July 3, 2025

Acceptance Date

August 12, 2025

Published in Issue

Year 2025 Volume: 11 Number: 6

DOI

https://doi.org/10.18621/eurj.1733954

IZ

https://izlik.org/JA66XC36YC

Cite

RIS / Bibtex

APA

Ersoy, M. (2025). Comparing nivolumab response between smokers and ex-smokers in advanced non-small cell lung cancer: It is never too late to quit smoking. The European Research Journal, 11(6), 1078-1087. https://doi.org/10.18621/eurj.1733954

AMA

1.Ersoy M. Comparing nivolumab response between smokers and ex-smokers in advanced non-small cell lung cancer: It is never too late to quit smoking. Eur Res J. 2025;11(6):1078-1087. doi:10.18621/eurj.1733954

Chicago

Ersoy, Mustafa. 2025. “Comparing Nivolumab Response Between Smokers and Ex-Smokers in Advanced Non-Small Cell Lung Cancer: It Is Never Too Late to Quit Smoking”. The European Research Journal 11 (6): 1078-87. https://doi.org/10.18621/eurj.1733954.

EndNote

Ersoy M (November 1, 2025) Comparing nivolumab response between smokers and ex-smokers in advanced non-small cell lung cancer: It is never too late to quit smoking. The European Research Journal 11 6 1078–1087.

IEEE

[1]M. Ersoy, “Comparing nivolumab response between smokers and ex-smokers in advanced non-small cell lung cancer: It is never too late to quit smoking”, Eur Res J, vol. 11, no. 6, pp. 1078–1087, Nov. 2025, doi: 10.18621/eurj.1733954.

ISNAD

Ersoy, Mustafa. “Comparing Nivolumab Response Between Smokers and Ex-Smokers in Advanced Non-Small Cell Lung Cancer: It Is Never Too Late to Quit Smoking”. The European Research Journal 11/6 (November 1, 2025): 1078-1087. https://doi.org/10.18621/eurj.1733954.

JAMA

1.Ersoy M. Comparing nivolumab response between smokers and ex-smokers in advanced non-small cell lung cancer: It is never too late to quit smoking. Eur Res J. 2025;11:1078–1087.

MLA

Ersoy, Mustafa. “Comparing Nivolumab Response Between Smokers and Ex-Smokers in Advanced Non-Small Cell Lung Cancer: It Is Never Too Late to Quit Smoking”. The European Research Journal, vol. 11, no. 6, Nov. 2025, pp. 1078-87, doi:10.18621/eurj.1733954.

Vancouver

1.Mustafa Ersoy. Comparing nivolumab response between smokers and ex-smokers in advanced non-small cell lung cancer: It is never too late to quit smoking. Eur Res J. 2025 Nov. 1;11(6):1078-87. doi:10.18621/eurj.1733954