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        ICIs have revolutionized the modern treatment of advanced NSCLC. Survival advantages have been reported in up to 20% to 40% of the study populations in various studies. Kaplan-Meier curves and Cox proportional hazard analysis have been used to report analysis in all the major clinical trials which have eventually led to Food and Drug Administration approvals of ICI. This work suggests that estimations of hazard ratio (HR) might not be representative of the effect size as disproportionately long plateau tails of Kaplan-Meier curves may sway ICI trial results. To overcome this, Cox-TEL adjustment method was used and data of nine major ICI trials were reevaluated to calculate the survival benefits of ICIs over chemotherapy. The proportional hazard model divides the study population in two groups, short-term (ST) survivors and long-term (LT) survivors, and the differences in proportions (DPs) and HRs for ST and LT survivors were calculated. The DP, which was representative of the incremental gain in LT survival probability, was greatest in patients with programmed death-ligand 1 (PD-L1) expression of 1% or more treated with nivolumab, whereas the ST-HR was nonsignificant in eight of nine trials. Pooled Cox HR, ST-HR, and LT-DP were 0.74 (95% confidence interval [CI]: 0.68–0.82), 0.88 (95% CI: 0.82–0.94), and 0.09 (95% CI: 0.06–0.12), respectively, for NSCLC cases with PD-L1 less than 1%, and none of the trials revealed any statistical significance for ST-HR. In second-line setting among NSCLC cases with PD-L1 greater than or equal to 1%, ST-HR consistently had ICI benefit with pooled ST-HR of 0.84 (95% CI: 0.78–0.91). One of the main limitations of the analysis was the lack of LT follow-up data in most studies. Nevertheless, this work highlights the limitation of the traditional Cox HR model to predict survival benefit when the effect of treatment is not constant over time.
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