Li JJN, Karim K, Sung M, et al. - In 268 patients with advanced non-small-cell lung cancer (NSCLC), researchers evaluated how smoking status impacted patient outcomes with anti-programmed death-ligand 1 (PD-L1) therapy in addition to PD-L1 tumor expression. Researchers carried out a prospective real-world cohort including patients with advanced NSCLC treated with anti-PD-1 monotherapy at the Princess Margaret Cancer Centre. Factors correlated with treatment response (RECIST v1.1), including PD-L1 tumor proportion score (TPS) and smoking status were evaluated via logistic regression. The findings revealed that smoking is correlated with response to anti-PD-1 monotherapy and patients with advanced NSCLC with positive PD-L1 expression are more likely to respond to anti-PD-1 monotherapy whether they are current smokers vs never smokers. In current and former smokers vs never smokers, overall response rates (ORR) to immunotherapy were significantly higher (36% vs 26% vs 14%). Higher 1-year survival rates were seen in smokers vs never smokers in the exploratory analysis.