Indian Journal of Medical Research最新文献

{"title":"Health risks of arsenic and chromium in groundwater and surface water in India: A systematic review.","authors":"Vartika Sakalkar, Shipra Singh, Ekta Gupta, Anuj Kumar, Pramod Kumar, Chander Prakash Yadav","doi":"10.25259/IJMR_218_2026","DOIUrl":"10.25259/IJMR_218_2026","url":null,"abstract":"<p><p>Background and objectives India ranks third in global cancer incidence. Groundwater often carries undetectable contaminants such as arsenic, a highly toxic element, and chromium, a probable carcinogen. This systematic review aims to identify patterns of arsenic and chromium exposure in Indian population through groundwater and surface water, and the resulting health effects, including cancer and other non-communicable diseases. Methods A comprehensive search was conducted in PubMed, Embase, and Scopus for English-language studies from inception to January 8, 2025. Studies assessing health effects of arsenic or chromium in groundwater or surface were included. After screening the articles, data on key health risk indices: hazard quotient (HQ) and carcinogenic risk, were extracted and categorised by standard thresholds. Heat maps and violin plots were used to represent health risk levels across studies and regions. Joanna Briggs Institute (JBI) critical appraisal tool was used for quality assessment. Results A total of 1259 articles were identified, with 63 included studies. All reported studies presented a low risk of bias. Arsenic ingestion indicated non-carcinogenic risks in 49% of adult and 60% of child-focused studies. Chromium ingestion risks were lower, reported in 12% and 14% of adult and children-focused studies, respectively. Carcinogenic risk was higher for both metals, particularly through ingestion. Higher non-carcinogenic risk was reported from groundwater than surface water, especially via dermal exposure in children. Affected regions were Punjab, West Bengal, Haryana, Delhi, Uttarakhand, and Jammu and Kashmir. Interpretation and conclusions Groundwater arsenic contamination poses a major public health threat in India, while evidence on chromium ingestion risks are limited.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 2","pages":"273-286"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent high diphtheria positivity in North India: Evidence from a tertiary hospital-based study, 2007-2021.","authors":"Naresh Chand Sharma, Rajesh Ranjan, Kartikey Sharma, Thandavarayan Ramamurthy, Manoj Vasant Murhekar, Vasim Ahmad","doi":"10.25259/IJMR_249_2026","DOIUrl":"10.25259/IJMR_249_2026","url":null,"abstract":"<p><p>Background and objectives Despite the availability of effective vaccines, diphtheria continues to cause morbidity and mortality in parts of India. We analysed 15 yr of hospital-based data from a tertiary care infectious disease hospital to describe the epidemiology of diphtheria in northern India. Methods We analysed data from January 2007 to December 2021 on suspected diphtheria cases (defined as upper respiratory tract illness with an adherent membrane in pharynx, tonsils, larynx, or nose) hospitalised at an infectious diseases hospital. Information on demographic characteristics, vaccination status, laboratory findings, and clinical outcomes was abstracted from the records. We described the distribution of diphtheria by person, place, and time. Multivariable logistic regression was used to examine the association between vaccination status and culture-confirmed diphtheria. Results Among 5,493 suspected diphtheria cases hospitalised during the study period, C. diphtheriae was isolated from 2,131 (38.8%). 408 diphtheria patients died (case-fatality ratio: 19.1%). Culture positivity among suspected cases remained consistently high (range: 15% to 56%) over time. The median age of culture-confirmed cases increased from 5 yr [interquartile range (IQR) 4-8)] during 2007-2011 to 7 yr (IQR 5-9) during 2012-2016 and 7 yr (IQR 6-10) during 2017-2021. Most (n=1876, 88.0%) cases were from Uttar Pradesh and Delhi. Only 23 (1.1%) reported being fully vaccinated for age. Compared with fully vaccinated individuals, partially vaccinated [adjusted odds ratio (aOR): 4.5; 95% confidence interval (CI): 2.8-7.4] and unvaccinated or unknown-status individuals (aOR: 4.2; 95% CI: 2.7-6.5) had higher odds of having diphtheria. Interpretation and conclusions Sustained high diphtheria positivity over 15 yr indicates ongoing transmission in parts of northern India, likely driven by immunity gaps due to suboptimal booster-dose coverage. Strengthening the Universal Immunization Programme with focus on timely booster doses among preschool- and school-aged children is essential to reduce transmission.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 2","pages":"304-310"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deciphering the prognostic weight of tumour-cell CTLA-4 in gastric carcinoma: The need for molecular stratification.","authors":"Koji Takahashi","doi":"10.25259/IJMR_446_2026","DOIUrl":"10.25259/IJMR_446_2026","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 4","pages":"660-661"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation, development, and validation of an in-house antibody cell panel: A prospective cross-sectional study from a tertiary care hospital.","authors":"Subha Palanikumarasamy, Gautam Harsh, Suseendar Shanmugasundaram, Sathish Saravanan, M Arun, P S Gowtham, Siddharth Mittal, Anubhav Gupta, Poonam Elhence, Archana Bajpayee","doi":"10.25259/IJMR_3729_2025","DOIUrl":"10.25259/IJMR_3729_2025","url":null,"abstract":"<p><p>Background and objectives Minor blood group antigens (apart from ABO) can cause haemolytic transfusion reaction in patients who need multiple transfusions. Antibodies against these antigens are typically detected using commercial cell panels. Developing indigenous panels ensures the potential for inclusion of population-specific antigens. We aimed to develop and validate in-house antibody cell panels to detect antibodies against minor blood group antigens and compare it with commercial panel. Methods A cross-sectional study was conducted between July 2022 and December 2023 among 3000 voluntary blood donors. Participants with 'O' blood group who were direct antiglobulin test negative and transfusion-transmitted infection non-reactive underwent phenotyping for low-prevalence antigens (E, K, Ina, Cw). Extended phenotyping was performed for individuals positive for these antigens. Based on selected antigens corresponding to commonly encountered clinically significant alloantibodies, in-house panels were developed and validated using known antibody-positive and antibody-negative samples, and their diagnostic performance was evaluated against a commercial panel. Results Of the 3,000 participants, 700 belonged to 'O' blood group. The prevalence of E, K, Ina, and Cw positivity was 105 (15%), 17 (2.4%), 15 (2.1%), and 10 (1.4%), respectively. A 4- and a 12-cell panel were developed for screening and identification, respectively, from 16 participants. The sensitivity and specificity of in-house panel were 100% [95% Confidence interval (CI): 91.2-100%], and 100% (95% CI: 98.6-100%), respectively when validated with commercial cell panel. The annual cost for a commercial cell panel was INR (₹) ₹1,04,800, while in-house panel's one-time cost was ₹55,760 with recurring cost of ₹1,440 every three months. Interpretation and conclusions The in-house antibody cell panel demonstrated comparable diagnostic performance to the commercial panel, with complete concordance, along with lower cost.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 4","pages":"543-549"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Resistance & virulence traits in dermatophytes isolated from Mangaluru, India.","authors":"","doi":"10.25259/IJMR_283_2025_ER","DOIUrl":"10.25259/IJMR_283_2025_ER","url":null,"abstract":"<p><p>This corrects the article DOI: 10.25259/IJMR_283_2025.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 2","pages":"336"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunomodulatory effect of Manuka honey on macrophage polarisation and its impact on acute wound healing: An experimental study in Swiss albino mice.","authors":"Anumanchi Dattasai Subramanyam, Vivek Srivastava, Rajiv Kumar, Tuhina Banerjee, Amrita Ghosh Kar, Mumtaz A Ansari, Ritwik Kishore, Kumar Kaushik","doi":"10.25259/IJMR_2669_2025","DOIUrl":"10.25259/IJMR_2669_2025","url":null,"abstract":"<p><p>Background and objectives Manuka honey promotes wound healing through antimicrobial and immunomodulatory actions, but its effect on the temporal dynamics of macrophage polarisation (M1→M2 switch) in acute wounds is poorly characterised. The primary objective was to compare the percentage reduction in wound size (wound healing rate) between Manuka honey and control groups; secondary objectives were to compare histopathological healing parameters and tissue cytokines (IL-1β, IL-10, and the IL-1β:IL-10 ratio) as surrogate markers of macrophage polarisation. Methods Thirty male Swiss albino mice (8-12 wk; 25-30 g) were randomised equally to Manuka honey (test) or saline (control), with two dorsal full-thickness wounds (1.0 cm) per animal treated daily for 10 days. The primary outcome was wound healing rate (WHR; % reduction in wound area from day 0 to day 10; a continuous variable measured by ImageJ planimetry). Secondary outcomes were histopathological parameters (inflammatory cell density, neutrophils, eosinophils, oedema, granulation tissue, fibroblast density and activation, epithelialisation, keratinisation), scored as categorical variables, and tissue IL-1β and IL-10 measured by ELISA, on days 5 and 10. Continuous variables were compared using Student's t-test and categorical variables using the Chi-square/Fisher's exact test; P<0.05 was considered significant. Results The test group achieved a higher WHR at day 10 (77.3±5.9% vs. 69.6±5.1%; P=0.003). Histologically, granulation tissue was greater on day 5 (P=0.037); by day 10, neutrophils (P=0.016) and oedema (P=0.038) were reduced, while fibroblast density (P=0.010) and activation (P<0.001) increased. Cytokines were comparable on day 5; by day 10 the test group had lower IL-1β (44.33±11.37 vs. 56.38±16.10 ng/mL; P=0.034), higher IL-10 (17.89±3.15 vs. 14.58±3.87 ng/mL; P=0.022), and a lower IL-1β:IL-10 ratio (3.02±1.90 vs. 4.02±1.46; P=0.044). Interpretation and conclusions Manuka honey accelerated acute wound healing, increasing the wound healing rate alongside an earlier M1→M2 macrophage shift - reflected in lower pro-inflammatory and higher anti-inflammatory cytokines and improved histological repair - supporting its therapeutic potential in wound management.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 2","pages":"161-168"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmaco-economic profile, effectiveness, and safety of a dolutegravir based first line ART regimen among people living with HIV in South Gujarat.","authors":"Brijeshkumar Sojitra, Chetna Patel, Krishnakant Niranjanbhai Bhatt, Sajal Pandya, Paras Shah, Akash Shah, Jaykumar Patel, Chirag Adwani, Vaibhav Panchal","doi":"10.25259/IJMR_3640_2025","DOIUrl":"10.25259/IJMR_3640_2025","url":null,"abstract":"<p><p>Background and objectives Dolutegravir (DTG)-based first line antiretroviral therapy (ART) is preferred globally due to its high efficacy, and tolerability. In India, data on evaluation of its pharmacoeconomic impact with effectiveness and safety remains limited. This study aimed to assess the pharmacoeconomic variables, effectiveness, and safety of the dolutegravir based first line ART regimen among people living with HIV (PLHIV) in south Gujarat. Methods This prospective, and observational study was conducted at an ART centre in a tertiary care hospital. Adults (≥18 yr) receiving first-line ART for ≥6 months were enrolled (n=204) following the informed consent. Pharmacoeconomic outcomes were evaluated using analysis of cost-effectiveness, cost minimisation, cost-utility, and cost-benefit. For effectiveness, CD4 count and plasma viral load (PVL) were recorded at baseline and 6 months. The safety was assessed using causality, severity, and preventability assessment of adverse drug reactions. Results Among 204 participants, 102 received TLD (tenofovir/lamivudine/dolutegravir) and 102 TLE (tenofovir/lamivudine/efavirenz). The TLD regimen demonstrated significantly better cost effectiveness (median CER 45.7 vs. 84.7; P<0.001) and lower mean annual treatment cost [INR (₹)17,074 vs. ₹19,283; P<0.001]. Quality-adjusted life years (QALY) and disability-adjusted life years (DALY) values were comparable between regimens. Both groups showed significant CD4 improvement over 6 months; inter-regimen differences were non-significant (P=0.386). Viral suppression at 6 months was higher with TLD (99% vs. 92.2%; P=0.019). Fourteen ADRs were reported for TLD group. Interpretation and conclusions Dolutegrevir-based regime demonstrated better cost effectiveness, lower annual cost, and more consistent viral load suppression, with comparable immunological recovery and a favourable safety profile, as compared to standard ART regime.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 2","pages":"252-259"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential activity of helper T-cell subsets and cytokine signature profiles in alloimmunisation of sickle cell disease.","authors":"Somnath Mukherjee, Tahsim Anwar, Gaurav Chhabra, Satya Prakash, Ansuman Sahu, Debasish Mishra, Ashutosh Panigrahi","doi":"10.25259/IJMR_144_2026","DOIUrl":"10.25259/IJMR_144_2026","url":null,"abstract":"<p><p>Background and objectives Red blood cell (RBC) transfusion, a cornerstone of therapy in sickle cell disease (SCD), carries the risk of alloimmunisation. Interestingly, not all SCD patients develop alloimmunisation. Research findings underscore the pivotal role of T-cell subsets and their cytokine profiles in regulating alloimmunisation. But the mechanisms of selective alloimmunisation are poorly understood. This study aimed to characterise helper T cell subsets with their signature cytokines in multi-transfused SCD patients. Methods The patients were divided into two groups: alloimmunised and non-alloimmunised, depending on the presence or absence of alloantibodies following transfusions. Flow cytometric analysis of the Tfh and Treg subsets was performed. The supernatant plasma was used to estimate the levels of signature cytokines. The Mann-Whitney U test, independent sample median test, and Spearman's Rho correlation test were performed for statistical analysis. Results A total of 12 patients from each group were included. A significantly higher percentage of T-regs was observed in the non-alloimmunised group [median 7.65, interquartile range (IQR) 6.37-8.20] than in the alloimmunised group (median 6.27, IQR 4.77-6.80) (P<0.05). A significantly higher expression of IL-21 was observed in the alloimmunised group. Significantly higher expression of TGF-β and IL-10 was found in the non-alloimmunised group (P<0.05). Interpretation and conclusions Our study highlights increased Treg percentages and anti-inflammatory cytokine concentrations in the non-immune group, as well as increased pro-inflammatory cytokines and activated Tfh subsets in alloimmunised patients.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 2","pages":"194-201"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community health worker-led interventions for cardio-metabolic diseases in India: Evidence from a systematic review and meta-analysis.","authors":"Suprakash Mandal, Priyanka Virdi, Kriti Singh, Rambha Pathak","doi":"10.25259/IJMR_3058_2025","DOIUrl":"10.25259/IJMR_3058_2025","url":null,"abstract":"<p><p>Background and objectives Cardio-metabolic diseases are leading cause of disability-adjusted life years (DALYs) in India. Community health workers' (CHW) local proximity and contextual understanding enable low-cost, and sustainable health interventions. This systematic review and meta-analysis of interventional studies aimed to identify types of CHW-led interventions and their effect on cardio-metabolic diseases. Methods Studies done in India (2000-2024) were searched from PubMed, Embase and Scopus databases. Screening of studies, followed by risk of bias assessment, data extraction was done and pooled mean difference (MD), 95% confidence interval (CI) was estimated by the random effect model. Subgroup, sensitivity analysis, and meta-regression was performed along with certainty assessment using grading of recommendations assessment, development and evaluation (GRADE). Results Thirteen studies (10 randomised trial and 3 pre-post studies) involving adults (mean age ranging from 45 to 65 yr) with hypertension, diabetes, stroke, and overweight were included in systematic review and 9 studies were included in meta-analysis. The CHW-led intervention significantly reduced systolic blood pressure (n=7,114; MD -5.5 mm Hg, 95% CI -9.0 to -1.9; P=0.041; I2=79.3%), with higher effect among people with hypertension (MD -7.5 mm Hg) and body mass index (MD -0.63 kg/m2; P=0.038) in intervention group. No significant change was observed in diastolic blood pressure, fasting blood glucose, glycated haemoglobin, and lipid profiles. Sensitivity analysis revealed no differential effect, and meta-regression showed no significant covariates. GRADE certainty of evidence was low to very low for outcome variables. Interpretation and conclusions CHW-led interventions in an Indian community setting showed beneficial effect on cardiometabolic outcomes, particularly blood pressure and body mass index, though the strength of evidence ranged from weak to moderate.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 2","pages":"241-251"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of immunotherapy in driver mutation-negative advanced non-small cell lung cancer: A systematic review and meta-analysis.","authors":"Jogender Kumar, Shuvadeep Ganguly, Parminder Kaur, Alok Raghav, Kirti Pai, Jitendra Meena, Jagdish Prasad Goyal, Jaivinder Yadav","doi":"10.25259/IJMR_3200_2025","DOIUrl":"10.25259/IJMR_3200_2025","url":null,"abstract":"<p><p>Background and objectives Despite substantial research on immunotherapy, its efficacy and safety in treating advanced non-small cell lung cancer (NSCLC) without identifiable driver mutations remain unclear. The objective of this review was to examine the efficacy and safety of immunotherapy, used as monotherapy or alongside chemotherapy, vs. chemotherapy alone in patients with advanced driver mutation-negative NSCLC. Methods A comprehensive literature search of PubMed, Embase, Scopus, and CENTRAL databases was conducted until December 2024. The protocol was registered in PROSPERO (CRD42024585050). Randomised controlled trials (RCTs) evaluating the efficacy and safety of immunotherapy, either as monotherapy or in combination with chemotherapy, compared with chemotherapy alone, were included. A random-effects meta-analysis was performed. Risk of bias was assessed using the Cochrane RoB 2 tool, and the certainty of evidence was evaluated using the GRADE framework. Results Twenty-three RCTs (n=14605 participants) were included. Immunotherapy (± chemotherapy) significantly improved overall survival [22 RCTs; 14,375 participants, hazard ratio (HR): 0.77; 95% Confidence interval (CI): 0.72-0.83] and progression-free survival (22 RCTs; 14,003 participants, HR: 0.67; 95% CI: 0.58-0.76) compared with chemotherapy alone. The objective response rate was also higher with immunotherapy (23 RCTs; 12,967 participants, RR 1.38, 95% CI: 1.24-1.54). No statistically significant differences were observed between the groups in terms of overall adverse event rates. Interpretation and conclusions Immunotherapy, whether administered alone or in combination with chemotherapy, provides significant survival benefits in patients with advanced driver mutation-negative NSCLC.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 2","pages":"203-219"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}