为了确定在晚期非小细胞肺癌患者中，添加免疫检查点抑制剂（ICI）与单纯铂类联合化疗相比，是否增加了血栓栓塞的风险。本研究从日本诊断程序组合数据库中确定了75,807例于2010年7月至2021年3月期间开始接受铂类联合化疗的晚期非小细胞肺癌患者。比较了接受ICI化疗（ICI组，n = 7,177）和未接受ICI化疗（非ICI组，n = 37,903）的患者在开始接受铂类联合化疗后6个月内发生的静脉血栓栓塞（VTE）、动脉血栓栓塞（ATE）和全因死亡率。使用重叠加权法和倾向评分进行生存时间分析，以调整背景因素。使用Fine-Gray模型计算发生血栓栓塞的亚分布危险比，以死亡作为竞争风险。也使用Cox比例风险模型计算全因死亡率的风险比。总体而言，VTE和ATE分别发生在761例（1.0%）和389例（0.51%）患者身上，死亡率为11.7%。倾向评分重叠加权结果显示，与非ICI组相比，ICI组的VTE和ATE的亚分布危险比（95%置信区间）分别为1.27（1.01-1.60）和0.96（0.67-1.36）。ICI组的死亡率风险比为0.68（0.62-0.74）。添加ICI到铂类联合疗法相比单纯铂类联合化疗，可能增加了VTE的风险，而ATE的风险可能是可比较的。© 2023。作者（们）。

To determine the associated thromboembolism risk with adding immune checkpoint inhibitors (ICI) to platinum combination chemotherapy compared with platinum combination chemotherapy alone in patients with advanced non-small cell lung cancer.This study identified 75,807 patients with advanced non-small cell lung cancer from the Japanese Diagnosis Procedure Combination database who started platinum combination chemotherapy between July 2010 and March 2021. The incidence of venous thromboembolism (VTE), arterial thromboembolism (ATE), and all-cause mortality within 6 months after commencing platinum combination chemotherapy was compared between patients receiving chemotherapy with ICI (ICI group, n = 7,177) and without ICI (non-ICI group, n = 37,903). Survival time analysis was performed using the overlap weighting method with propensity scores to adjust for background factors. The subdistribution hazard ratio for developing thromboembolism was calculated using the Fine-Gray model with death as a competing risk. The hazard ratio for all-cause mortality was also calculated using the Cox proportional hazards model.Overall, VTE and ATE occurred in 761 (1.0%) and 389 (0.51%) patients, respectively; mortality was 11.7%. Propensity score overlap weighting demonstrated that the subdistribution hazard ratio (95% confidence interval) for VTE and ATE in the ICI group was 1.27 (1.01-1.60) and 0.96 (0.67-1.36), respectively, compared with the non-ICI group. The mortality hazard ratio in the ICI group was 0.68 (0.62-0.74).The addition of ICI to platinum combination therapy was associated with a higher risk of VTE compared with platinum combination therapy alone, while the risk of ATE might be comparable.© 2023. The Author(s).