Comprehensive real-world utilization, treatment trajectories, and outcomes of immune checkpoint inhibitors across cancer types: the multicenter FAIR-ICI cohort

In the multicenter FAIR-ICI cohort of 3,231 Belgian adults receiving immune checkpoint inhibitors, 22.6% of metastatic patients discontinued without later systemic therapy, with median post-discontinuation OS 21.4 months.

• Why it matters: Real-world evidence on how ICIs are used over time and how outcomes compare with pivotal trials is limited, especially regarding discontinuation patterns and patient factors.
• What they did: This retrospective study harmonized structured and unstructured EHR data from four Belgian hospitals into OMOP-CDM using natural language processing, then estimated OS, ToT, TTNT, and post-discontinuation survival with multivariable Cox regression.
• The result: ECOG ≥2 was linked to worse OS than ECOG 0–1 (adjusted HR 2.18, 95% CI 1.82–2.60), and real-world survival was often less favorable than pivotal trial results.

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