Objective To compare the efficacy of programmed death-1 (PD-1) inhibitors combined with chemotherapy with that of bevacizumab combined with chemotherapy as first-line treatments for advanced non-squamous non-small cell lung cancer (nsNSCLC).

Methods Retrospective collection of 237 patients with advanced nsNSCLC who received first-line treatment at the Fourth Hospital of Hebei Medical University from November 2014 to March 2024. According to the treatment plan, 119 cases were assigned into PD-1 inhibitor combined with chemotherapy (IC group) and 118 cases were assigned into bevacizumab combined with chemotherapy (BC group). Propensity score matching (PSM) was used to balance covariates. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were objective response rate (ORR), disease control rate (DCR), and overall survival (OS).

Results Among 237 patients with PSM, 87 were assigned to the IC group and 87 to the BC group, with respective ORRs of 31.0% (27/87) and 43.7% (38/87) (P=0.085) and respective DCRs of 96.6% (84/87) and 95.4% (83/87) (P=1.000). No significant difference in the median PFS was observed between the two groups, with a PFS value of 9.3 months in the IC group and 9.1 months in the BC group (P=0.053). In addition, the two groups also showed no significant difference in OS (neither group reached the median OS; P=0.116).

Conclusions There was no significant difference in the short-term efficacy between chemotherapy combined with PD-1 inhibitor and that combined with bevacizumab as first-line treatments for advanced nsNSCLC.