OBJECTIVE: To probe into the prognosis and safety of programmed death 1（PD-1） inhibitors in first-line treatment of advanced non-small cell lung cancer（NSCLC）. METHODS: Clinical data of 90 patients with advanced NSCLC treated with three kinds of PD-1 inhibitors（camrelizumab

sintilizumab and tislelizumab） as first-line treatment in the hospital from May 2019 to Jan. 2021 were collected. Clinical characteristics and adverse drug reactions were retrospectively analyzed

and the effects of clinical characteristics on disease control（DCR） and progression-free survival（PFS） of advanced NSCLC treated with PD-1 inhibitors as first-line treatment were compared. RESULTS: The objective response rate（ORR） of all patients was 54.4%（49/90）

and the DCR was 78.9%（71/90）. Multivariate analysis showed that Ⅲb and Ⅲc

combined chemotherapy and PD-1 positive were the protective factors for DCR in advanced NSCLC（P<0.05）. In follow-up observation

the median PFS of 90 patients was 8.6 months. COX regression analysis showed that s Ⅲb and Ⅲc

combined chemotherapy and PD-1 positive were the protective factors of PFS in advanced NSCLC. Ⅲb and Ⅲc（median PFS:11.0 months vs. 7.2 months

χ~2=4.152

P=0.042）

combined chemotherapy（median PFS:9.6 months vs. 7.6 months

χ~2=4.066

P=0.044） and PD-1 positive（median PFS:10.9 months vs. 6.6 months

χ~2=13.978

P<0.001） patients had longer PFS. The overall incidence of adverse drug reactions was 67.8%（61/90）. The incidences of adverse drug reactions of camrelizumab

sintilide and tislelizumab were respectively 75.0%（21/28）

73.3%（22/30） and 56.3%（18/32）

there was no significant difference among three groups（χ~2=3.041

P=0.218）. CONCLUSIONS: PD-1 inhibitors have good clinical value as the first-line treatment for patients with advanced NSCLC

yet attention should be paid to adverse drug reactions during treatment. The clinical effect of PD-1 inhibitor is better for advanced NSCLC patients with Ⅲb and Ⅲc

and PD-L1 positive

and patients treated with PD-1 combined with chemotherapy have better benefits.