Over the last decade, immune checkpoints inhibitors (ICIs) have changed the landscape of treatment for patients with advanced non-small-cell lung cancer (NSCLC) in the absence of actionable molecular biomarkers. Although the current evidence from phase III randomised clinical trials (RCTs) supports the use of ICIs as first-line and second-line therapy,1 some questions remained about their use in daily clinical practice, specifically if the outcomes reported in RCTs are reproducible with ‘real-world’ data from observational studies. The systematic review and meta-analysis by Kanabar et al published in Thorax,2 summarises current evidence from RCTs and cohort studies regarding the impact of ICIs on progression-free survival (PFS), overall survival (OS), adverse events and quality of life. Although the results of this study can appear obvious to the reader—given the consistent benefit of ICIs in this clinical settin—a deeper vision into such findings deserves …