Introduction: Bronchiectasis is a chronic progressive respiratory disease characterized by permanent dilatation of the bronchi. It is a complex condition with numerous different etiologies, co-morbidities, and a heterogeneous presentation. As we know, there is a lack of studies that describe the differences and compare the characteristics between focal and multifocal bronchiectasis. The aim of this study is to identify differences in clinical characteristics presentation, severity or distribution in focal and multifocal bronchiectasis, and prognostic implications. Methods: 126 patients with computed tomography (CT)-verified bronchiectasis were enrolled. Baseline characteristics that included age, sex, smoking history, and respiratory symptoms were recorded, with special attention paid to hemoptysis appearance, body mass index, and comorbidities. The type of bronchiectasis determined by CT scan and the modified Reiff scores indicating radiological severity were recorded. Patients were divided in two groups (I is focal and II is multifocal). Results: There were no statistically significant differences in age, smoking status, comorbidity, and BMI between the two groups. Multifocality was associated with a significantly higher proportion of females (p = 0.014), the rate of hemoptysis (p = 0.023), and the number of hospitalizations, but not of exacerbations and prevalence of immunodeficiency (p = 0.049). Significantly, a high number of subjects with multifocality had bronchiectasis of moderate severity, and post-infective and asthma-associated phenotypes were the dominant in this group. Unexpectedly, the cystic and varicose radiological phenotype (which need more time to develop) were more dominant in the focal group. The cylindrical phenotype was equally observed in the multifocal and focal groups. Conclusions: Our study suggests that multifocality is not related to age, number of exacerbations, or radiological phenotype, but it seems to be associated with the clinical post-infective phenotype, immunodeficiency, frequent hospitalizations, and severity. Thus, the presence of multifocal bronchiectasis may act as a biomarker of severity and poor outcomes in these patients.

Background: Immune checkpoint inhibitor monotherapy targeting the PD-1/PD-L1 axis is a standard first-line treatment option for patients with metastatic non-small cell lung cancer (NSCLC) and high PD-L1 expression. However, comparative real-world data evaluating PD-1 versus PD-L1 inhibitor monotherapy in this population remain limited. Methods: We conducted a retrospective, single-center real-world analysis of patients with metastatic NSCLC and high PD-L1 expression who initiated first-line immune checkpoint inhibitor monotherapy between May 2024 and January 2025. Patients were treated with either pembrolizumab (PD-1 inhibitor) or atezolizumab (PD-L1 inhibitor) as monotherapy. Progression-free survival (PFS) was estimated using the Kaplan–Meier method and compared using the log-rank test. Univariable and multivariable Cox proportional hazards regression models were applied to identify clinical factors associated with PFS. Results: A total of 125 patients were included, of whom 73 received pembrolizumab and 52 received atezolizumab. The median PFS was numerically longer in patients treated with pembrolizumab compared with atezolizumab (9.93 vs. 5.33 months), although this difference did not reach statistical significance (HR 1.14, 95% CI 0.74–1.74; p = 0.559). Poor performance status (ECOG PS 2) was independently associated with inferior PFS (HR 3.22, 95% CI 2.02–5.12), whereas very high PD-L1 expression (TPS 90–100%) was independently associated with improved PFS (HR 0.57, 95% CI 0.35–0.93). Conclusions: In this real-world cohort, pembrolizumab was associated with numerically longer PFS than atezolizumab; however, this difference was not statistically significant. Outcomes were primarily driven by baseline clinical factors, particularly performance status and the degree of PD-L1 expression. Larger cohorts with longer follow-up are warranted to clarify potential differences and assess long-term outcomes.