{
  "abstract": "Background/objectives\n\nImmune checkpoint inhibitors have transformed oncology by inducing unexpected and sustained remissions in some patients; however, this atypical survival may be accompanied by significant psychosocial and existential challenges. The objective was to synthesize the available scientific evidence on the psychosocial burden of the 'Lazarus Effect', characterized by survivor guilt, identity shift, and discontinuation anxiety.Methods\n\nA systematic review was conducted following the PRISMA2020 guidelines, based on a preregistered protocol on the OSF. Searches were performed in PubMed, Scopus, Web of Science, and APA PsycINFO using PICOS-based eligibility criteria. Seven primary empirical studies were included, and their methodological quality and risk of bias were assessed using the MMAT 2018.Results\n\nSurvivor guilt stems interpersonally from peer deaths and intrapersonally from perceived autonomy loss. Identity shift involves transitioning into an \"existential limbo,\" re-establishing self-identity while off active treatment. Discontinuation anxiety relates to recurrence fears, absence of curative biomarkers, and uncertainty regarding treatment duration. Interactively, these dimensions drive broader psychosocial burden, including social isolation, \"scanxiety,\" and a discrepancy between physical recovery and emotional vulnerability.Conclusions\n\nCurrent evidence-limited to seven heterogeneous studies concentrated in high-income settings-indicates exceptional responses to immunotherapy may involve nuanced psychosocial challenges. Given small sample sizes, melanoma overrepresentation, potential report retrieval bias, and non-standardized assessment tools, findings require cautious interpretation. They offer an exploratory foundation for future research rather than definitive clinical conclusions, supporting preliminary psycho-oncological screening during treatment transitions.",
  "abstract_shown": true,
  "affiliations": [
    "Faculty of Social and Health Sciences, Peninsula of Santa Elena State University, La Libertad 240204, Ecuador.",
    "Faculty of Educational Sciences and Languages, Peninsula of Santa Elena State University, La Libertad 240204, Ecuador."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Johanna Alcívar Ponce",
      "orcid": "0009-0006-7313-1118"
    },
    {
      "affs": [
        0
      ],
      "name": "Wilson Alexander Zambrano Vélez",
      "orcid": "0000-0003-1061-878X"
    },
    {
      "affs": [
        1
      ],
      "name": "Marianela Silva Sánchez",
      "orcid": "0000-0002-0775-6826"
    },
    {
      "affs": [
        0
      ],
      "name": "Gioryi Sornoza Zavala",
      "orcid": "0000-0002-5573-3119"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9j20h883q846r.bib",
  "cited_by": 0,
  "doi": "10.3390/diseases14100354",
  "fulltext_url": "https://europepmc.org/articles/PMC13703520",
  "id": "9j20h883q846r",
  "issns": [
    "2079-9721"
  ],
  "landing_url": "https://europepmc.org/article/MED/42929982",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2730|Cancer survivorship and care"
    ]
  ],
  "openalex": "W7214326428",
  "pdf_url": "https://europepmc.org/articles/PMC13703520?pdf=render",
  "pmcid": "PMC13703520",
  "pmid": "42929982",
  "published": "2026-09-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9j20h883q846r.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:22:01Z",
      "native_id": "MED:42929982",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42929982"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Cancer survivorship and care",
      "subfield": "oncology"
    }
  ],
  "title": "The Psychosocial Burden of the 'Lazarus Effect': A Systematic Review of Survivor Guilt, Identity Shift, and Discontinuation Anxiety in Exceptional Responders to Cancer Immunotherapy.",
  "title_text": "The Psychosocial Burden of the 'Lazarus Effect': A Systematic Review of Survivor Guilt, Identity Shift, and Discontinuation Anxiety in Exceptional Responders to Cancer Immunotherapy.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:01Z",
  "url": "https://research.draconitic.com/paper/9j20h883q846r",
  "venue": "Diseases (Basel, Switzerland)",
  "versions": []
}