Real-world data on the first-line immune checkpoint inhibitors or in combination with chemotherapy in older patients (aged ≥ 75 years) with advanced non-small cell lung cancer

作者：Panpan Zhang, Minting Ma, Jun Nie, Ling Dai, Weiheng Hu, Jie Zhang, Di Wu, Xiaoling Chen, Xiangjuan Ma, Guangming Tian, Sen Han, Jieran Long, Yang Wang, Ziran Zhang, Qianyun Hao, Jian Fang · 发表于：Heliyon · 年份：2024 · DOI：10.1016/j.heliyon.2024.e26026 · 被引用次数：9 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Research Studies、Multiple and Secondary Primary Cancers

Purpose The purpose of this study is to investigate the efficacy and safety of immune checkpoint inhibitors (ICIs) or plus with chemotherapy in older patients. Methods We enrolled 110 older patients with non-small cell lung cancer (NSCLC ≥75 years) who received either chemotherapy alone (chemo), ICI plus chemotherapy (ICI + chemo), or ICI alone and ICI plus other therapies, which included anti-angiogenesis drugs or other novel ICI (ICIs). Patient characteristics, treatment response, survival, and toxicity were evaluated. Results In total population, the ICIs group has the highest disease control rate (DCR 75%). There were no significant differences in progression-free survival (PFS) and overall survival (OS) among older patients between ICI + chemo and ICIs groups (PFS: 5.3 months vs. 5.5 months, p = 0.70, OS: 10.7 months vs. 20.3 months, p = 0.995). Meanwhile, we observed ICIs had a longer PFS and OS than chemo group (PFS: 3.9 months vs. 5.5 months, p = 0.01, OS: 10.9 months vs. 20.3 months, p = 0.05). Subgroup analysis showed that patients with programmed death ligand-1 (PD-L1) ≥ 1% had a distinct longer trend toward OS in ICIs group compared to ICI + chemo group (22.4 months vs. 10.7 months, p = 0.605), even though there was no significant difference. In terms of safety, ICIs was more tolerable and had a lower discontinuation rate than ICI + chemo group. Conclusion In the real world, ICI + chemo is more likely to be discontinued due to adverse effects and does not signific...