Chemoimmunotherapy Combinations in Elderly Patients with Metastatic Non-Small Cell Lung Cancer and PD-L1 Expression < 50%: Results from an Italian Real-World Study
作者：Antonello Veccia, Ettore D’Argento, Floriana Morgillo, Elio Gregory Pizzutilo, Fabiana Vitiello, Alberto Pavan, Fiorella Lombardo, M. Russano, Alessandro Morabito, Eleonora Gariazzo, C Genova, Rita Chiari, Antonella Cristofano, Alessandro Delconte, Emanuela Vattemi, Alessandra Dessì, Daniele Galanti, Simona Busato, Giovanni Palazzolo, Clementina Savastano, Giuseppe Azzarello, Francesco Verderame, Cristina Mazzi, Daniela Bencardino, Mariachiara Dipasquale, Alessandro Scala, Carminia Maria Della Corte, Daniele Piscazzi, Marina Gilli, Emilio Bria, O. Caffo, Stefania Gori, Alessandro Inno · 发表于：Journal of Clinical Medicine · 年份：2026 · DOI：10.3390/jcm15031165 · 被引用次数：1 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Treatments and Mutations、Advanced Breast Cancer Therapies
Background: Chemoimmunotherapy combinations represent the standard first-line treatment for non-oncogene addicted metastatic NSCLC (mNSCLC). However, evidence in elderly patients remains limited and conflicting. We conducted an analysis of the efficacy and safety of chemoimmunotherapy in patients aged ≥75 years enrolled in the Real-Combo Lung study, an observational study including patients with non-oncogene-addicted mNSCLC and PD-L1 expression < 50%. Patients and Methods: The primary objective of the study was to compare progression-free survival (PFS) and overall survival (OS) between patients aged ≥75 (elderly cohort) and those aged <75 years (non-elderly cohort). Safety outcomes were evaluated as a secondary objective. Results: A total of 495 patients were enrolled, with 89 (18%) aged ≥75 and 406 (82%) aged <75 years. No significant differences in PFS and OS were observed between the two cohorts. The median PFS was 13.3 months (95% CI: 9.3–NR) in the elderly cohort and 10.5 months (95% CI: 9.5–12.9) in the non-elderly cohort (unadjusted HR 0.84, 95% CI: 0.61–1.16, p = 0.29). The median OS was 17.5 months (95% CI: 14.7–NR) versus 21.4 months (95% CI: 17–NR), respectively (unadjusted HR 1.09, 95% CI: 0.76–1.56, p = 0.63). In multivariable analysis, ECOG PS ≥ 2 and baseline use of steroids were significantly associated with a worse outcome in the elderly cohort for both PFS and OS. Safety data did not differ significantly between cohorts. Conclusions: In this real-w...