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Research Paper|Volume 15, Issue 24|pp 15025—15049

The efficacy of immune checkpoint inhibitors is limited in elderly NSCLC: a retrospective efficacy study and meta-analysis

Jiaxin Yin1, Yuxiao Song1, Yang Fu2, Wang Jun3, Jiazhuo Tang1, Zhimin Zhang1, Qibin Song1, Bicheng Zhang1
  • 1Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China
  • 2Department of Oncology, Xiangyang Hospital, Hubei University of Chinese Medicine, Xiangyang, China
  • 3Department of Oncology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
* Equal contribution and shared first authorship
Received: July 29, 2023Accepted: November 3, 2023Published: December 19, 2023
https://doi.org/10.18632/aging.205328

Copyright: © 2023 Yin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Immune checkpoint inhibitors (ICIs) have improved the long-term survival of NSCLC patients. However, the efficacy of ICIs in elderly NSCLC patients remains controversial. We conducted a retrospective study and meta-analysis exploring the efficacy of ICIs in those patients using public databases and RCTs. NSCLC patients were identified into elderly and non-elderly groups by age 75 years. The retrospective study showed significant differences in OS and PFS between non-elderly and elderly patients treated with ICIs (P= 0.029 and 0.027), with reduced efficacy in elderly NSCLC patients. ECOG PS also negatively affected OS in elderly NSCLC patients (P= 0.007). In meta-analysis, the HR for OS in the non-elderly and elderly groups were 0.74 and 0.90, respectively, and the difference between the two age groups was statistically significant (P= 0.025). ICIs resulted in a lower incidence of all-grade (OR= 0.47) and high-grade TRAEs (OR= 0.38) than chemotherapy. Our findings revealed that the survival benefit of ICIs in elderly patients (≥ 75 years) may be lower than in non-elderly patients. In addition, the incidence of TRAEs induced by ICIs was lower than chemotherapy.