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

© 2024 The Authors..

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 significantly improve patient survival compared with ICIs treatment in total population and subgroup. Therefore, ICI alone or ICIs plus other therapies, such as anti-angiogenesis drugs or other novel ICI (ICIs) could be recommended for older cases with PD-L1 positive NSCLC.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:10

Enthalten in:

Heliyon - 10(2024), 4 vom: 29. Feb., Seite e26026

Sprache:

Englisch

Beteiligte Personen:

Zhang, Panpan [VerfasserIn]
Ma, Minting [VerfasserIn]
Nie, Jun [VerfasserIn]
Dai, Ling [VerfasserIn]
Hu, Weiheng [VerfasserIn]
Zhang, Jie [VerfasserIn]
Wu, Di [VerfasserIn]
Chen, Xiaoling [VerfasserIn]
Ma, Xiangjuan [VerfasserIn]
Tian, Guangming [VerfasserIn]
Han, Sen [VerfasserIn]
Long, Jieran [VerfasserIn]
Wang, Yang [VerfasserIn]
Zhang, Ziran [VerfasserIn]
Hao, Qianyun [VerfasserIn]
Fang, Jian [VerfasserIn]

Links:

Volltext

Themen:

Immunotherapy
Journal Article
Non-small cell lung cancer
Older patients

Anmerkungen:

Date Revised 24.02.2024

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.1016/j.heliyon.2024.e26026

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM368800571