Purpose: To provide a comprehensive analysis of ICI usage and treatment outcomes in elderly Korean veterans with stage IV NSCLC. Methods: Patients diagnosed with stage IV NSCLC between 2016 and 2021 were included, and three cohorts were derived according to the type of ICI received. Thereafter, the clinical characteristics and survival outcomes were compared. Results: Of the 180 patients with NSCLC (median age, 76 years) included in this study, 49 (27.7%), 61 (33.9%), and 70 (38.9%) received pembrolizumab, nivolumab, and atezolizumab, respectively, and 19.4%, 36.1%, and 34.4% had PD-L1 expressions < 1%, 1–49%, and ≥50%, respectively. The pembrolizumab, nivolumab, and atezolizumab groups, the objective response rates (ORR), and the disease control rates (DCR) were 22.4%, 8.2%, and 4.3% (p= 0.004), and 59.2, 55.7%, and 30.0% (p= 0.001), respectively. However, no difference in the overall survival (OS) rate was noted among the groups (12.6 months vs. 8.4 months vs. 7.7 months,p= 0.334). Similarly, there was no treatment specific OS benefit with respect to the tumor PD-L1 expression status. Interestingly, multivariate analysis identified bone metastasis as a significant poor prognostic factor for OS (HR = 2.75 [95% CI, 1.31–5.76],p= 0.007). Conclusion: Pembrolizumab and nivolumab showed stronger associations with increases in ORR and DCR than atezolizumab, but no statistically significant differences were observed with respect to OS.
目的：旨在对韩国老年退伍军人中IV期非小细胞肺癌患者使用免疫检查点抑制剂的治疗情况及临床结局进行全面分析。方法：纳入2016年至2021年间诊断为IV期非小细胞肺癌的患者，根据所接受免疫检查点抑制剂类型分为三个队列，比较其临床特征与生存结局。结果：本研究共纳入180例非小细胞肺癌患者（中位年龄76岁），其中分别有49例（27.7%）、61例（33.9%）和70例（38.9%）接受了帕博利珠单抗、纳武利尤单抗和阿替利珠单抗治疗；PD-L1表达水平＜1%、1-49%和≥50%的患者分别占19.4%、36.1%和34.4%。帕博利珠单抗组、纳武利尤单抗组和阿替利珠单抗组的客观缓解率分别为22.4%、8.2%和4.3%（p=0.004），疾病控制率分别为59.2%、55.7%和30.0%（p=0.001）。然而三组间总生存期无显著差异（12.6个月 vs. 8.4个月 vs. 7.7个月，p=0.334）。同样，在不同肿瘤PD-L1表达状态亚组中，也未观察到特定治疗带来的总生存期获益。值得注意的是，多因素分析显示骨转移是总生存期的独立不良预后因素（风险比=2.75[95%置信区间1.31-5.76]，p=0.007）。结论：帕博利珠单抗和纳武利尤单抗在提升客观缓解率和疾病控制率方面优于阿替利珠单抗，但三组间总生存期未呈现统计学显著差异。
肿瘤(癌症)患者之家