文章：

老年晚期非小细胞肺癌患者免疫检查点抑制剂真实世界数据回顾性研究

Real-World Data on Immune-Checkpoint Inhibitors in Elderly Patients with Advanced Non-Small Cell Lung Cancer: A Retrospective Study

原文发布日期：29 June 2025

DOI: 10.3390/cancers17132194

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: Non-small cell lung cancer (NSCLC) accounts for approximately 85% of lung cancer cases, with an increasing incidence in patients over 65 years. Although immune-checkpoint inhibitors (ICIs) have transformed the treatment landscape, elderly patients remain underrepresented in pivotal clinical trials, highlighting the need for real-world evidence on their efficacy and tolerability in this population.Methods: We conducted a multicenter, retrospective study of advanced NSCLC patients treated with ICI alone or in combination with chemotherapy between April 2017 and December 2023. Patients were categorized into three age groups: ≤65 (younger group, YG), 66–79 (older group, OG), and ≥80 years (advanced older group, AOG). Efficacy and safety outcomes were compared across groups.Results: Among 452 patients, 221 (48.9%) were in the OG and 36 (8%) in the AOG. Median progression-free survival (PFS) was similar across groups: 8.3 months (YG), 8.4 months (OG;p= 0.872 vs. YG), and 10.5 months (AOG;p= 0.628 vs. YG). Median overall survival (OS) showed a non-significant trend favoring younger patients: 15.1 months (YG), 10.3 months (OG;p= 0.076 vs. YG), and 12.5 months (AOG;p= 0.070 vs. YG). Grade ≥ 3 immune-related adverse events (irAEs) occurred in 9.7% (YG), 5.9% (OG), and 8.3% (AOG). In patients ≥ 66 years, irAEs were associated with longer PFS (18.1 vs. 6 months;p< 0.001).Conclusions: ICIs demonstrated comparable PFS and OS across age groups, including patients aged ≥ 80 years. Chronological age did not increase irAE incidence. The development of irAEs may serve as a favorable prognostic factor in elderly patients.

摘要翻译： 

背景/目的：非小细胞肺癌约占肺癌病例的85%，在65岁以上人群中的发病率持续上升。尽管免疫检查点抑制剂已显著改变了治疗格局，但关键临床试验中老年患者的代表性仍然不足，这凸显了在该人群中获取其疗效与耐受性真实世界证据的必要性。 方法：我们开展了一项多中心回顾性研究，纳入2017年4月至2023年12月期间接受免疫检查点抑制剂单药或联合化疗治疗的晚期非小细胞肺癌患者。将患者分为三个年龄组：≤65岁（年轻组）、66-79岁（老年组）和≥80岁（高龄老年组），比较各组间的疗效与安全性结局。 结果：在452例患者中，221例（48.9%）属于老年组，36例（8%）属于高龄老年组。中位无进展生存期在各组间相近：年轻组8.3个月，老年组8.4个月（与年轻组相比p=0.872），高龄老年组10.5个月（与年轻组相比p=0.628）。中位总生存期呈现有利于年轻患者的非显著性趋势：年轻组15.1个月，老年组10.3个月（与年轻组相比p=0.076），高龄老年组12.5个月（与年轻组相比p=0.070）。≥3级免疫相关不良事件发生率分别为：年轻组9.7%、老年组5.9%、高龄老年组8.3%。在≥66岁患者中，发生免疫相关不良事件与更长的无进展生存期相关（18.1个月 vs 6个月，p<0.001）。 结论：免疫检查点抑制剂在各年龄组（包括≥80岁患者）中均显示出相似的无进展生存期和总生存期。时序年龄未增加免疫相关不良事件发生率。免疫相关不良事件的发生可能成为老年患者的有利预后因素。

原文链接：

Real-World Data on Immune-Checkpoint Inhibitors in Elderly Patients with Advanced Non-Small Cell Lung Cancer: A Retrospective Study