Clinical Efficacy Of Immune Checkpoint Inhibitors In Elderly Patiets With Advanced Non-small Cell Lung Cancer:A Meta-analysis

BACKGROUND Elderly are representative group of advanced non-small-cell lung cancer(NSCLC)patients.Despite the acknowledged survival improvement by immune check point inhibitors(ICIs),impact of age on the efficacy of ICIs in NSCLC patients remains to be clarified.The present study performed a systematic review and meta-analysis to evaluate the clinical efficacy of ICIs in patients with advanced NSCLC based on age(<65 years vs ≥65 years).METHODS The study systematically searched randomized controlled trials(RCTs)of ICIs on advanced NSCLC patients matching inclusion and exclusion criteria.The search deadline was March 1st,2021.Random/fixed effects models were utilized to calculate pooled hazard ratios(HRs)and 95% confidence intervals(95% CIs)estimates on overall survival(OS)according to stratified age(cut off age,65 years)and heterogeneity between the studies were considered.RESULTS A preliminary search identified 132 articles,18 of which were randomized controlled trials comparing nivolumab,avelumab,ipilimumab,pembrolizumab,atezolizumab vs chemotherapy,targeted therapy,and reported age-based hazard ratio(HR)for OS in this meta-analysis.HR for OS was 0.74(95%CI,0.68-0.81,P=0.014)in patients < 65 years vs 0.81(95%CI,0.76-0.87,P=0.479)in patients ≥65 years.There was no significant difference between the two groups.Subgroup analyses according to line of therapy,type of drugs,and study methodology.CONCLUSIONS ICIs therapy presents comparable efficacy in elderly advanced NSCLC patients with young patients.