Efficacy of PD-1 Inhibitors in Older Non-small Cell Lung Cancer Patients

Background/Aim: We assessed the efficacy of immune checkpoint inhibitors (ICIs) in older patients because of the limited information regarding these patients. Patients and Methods: We retrospectively analyzed 66 consecutive patients ≥70 years old with advanced non-small cell lung cancer (NSCLC). A total of 31 patients received ICIs (ICIs group) and 35 patients received only cytotoxic regimens (No ICIs group). Results: Patients with squamous cell carcinoma who received ICIs had better overall survival (OS) than those who did not (9.7 versus 4.7 months, p=0.027). In multivariate analysis, treatment with ICIs [hazard ratio (HR)=0.54, 95% confidence interval (CI)=0.30-0.98, p=0.044], good performance status (HR=0.30, 95%CI=0.16-0.57, p=0.0003), and histology other than squamous cell carcinoma (HR=0.41, 95%CI=0.19-0.83, p=0.014) were significantly favorable factors for OS. Conclusion: ICIs may be effective for older patients with NSCLC, especially squamous cell carcinoma patients.

[1]  L. Einhorn,et al.  Safety, Efficacy, and Patient-reported Health-related Quality of Life and Symptom Burden with Nivolumab in Patients with Advanced Non-Small Cell Lung Cancer, Including Patients Aged ≥70 Years or with Poor Performance Status (CheckMate 153). , 2019, Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer.

[2]  F. Cappuzzo,et al.  Use of nivolumab in elderly patients with advanced squamous non-small-cell lung cancer: results from the Italian cohort of an expanded access programme. , 2018, European journal of cancer.

[3]  A. Abernethy,et al.  Characteristics of Real-World Metastatic Non-Small Cell Lung Cancer Patients Treated with Nivolumab and Pembrolizumab During the Year Following Approval. , 2018, The oncologist.

[4]  Hui Shi,et al.  The effectiveness of PD-1 inhibitors in non-small cell lung cancer (NSCLC) patients of different ages , 2017, Oncotarget.

[5]  Y. Shentu,et al.  Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial , 2016, The Lancet.

[6]  A. Jemal,et al.  Lung Cancer Statistics. , 2016, Advances in experimental medicine and biology.

[7]  C. Rudin,et al.  Nivolumab versus Docetaxel in Advanced Nonsquamous Non-Small-Cell Lung Cancer. , 2015, The New England journal of medicine.

[8]  L. Crinò,et al.  Nivolumab versus Docetaxel in Advanced Squamous-Cell Non-Small-Cell Lung Cancer. , 2015, The New England journal of medicine.

[9]  Wen-feng Zhang,et al.  Differences in TCR-Vβ Repertoire and Effector Phenotype between Tumor Infiltrating Lymphocytes and Peripheral Blood Lymphocytes Increase with Age , 2014, PloS one.

[10]  D. Farber,et al.  Human memory T cells: generation, compartmentalization and homeostasis , 2013, Nature Reviews Immunology.