Abstract：
OBJECTIVE: The reported impact of age on the effectiveness of emerging immunotherapies in patients with advanced non-small cell lung cancer (NSCLC) has been inconsistent in clinical trials, largely due to an underrepresentation of older individuals. This meta-analysis aimed to evaluate the efficacy of immune checkpoint inhibitor (ICI) in older patients with NSCLC.
METHODS: The literature up to April 2024 was reviewed to identify articles meeting the criteria for inclusion. Hazard ratios (HRs) for overall survival (OS) across various age groups were examined. The ratio of HR (RHR) was computed and combined for each study.
RESULTS: A preliminary search identified 118 articles, with 13 being phase II or III randomized clinical trials comparing the efficacy of nivolumab, avelumab, ipilimumab, pembrolizumab, atezolizumab, and chemotherapy with or without antiangiogenic therapy. The analysis revealed that the HR for OS was 0.75 (95 % CI: 0.70-0.80, P=0.080) in patients aged under 75 years and 0.87 (95 % CI: 0.74-1.01, P=0.913) in patients aged 75 years and older. The combined RHR for patients aged 75 years and above versus those aged under 75 years was 1.14 (95 % CI: 0.97-1.34, P=0.697). There was no significant difference in OS benefit between patients over 75 years and younger patients (P=0.105). Subgroup analyses indicated that the benefit of OS was consistent across all subgroups and age groups.
CONCLUSIONS: Our investigation found no significant differences in the efficacy of immunotherapy for patients with NSCLC aged 75 years and older compared to those under 75 years old. This suggests that the efficacy of immunotherapy against NSCLC is consistent across age groups.
METHODS: The literature up to April 2024 was reviewed to identify articles meeting the criteria for inclusion. Hazard ratios (HRs) for overall survival (OS) across various age groups were examined. The ratio of HR (RHR) was computed and combined for each study.
RESULTS: A preliminary search identified 118 articles, with 13 being phase II or III randomized clinical trials comparing the efficacy of nivolumab, avelumab, ipilimumab, pembrolizumab, atezolizumab, and chemotherapy with or without antiangiogenic therapy. The analysis revealed that the HR for OS was 0.75 (95 % CI: 0.70-0.80, P=0.080) in patients aged under 75 years and 0.87 (95 % CI: 0.74-1.01, P=0.913) in patients aged 75 years and older. The combined RHR for patients aged 75 years and above versus those aged under 75 years was 1.14 (95 % CI: 0.97-1.34, P=0.697). There was no significant difference in OS benefit between patients over 75 years and younger patients (P=0.105). Subgroup analyses indicated that the benefit of OS was consistent across all subgroups and age groups.
CONCLUSIONS: Our investigation found no significant differences in the efficacy of immunotherapy for patients with NSCLC aged 75 years and older compared to those under 75 years old. This suggests that the efficacy of immunotherapy against NSCLC is consistent across age groups.
摘要：
目的：据报道，年龄对晚期非小细胞肺癌（NSCLC）患者新兴免疫疗法有效性的影响在临床试验中一直不一致，主要是由于老年人的代表性不足。这项荟萃分析旨在评估免疫检查点抑制剂（ICI）在老年NSCLC患者中的疗效。
方法：回顾了截至2024年4月的文献，以确定符合入选标准的文章。检查了各个年龄组的总生存期（OS）的危险比（HR）。计算每个研究的HR比率(RHR)并组合。
结果：初步搜索确定了118篇文章，其中13项是比较纳武单抗疗效的II期或III期随机临床试验，阿维鲁单抗,ipilimumab,pembrolizumab,阿替珠单抗,以及有或没有抗血管生成疗法的化疗。分析显示，75岁以下患者的OSHR为0.75（95％CI：0.70-0.80，P=0.080），75岁以上患者为0.87（95％CI：0.74-1.01，P=0.913）。75岁及以上患者与75岁以下患者的综合RHR为1.14（95％CI：0.97-1.34，P=0.697）。75岁以上患者和年轻患者的OS获益无显著差异(P=0.105)。亚组分析表明，OS的益处在所有亚组和年龄组中是一致的。
结论：我们的调查发现，与75岁以下的患者相比，75岁及以上的NSCLC患者的免疫治疗疗效没有显着差异。这表明针对NSCLC的免疫疗法的功效在各年龄组中是一致的。
方法：回顾了截至2024年4月的文献，以确定符合入选标准的文章。检查了各个年龄组的总生存期（OS）的危险比（HR）。计算每个研究的HR比率(RHR)并组合。
结果：初步搜索确定了118篇文章，其中13项是比较纳武单抗疗效的II期或III期随机临床试验，阿维鲁单抗,ipilimumab,pembrolizumab,阿替珠单抗,以及有或没有抗血管生成疗法的化疗。分析显示，75岁以下患者的OSHR为0.75（95％CI：0.70-0.80，P=0.080），75岁以上患者为0.87（95％CI：0.74-1.01，P=0.913）。75岁及以上患者与75岁以下患者的综合RHR为1.14（95％CI：0.97-1.34，P=0.697）。75岁以上患者和年轻患者的OS获益无显著差异(P=0.105)。亚组分析表明，OS的益处在所有亚组和年龄组中是一致的。
结论：我们的调查发现，与75岁以下的患者相比，75岁及以上的NSCLC患者的免疫治疗疗效没有显着差异。这表明针对NSCLC的免疫疗法的功效在各年龄组中是一致的。
