Age-related efficacy of immunotherapies in advanced non-small cell lung cancer: a comprehensive meta-analysis

IF 4.5 2区医学 Q1 ONCOLOGY

Lung Cancer Pub Date : 2024-08-08 DOI:10.1016/j.lungcan.2024.107925

Yao Ding , Shun Lei , Ling Wang , Long Tang , Yue Zhang , Yiran Liao , Xia Deng , Yan Li , Yi Gong , Yongsheng Li

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引用次数: 0

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.

Materials and 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.

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免疫疗法对晚期非小细胞肺癌的疗效与年龄有关：一项综合荟萃分析。

目的：在临床试验中，年龄对新出现的免疫疗法在晚期非小细胞肺癌（NSCLC）患者中疗效的影响报道并不一致，这主要是由于老年患者的代表性不足。这项荟萃分析旨在评估免疫检查点抑制剂（ICI）对老年非小细胞肺癌患者的疗效：对截至2024年4月的文献进行了审查，以确定符合纳入标准的文章。对不同年龄组总生存期（OS）的危险比（HRs）进行了研究。对每项研究的HR比值（RHR）进行计算和合并：初步检索发现了118篇文章，其中13篇为II期或III期随机临床试验，比较了nivolumab、avelumab、ipilimumab、pembrolizumab、atezolizumab和化疗加或不加抗血管生成疗法的疗效。分析显示，75 岁以下患者的 OS HR 为 0.75（95 % CI：0.70-0.80，P=0.080），75 岁及以上患者的 OS HR 为 0.87（95 % CI：0.74-1.01，P=0.913）。75 岁及以上与 75 岁以下患者的合并 RHR 为 1.14（95 % CI：0.97-1.34，P=0.697）。75岁以上患者与年轻患者的OS获益无明显差异（P=0.105）。亚组分析表明，在所有亚组和年龄组中，OS的获益是一致的：我们的调查发现，75岁及以上的NSCLC患者与75岁以下的患者相比，免疫疗法的疗效没有明显差异。这表明，免疫疗法对不同年龄组的 NSCLC 患者的疗效是一致的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lung Cancer 医学-呼吸系统

CiteScore

9.40

自引率

3.80%

发文量

407

审稿时长

25 days

期刊介绍： Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.