The effectiveness of PD-1 inhibitors in non-small cell lung cancer (NSCLC) patients of different ages

Oncotarget
Yingcheng WuHui Shi

Abstract

Immunosenescence, the age-related decline of immunity, affects the immune responses of non-small cell lung cancer (NSCLC) patients. Through immune responses, programmed death-1 (PD-1) inhibitors exert their antitumor robustness. In different ages of NSCLC patients, especially the older patients, the effectiveness of PD-1 inhibitors remains unclear. It is still controversial whether pembrolizumab or nivolumab should be used in treating NSCLC patients. 2,192 NSCLC patients from four phase III RCTs were included. PD-1 inhibitors significantly prolonged the OS in both younger group (<65-year-age) (HR: 0.64, 95% CI: 0.54-0.75,P= 0.000) and older group (≥65-year-age) (HR: 0.68, 95% CI: 0.54-0.81,P= 0.001) than chemotherapy. Among patients aged over 75, no significantly longer OS was observed (HR: 1.02, 95% CI: 0.35-1.69,P= 0.971) than controls. In the older group (≥65-year-age), HR of OS favors nivolumab rather than pembrolizumab. Among patients aged over 75, no significantly prolonged overall survival was observed compared with chemotherapy. In comparison with pembrolizumab, nivolumab was associated with better OS in older NSCLC patients (≥65-year-age), and better PFS in all NSCLC patients. Older patients, especially those aged over...Continue Reading

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