AUTHOR=Sun You-Meng , Wang Ying , Sun Xin-Xing , Chen Jing , Gong Zhi-Ping , Meng Hai-Yan 

TITLE=Clinical Efficacy of Immune Checkpoint Inhibitors in Older Non-small-Cell Lung Cancer Patients: A Meta-Analysis

JOURNAL=Frontiers in Oncology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.558454

DOI=10.3389/fonc.2020.558454

ISSN=2234-943X

ABSTRACT=<p><bold>Background:</bold> Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape among non-small-cell lung cancer (NSCLC) patients. The efficacy of ICI therapy in older patients (≥65 years) is controversial and not fully clarified. We performed a systematic review and meta-analysis to evaluate the efficacy of ICIs in patients with advanced or metastatic NSCLC based on age (&lt;65 years vs. ≥65 years).</p><p><bold>Methods:</bold> A comprehensive literature search for eligible randomized control phase II/III trials that compared the efficacy of anti-PD-1/PD-L1 agents against chemotherapy in advanced or metastatic NSCLC patients. Pooled overall survival (OS) and progression-free survival (PFS) estimates were calculated based on random/fixed effects models according to the heterogeneity between the studies.</p><p><bold>Results:</bold> A total of 10 studies involving 8 randomized controlled trials (2 updates) were enrolled in this meta-analysis [2,662 young patients (&lt;65 years) and 1,971 older patients (≥65 years)]. The efficacy of anti-PD-1/PD-L1 agents is comparable between young (&lt;65 years) and older (≥65 years) patients for OS [HR 0.75 95% CI (0.64–0.88) vs. 0.76 95% CI (0.66–0.87)]. However, our pooled analysis was not sufficient to show a significant benefit in terms of PFS for anti-PD-1/PD-L1 agents [HR 0.87 95% CI (0.74–1.01), <italic>P</italic> = 0.06]. In addition, we failed to see a PFS superiority of anti-PD-1/PD-L1 agents against chemotherapy in two age subgroups [&lt;65 years and ≥65 years, HR 0.85 95% CI (0.72–1.01), <italic>P</italic> = 0.07 and HR 0.87 95% CI (0.68–1.10), <italic>P</italic> = 0.25].</p><p><bold>Conclusion:</bold> ICIs therapy presents comparable efficacy in older advanced or metastatic NSCLC patients with young patients.</p>