Department of Medicine, Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Department of Medicine, Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts.
J Thorac Oncol. 2019 Mar;14(3):547-552. doi: 10.1016/j.jtho.2018.11.011. Epub 2018 Nov 23.
Immunotherapy has revolutionized the treatment of NSCLC, but little is known about the activity of programmed cell death 1 and programmed death ligand 1 blockade across age groups.
We retrospectively evaluated patients with NSCLC who initiated programmed cell death 1 and programmed death ligand 1 inhibitors from January 2013 through July 2017. Medical records and radiographic imaging were reviewed to determine progression-free survival (PFS) and overall survival (OS). We also compared immunotherapy-related toxicities, steroid use, and hospitalizations by age.
Of the 245 patients, 26.1% were younger than 60 years, 31.4% were age 60 to 69 years, 31.0% were age 70 to 79 years, and 11.4% were age 80 years or older. The median PFS times by age group were as follows: younger than 60 years, 1.81 months; age 60 to 69 years, 2.53 months; age 70 to 79 years, 3.75 months; and age 80 years or older, 1.64 months (log-rank p value = 0.055). The median OS times by age group were as follows: younger than 60 years, 13.01 months; age 60 to 69 years, 14.56 months; age 70 to 79 years, 12.92 months; and age 80 years or older, 3.62 months (log-rank p value = 0.011). Rates of immunotherapy-related toxicities, steroid use, and hospitalizations did not differ by age.
Although the OS and PFS benefits of immunotherapy differ by age, the rates of toxicity are similar regardless of age.
免疫疗法已经彻底改变了 NSCLC 的治疗方法，但对于不同年龄组中程序性细胞死亡 1 和程序性死亡配体 1 阻断的活性知之甚少。
我们回顾性评估了 2013 年 1 月至 2017 年 7 月期间开始接受程序性细胞死亡 1 和程序性死亡配体 1 抑制剂治疗的 NSCLC 患者。通过回顾病历和影像学检查来确定无进展生存期（PFS）和总生存期（OS）。我们还比较了不同年龄组的免疫治疗相关毒性、类固醇使用和住院情况。
在 245 名患者中，26.1%的年龄小于 60 岁，31.4%的年龄为 60 至 69 岁，31.0%的年龄为 70 至 79 岁，11.4%的年龄为 80 岁或以上。按年龄分组的中位 PFS 时间如下：年龄小于 60 岁为 1.81 个月；年龄 60 至 69 岁为 2.53 个月；年龄 70 至 79 岁为 3.75 个月；年龄 80 岁或以上为 1.64 个月（对数秩检验 p 值=0.055）。按年龄分组的中位 OS 时间如下：年龄小于 60 岁为 13.01 个月；年龄 60 至 69 岁为 14.56 个月；年龄 70 至 79 岁为 12.92 个月；年龄 80 岁或以上为 3.62 个月（对数秩检验 p 值=0.011）。免疫治疗相关毒性、类固醇使用和住院率不因年龄而异。
尽管免疫疗法的 OS 和 PFS 获益因年龄而异，但毒性发生率与年龄无关。
