Takigawa Nagio, Ochi Nobuaki, Nakagawa Nozomu, Nagasaki Yasunari, Taoka Masataka, Ichiyama Naruhiko, Mimura Ayaka, Nakanishi Hidekazu, Kohara Hiroyuki, Yamane Hiromichi
General Internal Medicine 4, Kawasaki Medical School, Okayama 700-8505, Japan.
Cancers (Basel). 2020 Jul 21;12(7):1995. doi: 10.3390/cancers12071995.
Lung cancer patients ≥75 years represent nearly 40% of all lung cancer patients and continue to increase. If elderly patients have a good performance status and adequate organ function, they can be treated the same as non-elderly patients. However, few comparative studies limited to elderly patients (≥75 years) have been conducted. We review the evidence on using immune check inhibitors for the treatment of elderly patients (≥75 years old) with advanced non-small cell lung cancer. Prospective randomized or non-randomized, retrospective, registrational, insurance-based, and community-based studies have shown that elderly (≥75 years) and non-elderly patients are similarly treated with immune check inhibitors effectively and safely. However, such analyses have not shown that immune check inhibitors are significantly more effective than chemotherapy alone. In addition, patient selection might be critically performed to administer immune check inhibitors in the elderly because they are more likely to have a poor performance status with comorbidities, which lead to little benefit, even in non-elderly patients. There is a need for more evidence showing the benefit of immune check inhibitors in non-small cell lung cancer patients ≥75 years.
75岁及以上的肺癌患者占所有肺癌患者的近40%，且这一比例还在持续上升。如果老年患者身体状况良好且器官功能正常，他们可以接受与非老年患者相同的治疗。然而，针对老年患者（≥75岁）的比较研究却很少。我们回顾了关于使用免疫检查点抑制剂治疗老年（≥75岁）晚期非小细胞肺癌患者的证据。前瞻性随机或非随机、回顾性、注册登记、基于保险以及基于社区的研究表明，老年（≥75岁）和非老年患者使用免疫检查点抑制剂进行治疗的效果和安全性相似。然而，这些分析并未表明免疫检查点抑制剂比单纯化疗显著更有效。此外，在老年患者中使用免疫检查点抑制剂时，患者选择可能至关重要，因为他们更有可能因合并症而身体状况不佳，即使在非老年患者中，这也会导致获益甚微。需要更多证据来证明免疫检查点抑制剂对75岁及以上非小细胞肺癌患者的益处。
