Isik Deniz, Alan Özkan, Akdağ Goncagül, Yildirim Sedat, Kınıkoğlu Oğuzcan, Altintas Yunus Emre, Turkoglu Ezgi, Surmeli Heves, Basoglu Tugba, Sever Ozlem Nuray, Odabas Hatice, Yildirim Mahmut Emre, Turan Nedim
Department of Medical Oncology, Health Science University, Kartal Dr. Lütfi Kirdar City Hospital, Istanbul 34865, Türkiye.
Division of Medical Oncology, School of Medicine, Koç University, Istanbul 34450, Türkiye.
J Clin Med. 2024 Oct 20;13(20):6263. doi: 10.3390/jcm13206263.
Lung cancer remains the leading cause of cancer-related mortality globally, predominantly affecting older individuals. Despite the increasing use of immune checkpoint inhibitors (ICIs) like nivolumab in non-small cell lung cancer (NSCLC), the efficacy and safety in elderly patients, particularly those aged 65 and above, remain underexplored due to their underrepresentation in clinical trials. This retrospective study analyzed data from 60 elderly patients (≥65 years) with metastatic NSCLC who received nivolumab as second-line or later therapy between January 2020 and May 2023. The median age was 67 years, with a predominance of males (78%). Nivolumab was administered for a median of 8 cycles, with 33.3% of patients receiving 15 or more cycles. The median OS was 23 months, and the 1-, 3-, and 5-year survival rates were 93.3, 54.1, and 18.6%, respectively. Multivariate analysis identified adenocarcinoma histology, fewer than 15 cycles of nivolumab, and non-response to prior therapies as independent predictors of poor OS. Nivolumab treatment was generally well-tolerated, with 45% of patients experiencing at least grade 1 toxicity. Nivolumab is effective and well-tolerated in elderly patients with metastatic NSCLC, providing survival benefits comparable to those observed in younger populations. The number of treatment cycles and initial response to therapy are key determinants of survival, underscoring the importance of continued treatment in this age group.
肺癌仍然是全球癌症相关死亡的主要原因，主要影响老年人。尽管免疫检查点抑制剂（ICI）如纳武利尤单抗在非小细胞肺癌（NSCLC）中的使用越来越多，但老年患者，尤其是65岁及以上患者的疗效和安全性，由于他们在临床试验中的代表性不足，仍未得到充分研究。这项回顾性研究分析了2020年1月至2023年5月期间接受纳武利尤单抗作为二线或后续治疗的60例老年（≥65岁）转移性NSCLC患者的数据。中位年龄为67岁，男性占主导（78%）。纳武利尤单抗的中位给药周期为8个周期，33.3%的患者接受了15个或更多周期的治疗。中位总生存期为23个月，1年、3年和5年生存率分别为93.3%、54.1%和18.6%。多变量分析确定腺癌组织学、纳武利尤单抗治疗周期少于15个以及对先前治疗无反应是总生存期较差的独立预测因素。纳武利尤单抗治疗总体耐受性良好，45%的患者经历了至少1级毒性。纳武利尤单抗在老年转移性NSCLC患者中有效且耐受性良好，提供了与年轻人群相当的生存益处。治疗周期数和对治疗的初始反应是生存的关键决定因素，突出了该年龄组持续治疗的重要性。
