Xie Rui-Ling, Cai Wu-Lin, Ouyang Yan-Feng, Zou Ye-Hao, Sun Rui
Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, China.
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
BMC Cancer. 2025 Apr 14;25(1):691. doi: 10.1186/s12885-025-14108-w.
The use of immune checkpoint inhibitors (ICIs) combined with chemotherapy constitutes the first-line treatment for recurrent or metastatic nasopharyngeal carcinoma (RM-NPC). However, elderly patients are underrepresented in the majority of related clinical trials.
This retrospective study included RM-NPC patients aged 65 years or older who received immunotherapy between January 2015 and February 2022. Cox regression models were utilized to compare the outcomes. Comorbidity assessments (ACE-27, CCI, and ACCI) were used for the geriatric evaluation.
Among the 95 of 243 patients included in this analysis (71 men), the median follow-up time was 29.3 months. Patients receiving local therapy had longer progression-free survival (PFS) (HR 0.352; 95% CI: 0.145-0.853; p = .021). No significant differences in survival outcomes or toxicity profiles were observed between age groups or among the ICI agent groups.
The findings suggest that immunotherapy is efficacious and safe for treating RM-NPC in elderly patients. The combination of ICIs and local therapy significantly prolonged survival and could be an option for this vulnerable population.
免疫检查点抑制剂（ICI）联合化疗是复发性或转移性鼻咽癌（RM-NPC）的一线治疗方法。然而，在大多数相关临床试验中，老年患者的代表性不足。
这项回顾性研究纳入了2015年1月至2022年2月期间接受免疫治疗的65岁及以上的RM-NPC患者。采用Cox回归模型比较治疗结果。使用合并症评估（ACE-27、CCI和ACCI）进行老年评估。
在纳入本分析的243例患者中的95例（71例男性）中，中位随访时间为29.3个月。接受局部治疗的患者无进展生存期（PFS）更长（HR 0.352；95%CI：0.145-0.853；p = 0.021）。在年龄组之间或ICI药物组之间，未观察到生存结果或毒性特征的显著差异。
研究结果表明，免疫治疗对老年RM-NPC患者有效且安全。ICI与局部治疗相结合可显著延长生存期，可能是这类弱势群体的一种治疗选择。
