Current Status and Prospect of PD-1/PD-L1 Immune Checkpoint Inhibitor Therapy in Elderly Patients with Advanced NSCLC
10.3779/j.issn.1009-3419.2024.106.10
- VernacularTitle:老年晚期NSCLC患者PD-1/PD-L1免疫检查点抑制剂治疗现状及展望
- Author:
MAO YUNYE
1
,
2
;
SHENG SHU
;
WANG AN
;
ZHAI JINZHAO
;
GE XIANGWEI
;
LU DI
;
WANG JINLIANG
Author Information
1. 100071 北京,解放军总医院第五医学中心肿瘤医学部肿瘤内科
2. 100853 北京,解放军医学院
- Keywords:
Lung neoplasms;
Elderly non-small cell lung cancer;
Immunosenescence;
Immunotherapy;
Immuno-therapy combined with low-intensity chemotherapy
- From:
Chinese Journal of Lung Cancer
2024;27(5):367-375
- CountryChina
- Language:Chinese
-
Abstract:
The incidence of cancer is closely correlated with age,as 75％of non-small cell lung cancer(NSCLC)patients are aged at least 65 years.The availability of immune checkpoint inhibitors(ICIs)has altered the available NSCLC therapeutic pattern.Limited studies on elderly patients have demonstrated that ICIs as monotherapy provide substantial ben-efits for patients aged 65-75 years,showing no significant difference compared to younger patients.This benefit is also observed in combination with immune-combined chemotherapy or radiotherapy.For individuals older than 75 years,the survival effect was not evident,though.Immune-related adverse events(irAEs)with ICIs alone were similar in incidence across age catego-ries.Immune-combination chemotherapy resulted in a higher incidence of irAEs than chemotherapy alone,and patients ≥75 years of age were more likely to experience higher-grade irAEs.Besides the fact that immunosenescence in older patients influ-ences the immune milieu in a multifaceted manner,which in turn impacts the effectiveness of immunotherapy,the prognosis is also influenced by the Eastern Cooperative Oncology Group performance status(ECOG PS)score,among other factors.For certain individuals aged ≥75 years or in poor physical health,immunotherapy combined with low-intensity chemotherapy has emerged as a viable treatment option.However,there are fewer related studies,so there should be a conscious effort to increase the number of elderly patients enrolled in the trial and a comprehensive assessment to explore individualized treatment op-tions.To provide additional references and guidance for immunotherapy in elderly NSCLC patients and to propose new thera-peutic perspectives in combination with their characteristics,this review aims to summarize and analyze the pertinent studies on the application of programmed cell death protein 1(PD-1)/programmed cell death ligand 1(PD-L1)inhibitors in these patients.
