Immune checkpoint inhibitor for different age patients with NSCLC in efficacy: a systematic review and Meta-analysis

Abstract

Objective This article is a Meta-analysis aiming to systematically evaluate the difference in efficacy of immune checkpoint inhibitor in patients with non-small cell lung cancer (NSCLC) by age. Methods We performed a Meta-analysis of published randomized controlled trials concerning for patients with NSCLC by age. We compared overall survival among three groups (age < 65 years, age ≥ 65 years, age ≥ 75 years). Hazard ratios (HRs) and 95% confidence intervals (CIs) were collected and pooled. Results A total of 10,291 patients from 17 RCTs were included. In the group under age 65 years, immune checkpoint inhibitor can significantly prolong the overall survival of patients with NSCLC (HR = 0.73, 95% CI: 0.66∼0.81, P < 0.00001). Meanwhile, it can extend the overall survival of patients with NSCLC (HR = 0.78, 95% CI:0.71∼0.84, P < 0.00001) in the group older than 65 years. However, it has no significant effect on the overall survival of NSCLC patients (HR = 0.88, 95% CI:0.72∼1.08, P > 0.05) in the group older than 75 years. Conclusions According to the Meta-analysis, immune checkpoint inhibitor can prolong the overall survival of patients with NSCLC between the two groups(age < 65 years and age ≥ 65 years). However, it has no significant effect on the overall survival in the group older than 75 years, which may be related to the poor physique of elderly patients and impacted by other diseases.