一线检查点抑制剂免疫治疗和化疗治疗的晚期非小细胞肺癌患者中年龄的预后影响。

Prognostic impact of age in advanced non-small cell lung cancer patients undergoing first-line checkpoint inhibitor immunotherapy and chemotherapy treatment.

机构信息

Medical Oncology of Respiratory, Guangxi Medical University Cancer Hospital, Nanning, Guangxi 530021, China.

出版信息

Int Immunopharmacol. 2024 May 10;132:111901. doi: 10.1016/j.intimp.2024.111901. Epub 2024 Mar 29.

DOI:10.1016/j.intimp.2024.111901

PMID:38554448

Abstract

BACKGROUND

Research on the association between age and clinical outcome in patients with non-small cell lung cancer (NSCLC) treated with immunotherapy combined with chemotherapy as first-line setting is limited. The aim of study is to determine the influence of age on the progress-free survival (PFS) and overall survival (OS) in those patients after adjusting for potential confounders.

METHODS

A total of 207 advanced NSCLC patients treated with immunotherapy combined with chemotherapy in the first-line treatment in Guangxi Medical University Cancer Hospital from March 10, 2019, to December 31, 2022, was retrospectively analyzed. χ2 (categorical variables) was used to analyze the differences among the different age groups. Cox regression and Kaplan-Meier analyses were used to assess the association between age and clinical outcomes. P values < 0.05 (two-sided) were considered statistically significant.

RESULTS

The mean age of the cohort was 58.8 ± 10.3 years. The percentages of patients < 65, 65-69, 70-74, and ≥ 75 years were 66.7 %, 19.3 %, 9.2 % and 4.8 %, respectively. Compared to the aged < 65 years group, the HR for the risk of disease progression for each group are 0.67 (95 %CI = 0.40-1.12, P = 0.125), 0.66 (95 %CI = 0.31, 1.43, P = 0.298), and 2.27 (95 %CI = 0.80, 6.45, P = 0.124), respectively, with no significant differences in the results. And the HR for risk of death for the 65-69 years and 70-74 years groups was 1.16 (95 %CI = 0.64-2.08, P = 0.628) and 0.93 (95 %CI = 0.39-2.23, P = 0.879), respectively. The difference has no statistical significance. Whereas in patients aged ≥ 75, there is an increased risk of death after adjusted confounders with HR = 4.83 (95 %CI = 2.06-11.35). The difference was statistically significant (P < 0.001). Trend test indicates that with advancing age, the patient's risk of death increases (HR = 1.33, 95 % CI = 1.02-1.75, P = 0.034).

CONCLUSION

Age may not be the primary factor influencing the efficacy of immunotherapy combined with chemotherapy, but particular attention should be given to the elderly population.

摘要

背景

针对接受免疫治疗联合化疗作为一线治疗的非小细胞肺癌（NSCLC）患者，年龄与临床结局之间的关系研究有限。本研究旨在确定在调整潜在混杂因素后，年龄对这些患者无进展生存期（PFS）和总生存期（OS）的影响。

方法

回顾性分析 2019 年 3 月 10 日至 2022 年 12 月 31 日在广西医科大学附属肿瘤医院接受免疫治疗联合化疗一线治疗的 207 例晚期 NSCLC 患者。使用卡方检验（分类变量）分析不同年龄组之间的差异。Cox 回归和 Kaplan-Meier 分析用于评估年龄与临床结局之间的关系。P 值<0.05（双侧）被认为具有统计学意义。

结果

该队列的平均年龄为 58.8±10.3 岁。年龄<65 岁、65-69 岁、70-74 岁和≥75 岁的患者比例分别为 66.7%、19.3%、9.2%和 4.8%。与年龄<65 岁组相比，每个年龄组疾病进展风险的 HR 分别为 0.67（95%CI=0.40，1.12，P=0.125）、0.66（95%CI=0.31，1.43，P=0.298）和 2.27（95%CI=0.80，6.45，P=0.124），结果无显著差异。65-69 岁和 70-74 岁组死亡风险的 HR 分别为 1.16（95%CI=0.64，2.08，P=0.628）和 0.93（95%CI=0.39，2.23，P=0.879），差异无统计学意义。而在年龄≥75 岁的患者中，调整混杂因素后死亡风险增加，HR=4.83（95%CI=2.06-11.35）。差异具有统计学意义（P<0.001）。趋势检验表明，随着年龄的增长，患者死亡风险增加（HR=1.33，95%CI=1.02-1.75，P=0.034）。