Meta-analysis Of Clinical Efficacy For PD-1/PD-L1 Inhibitors In Elderly Patients With Advanced Non-small Cell Lung Cancer

Objective:The aim of this study is to evaluate the effcacy of PD-1/PD-L1 inhibitors in the treatment of advanced non-small cell lung cancer patients of different age by meta-analysis,and provide the reference for clinical application.Methods:Retrieve Pubmed,EMBASE,Cochrane,CNKI and Wanfang Database by computer.The time range is set from the database establishment to February 28,2023.Documents screening based on preset inclusion and exclusion criteria and data extraction.Calculating the pooled HR and the 95% confidence interval of the OS or PFS by using fixed or random effect models.Results:Analyzed 19871 patients from 30 clinical RCTs,comprising 11174(56.2%)patients aged <65 years old and 8697(43.8%)patients aged ≥65 years old.The pooled HR and the 95% confidence interval of the OS in <65 years old group is 0.72(95%CI,0.68-0.75),in ≥65 years old group it is 0.77(95%CI,0.73-0.82);the pooled HR and the 95% confidence interval of the OS in <65 years old group is 0.58(95%CI,0.50-0.68),in ≥65 years old group it is0.64(95%CI,0.56-0.73).For PFS,the data of the PD-1/PD-L1+CT subgroup shows the pooled HR of the <65 years old group comparing to ≥65 years old group is 0.48(95%CI,0.43-0.54)vs.0.58(95%CI,0.51-0.65).Conclusions:For patients with advanced NSCLC,all patients of different age can get benefits from PD-1/PD-L1 inhibitors,but patients aged <65 years old may have improved OS and PFS benefits compared to patients aged ≥65 years old;in patients received PD-1/PD-L1inhibitors+CT treatment,patients aged <65 years old may have more PFS benefits compared to patients aged ≥65 years old.