1489P - To investigate the differences in efficacy between immunotherapy and combined immunotherapy in elderly patients with non-small cell lung cancer

Background

Lung cancer is the leading cause of cancer death worldwide. In recent years, the therapeutic landscape for advanced non-small cell lung cancer (NSCLC) has changed with the rise of targeted therapies and immunotherapy. Elderly patients represent approximately half of the patient population, but studies on the treatment of elderly patients are limited.

Methods

A retrospective collection of 244 patients with pathologically confirmed NSCLC at APL General Hospital's First Medical Center and Fifth Medical Center, including 69 patients treated with immune monotherapy and 175 patients treated with combined immunotherapy. Cox regression analyses were used to assess whether there were differences in efficacy between immune monotherapy and combined immunotherapy.

Results

A total of 244 elderly patients were included in the study, and the analysis found that combined immunotherapy has a longer median OS. Patients with distant lung cancer metastases (HR 1.633, 95% CI 1.133-2.354), using immunotherapy as a second-line treatment (HR 1.717, 95% CI 1.238-2.380), and with pleural effusion (HR 1.772, 95% CI 1.246-2.522) had a shorter OS, whereas the patients treated with the combined immune therapy had a longer OS (HR 0.538, 95% CI 0.387-0.748). For patients aged 60-65 years with pleural effusion and second-line use of immunotherapy shortened OS. OS was shorter in patients aged 65-75 years with brain metastases and longer in patients receiving the combined immunotherapy. Multivariate analysis showed that BMI >24.8 and the use of combined immunotherapy were protective factors for OS and that the presence of pleural effusion was a risk factor. For patients aged 60 to 65 and 65 to 75, the presence of pleural effusion was a risk factor. Among patients >75 years, we only found a longer OS in patients with BMI >24.8(P=0.023).

Conclusions

For older patients with advanced NSCLC, the survival benefit of using combined immunotherapy is higher than that of immune monotherapy. However, that there was no difference in the efficacy of immune monotherapy or combined immunotherapy in this group (P =0.762), but patients with a BMI >24.8 had a longer OS.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Yunye Mao.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.