Efficacy and Side Effects of Single Agent Immunotherapy for Non-Small Cell Lung Cancer in Older and Younger Patients: A Systematic Review and Meta-Analysis

Abstract

Lung cancer is a leading cause of cancer related death and more common in older people. Immunotherapy has improved efficacy compared to chemotherapy in non-small cell lung cancer (NSCLC). We aimed to review existing data on efficacy and adverse events (AEs) of single agent immunotherapy for NSCLC by age. We reported OS, progression-free survival (PFS) and AEs by age. Suitable results were meta-analysed using the random effects model. 1803 papers were screened, ten eligible papers identified, seven included in meta-analyses. Included individual papers did not demonstrate a difference in OS, PFS or AEs. Meta-analyses showed no significant difference in OS (HR: 1.03, 95% CI 0.92-1.15; p=0.58), PFS (HR 0.96, 95% CI: 0.92-1.01; p=0.15) or AEs (HR:1.01 95% CI:0.83-1.23; p=0.91) in older vs younger patients. Existing data on differences in efficacy and AEs of immunotherapy by age is largely observational and points to similar efficacy and adverse events by age.