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Background <p>Non-small cell lung cancer (NSCLC) is prevalent and often diagnosed at advanced stages. Immune checkpoint inhibitors targeting PD-1/PD-L1 pathways have transformed treatment, yet elderly patients remain underrepresented in clinical trials.</p> Methods <p>We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) comparing PD-1/PD-L1 inhibitors with placebo and/or chemotherapy in elderly patients with NSCLC. Overall survival (OS), Event-Free Survival (EFS) and OS for large studies were evaluated. Random-effects model with 95% confidence intervals were applied.</p> Results <p>Twelve RCTs with 3078 patients were included. PD-1/PD-L1 inhibitors significantly improved OS (HR 0.76; 95% CI 0.69–0.84; <i>p</i> &lt; 0.001) and EFS (HR 0.67; 95% CI 0.54–0.83; <i>p</i> &lt; 0.001). Large studies showed consistent benefit.</p> Conclusions <p>PD-1/PD-L1 inhibitors significantly improve clinical outcomes in elderly NSCLC patients compared to standard treatments.</p>

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Use of PD-1/PD-L1 inhibitors in non-small cell lung cancer in elderly patients: a meta-analysis and systematic review of randomized clinical trials

  • 期刊论文

  • 发表日期：

    2025年8月8日

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  • Ana Paula Bedin,
  • Gabriela de Castro Neves Carmo Maffezolli,
  • Luis Henrique Rios Moreira Rego,
  • Maria Isadora Rodrigues Carlos,
  • Pedro Henrique Albuquerque da Silva,
  • Francisco Cezar Aquino de Moraes

摘要

Background

Non-small cell lung cancer (NSCLC) is prevalent and often diagnosed at advanced stages. Immune checkpoint inhibitors targeting PD-1/PD-L1 pathways have transformed treatment, yet elderly patients remain underrepresented in clinical trials.

Methods

We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) comparing PD-1/PD-L1 inhibitors with placebo and/or chemotherapy in elderly patients with NSCLC. Overall survival (OS), Event-Free Survival (EFS) and OS for large studies were evaluated. Random-effects model with 95% confidence intervals were applied.

Results

Twelve RCTs with 3078 patients were included. PD-1/PD-L1 inhibitors significantly improved OS (HR 0.76; 95% CI 0.69–0.84; p < 0.001) and EFS (HR 0.67; 95% CI 0.54–0.83; p < 0.001). Large studies showed consistent benefit.

Conclusions

PD-1/PD-L1 inhibitors significantly improve clinical outcomes in elderly NSCLC patients compared to standard treatments.