为了对老年韩国退伍军人IV期非小细胞肺癌患者的免疫检查点抑制剂（ICI）的使用和治疗结果进行全面分析。本研究纳入了2016年至2021年间诊断为IV期非小细胞肺癌的患者，并根据接受的ICI类型分为三个队列。然后，比较了临床特征和生存结果。在本研究中，纳入了180名非小细胞肺癌患者（中位年龄76岁），其中49例（27.7%），61例（33.9%），70例（38.9%）分别接受了pembrolizumab、nivolumab和atezolizumab，19.4%，36.1%和34.4%的患者表达PD-L1的百分比分别小于1%、1-49%和≥50%。相比之下，pembrolizumab、nivolumab和atezolizumab组的客观缓解率（ORR）和疾病控制率（DCR）分别为22.4%、8.2%和4.3%（p = 0.004），59.2%、55.7%和30.0%（p = 0.001）。然而，各组之间的总生存率（OS）没有显著差异（12.6个月vs. 8.4个月vs. 7.7个月，p = 0.334）。同样，针对肿瘤PD-L1表达状态，治疗特异性OS收益也没有显著差异。有趣的是，多变量分析确定骨转移是OS的显著不良预后因素（HR = 2.75 [95% CI, 1.31-5.76]，p = 0.007）。与atezolizumab相比，pembrolizumab和nivolumab与ORR和DCR的增加更为明显，但在OS方面没有统计学上显著的差异。

To provide a comprehensive analysis of ICI usage and treatment outcomes in elderly Korean veterans with stage IV NSCLC.Patients diagnosed with stage IV NSCLC between 2016 and 2021 were included, and three cohorts were derived according to the type of ICI received. Thereafter, the clinical characteristics and survival outcomes were compared.Of the 180 patients with NSCLC (median age, 76 years) included in this study, 49 (27.7%), 61 (33.9%), and 70 (38.9%) received pembrolizumab, nivolumab, and atezolizumab, respectively, and 19.4%, 36.1%, and 34.4% had PD-L1 expressions < 1%, 1-49%, and ≥50%, respectively. The pembrolizumab, nivolumab, and atezolizumab groups, the objective response rates (ORR), and the disease control rates (DCR) were 22.4%, 8.2%, and 4.3% (p = 0.004), and 59.2, 55.7%, and 30.0% (p = 0.001), respectively. However, no difference in the overall survival (OS) rate was noted among the groups (12.6 months vs. 8.4 months vs. 7.7 months, p = 0.334). Similarly, there was no treatment specific OS benefit with respect to the tumor PD-L1 expression status. Interestingly, multivariate analysis identified bone metastasis as a significant poor prognostic factor for OS (HR = 2.75 [95% CI, 1.31-5.76], p = 0.007).Pembrolizumab and nivolumab showed stronger associations with increases in ORR and DCR than atezolizumab, but no statistically significant differences were observed with respect to OS.