据报道，年龄对晚期非小细胞肺癌（NSCLC）患者新兴免疫疗法有效性的影响在临床试验中并不一致，这主要是由于老年个体代表性不足。这项荟萃分析旨在评估免疫检查点抑制剂 (ICI) 对老年 NSCLC 患者的疗效。对截至 2024 年 4 月的文献进行了回顾，以找出符合纳入标准的文章。检查了不同年龄组的总生存率（OS）的风险比（HR）。计算并合并每项研究的 HR (RHR) 比率。初步检索确定了 118 篇文章，其中 13 篇是 II 期或 III 期随机临床试验，比较 nivolumab、avelumab、ipilimumab、pembrolizumab、atezolizumab 和化疗与或无需抗血管生成治疗。分析显示，75 岁以下患者的 OS HR 为 0.75（95% CI：0.70-0.80，P=0.080），75 岁以下患者的 OS HR 为 0.87（95% CI：0.74-1.01，P=0.913）。年纪大了。 75 岁及以上患者与 75 岁以下患者的综合 RHR 为 1.14（95% CI：0.97-1.34，P=0.697）。 75 岁以上患者和年轻患者之间的 OS 获益没有显着差异 (P=0.105)。亚组分析表明，OS 的益处在所有亚组和年龄组中都是一致的。我们的调查发现，与 75 岁以下的患者相比，免疫治疗对 75 岁及以上 NSCLC 患者的疗效没有显着差异。这表明针对 NSCLC 的免疫疗法的疗效在不同年龄组中是一致的。版权所有 © 2024 Elsevier B.V. 保留所有权利。

The reported impact of age on the effectiveness of emerging immunotherapies in patients with advanced non-small cell lung cancer (NSCLC) has been inconsistent in clinical trials, largely due to an underrepresentation of older individuals. This meta-analysis aimed to evaluate the efficacy of immune checkpoint inhibitor (ICI) in older patients with NSCLC.The literature up to April 2024 was reviewed to identify articles meeting the criteria for inclusion. Hazard ratios (HRs) for overall survival (OS) across various age groups were examined. The ratio of HR (RHR) was computed and combined for each study.A preliminary search identified 118 articles, with 13 being phase II or III randomized clinical trials comparing the efficacy of nivolumab, avelumab, ipilimumab, pembrolizumab, atezolizumab, and chemotherapy with or without antiangiogenic therapy. The analysis revealed that the HR for OS was 0.75 (95 % CI: 0.70-0.80, P=0.080) in patients aged under 75 years and 0.87 (95 % CI: 0.74-1.01, P=0.913) in patients aged 75 years and older. The combined RHR for patients aged 75 years and above versus those aged under 75 years was 1.14 (95 % CI: 0.97-1.34, P=0.697). There was no significant difference in OS benefit between patients over 75 years and younger patients (P=0.105). Subgroup analyses indicated that the benefit of OS was consistent across all subgroups and age groups.Our investigation found no significant differences in the efficacy of immunotherapy for patients with NSCLC aged 75 years and older compared to those under 75 years old. This suggests that the efficacy of immunotherapy against NSCLC is consistent across age groups.Copyright © 2024 Elsevier B.V. All rights reserved.