WCLC 2025 - Posters & ePosters-EP.11.12 Real-World Impact of Immune Checkpoint Inhibitors in Elderly Patients With Advanced NSCLC: A Retrospective Cohort Study From South Korea

EP.11.12 Real-World Impact of Immune Checkpoint Inhibitors in Elderly Patients With Advanced NSCLC: A Retrospective Cohort Study From South Korea

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This retrospective cohort study from South Korea evaluated the real-world impact of immune checkpoint inhibitors (ICIs) on elderly patients (≥75 years) with advanced non–small cell lung cancer (NSCLC) following their approval for second-line treatment in August 2017. Data from 395 patients diagnosed with stage IV NSCLC between 2015 and 2021 at two major medical centers were analyzed to assess treatment patterns and survival outcomes.<br /><br />Key findings showed that ICI reimbursement approval did not significantly alter overall treatment patterns in this elderly population; less than 10% received ICIs as second-line therapy, and no patients received ICIs as first-line treatment. Despite this, ICIs demonstrated a meaningful survival benefit, particularly in patients with preserved performance status (Eastern Cooperative Oncology Group (ECOG) score 0–1) and high PD-L1 expression (≥50%). In patients with high PD-L1 expression, one-year survival rates were significantly higher with ICIs (65.4% vs. 15.7%, p=0.001), and median overall survival was longer (541.5 vs. 112 days, p=0.001). Among patients with poorer performance status (ECOG 2), ICIs also improved one-year survival (64.5% vs. 26.4%) and median survival (518 vs. 189.5 days), although this benefit was mainly seen in those with high PD-L1 expression after adjustment.<br /><br />In summary, while ICIs did not substantially change treatment patterns for elderly patients with advanced NSCLC in South Korea, they offer significant survival advantages in selected subgroups, emphasizing the importance of patient selection based on performance status and PD-L1 expression. The study highlights the need for personalized approaches to optimize ICI therapy benefits in the elderly NSCLC population.

Asset Subtitle

Eun Young Heo

Meta Tag

Speaker Eun Young Heo

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

immune checkpoint inhibitors

elderly patients

non-small cell lung cancer

South Korea

second-line treatment

PD-L1 expression

performance status

survival benefit

retrospective cohort study

treatment patterns