Multicenter retrospective study of efficacy and safety of chemoimmunotherapy for extensive-stage small cell lung cancer in elderly patients

A multicenter retrospective study in Japan evaluated first-line PD-L1 inhibitor plus platinum-based chemotherapy versus chemotherapy alone for extensive-stage small cell lung cancer (ES-SCLC) in patients aged ≥ 75 years. Between August 2019 and April 2024, a total of 364 consecutive patients were enrolled of whom 343 where included in the analysis. Of these, 132 were aged ≥ 75 years. Compared with chemotherapy alone, PD-L1 inhibitor plus chemotherapy significantly improved overall survival (median 13.6 versus 8.4 months; HR 0.543; p=0.0277). Median progression-free and overall survival were similar betwee the ≥ 75-year and < 75-year groups treated with PD-L1 inhibitor plus chemotherapy. Immune-related adverse events of grade ≥ 3 occurred in 4 and 12 patients in both age groups (p=0.78), whereas also the incidence of grade ≥ 3 non-irAEs was similar (p=0.52). The authors conclude that in this retrospective study, addition of PD-L1 inhibitor to first-line chemotherapy for ES-SCLC in elderly patients was associated with improved overall survival.