Comparison of Immune Checkpoint Inhibitors between Older and Younger Patients with Advanced or Metastatic Lung Cancer: A Systematic Review and Meta-Analysis

Table 1

Characteristics of studies included in this meta-analysis.

Author,; year	Phase	Pathology	Line	Treatment groups	No. of Patients	Median age, years	No. of younger (%)	No. of older (%)	Follow-up (months)	Overall survival
										Overall HR; (95% CI)	HR (95% CI) for younger	HR (95% CI) for older
Brahmer (2015)	3	NSCLC	>1	Nivolumab vs Docetaxel	272	63.0 (39-85)	152 (56%)	120 (44%)	11.0 months†	0.63 (0.48-0.82)	<65 yr: 0.62 (0.44-0.89)	A (≥65 and <75 yr): 0.51 (0.32-0.82); B (≥75 yr): 1.76 (0.77-4.05)
Borghaei (2015)	3	NSCLC	>1	Nivolumab vs Docetaxel	582	62.0 (21-85)	339 (58%)	243 (42%)	17.2 months	0.75 (0.62-0.91)	<65 yr: 0.81 (0.62-1.04)	A (≥65 and <75 yr): 0.63 (0.45-0.89); B (≥75 yr): 0.90 (0.43-1.87)
Herbst; (2015)	2/3	NSCLC	>1	Pembrolizumab; (2 mg/kg) vs Pembrolizumab (10 mg/kg) vs Docetaxel	1033	62.5 (54-70)	604 (58%)	429 (42%)	13.1 months	0.67 (0.56–0.80)	<65 yr: 0.63 (0.50-0.79)	≥65 yr: 0.76 (0.57–1.02)
Reck; (2016)	3	SCLC	1	Ipilimumab + EP vs Placebo + EP	954	62.5 (36-85)	576 (60%)	378 (40%)	10.5 vs10.2 months	0.94 (0.81-1.09)	<65 yr: 1.08 (0.90-1.31)	A (≥65 and <75 yr): 1.14 (0.87 to 1.49); B (≥75 yr): 0.70 (0.40 to 1.20)
Carbone; (2017)	3	NSCLC	1	Nivolumab vs Investigator’s choice of platinum doublet chemotherapy	541	64.0 (29-89)	281 (52%)	260 (48%)	18.0 months	1.08 (0.87–1.34)	<65 yr: 1.13 (0.83-1.54)	≥65 yr: 1.04 (0.77–1.41)
Govindan (2017)	3	NSCLC	1	Ipilimumab + PC vs Placebo +PC	749	64.0 (28-85)	380 (51%)	369 (49%)	12.5 vs 11.8 months	0.91 (0.77–1.07)	<65 yr: 0.82 (0.64-1.04)	A (65 and ≤ 74 yr): 1.06 (0.81-1.37); B (≥75 yr): 0.85 (0.51-1.43)
Gandhi; (2018)	3	NSCLC	>1	Pembrolizumab + Pemetrexed + PBC vs Placebo + Pemetrexed + PBC	616	64.0(34-84)	312 (51%)	304 (49%)	10.5 months	0.49 (0.38–0.64)	<65 yr: 0.43 (0.31-0.61)	≥65 yr: 0.64 (0.43–0.95)
Paz-Ares (2018)	3	NSCLC	1	Pembrolizumab + ICC vs Placebo + ICC	559	65.0 (29-88)	254 (45%)	305 (55%)	7.8; months	0.64 (0.49–0.85)	<65 yr: 0.52 (0.34-0.80)	≥65 yr: 0.74 (0.51–1.07)
Horn; (2018)	3	SCLC	1	Atezolizumab + CE vs Placebo + CE	403	64.0 (26–90)	217 (54%)	186 (46%)	13.9 months	0.70 (0.54–0.91)	<65 yr: 0.92 (0.64-1.32)	≥65 yr: 0.53 (0.36–0.77)
Antonia; (2018)	3	NSCLC	>1	Durvalumab vs Placebo	713	64.0 (23-90)	391 (55%)	322 (45%)	25.2 months	0.68 (0.54-0.86)	<65 yr: 0.62 (0.44-0.86)	≥65 yr: 0.76 (0.55–1.06)
Barlesi; (2018)	3	NSCLC	>1	Avelumab vs Docetaxel	529	63.5 (56-70)	279 (53%)	250 (47%)	18.9 months	0.90 (0.73–1.12)	<65 yr: 0.84 (0.63-1.13)	≥65 yr: 0.98 (0.71–1.34)
Fehrenbacher (2018)	3	NSCLC	>1	Atezolizumab vs Docetaxel	1225	63.5 (25-85)	661 (54%)	564 (46%)	26.0 months	0.80 (0.70-0.92)	<65 yr: 0.84 (0.79-1.01)	≥65 yr: 0.75 (0.61-0.91)

Abbreviations. NSCLC, non-small cell lung cancer; SCLC, small cell lung cancer. †Represents minimum follow-up time between the start of the study (the first visit of the first enrolled patient) and the end of the study (the last visit of the last enrolled patient). EP=Etoposide plus Platinum. PC=Paclitaxel plus Carboplatin. PDC=Platinum doublet chemotherapy. PBC=Platinum-based chemotherapy. ICC= investigator’s choice of chemotherapy. CE= Carboplatin plus Etoposide.