Article Dans Une Revue Clinical Lung Cancer Année : 2025

First-Line Pembrolizumab Efficacy in Octogenarians With NSCLCs Expressing ≥ 50% PD-L1 (ESCKEYP GFPC 05-2018)

Romain Corre
  • Fonction : Auteur
Chantal Decroisette
  • Fonction : Auteur
Jean-Bernard Auliac
  • Fonction : Auteur
Lionel Falchero
  • Fonction : Auteur
Hubert Curcio
  • Fonction : Auteur
Karim Amrane
  • Fonction : Auteur
Maurice Perol
  • Fonction : Auteur
Stéphane Hominal
  • Fonction : Auteur
Sabine Vieillot
  • Fonction : Auteur
Eric Huchot
  • Fonction : Auteur
Anne Laure Desage
  • Fonction : Auteur
Marie Bernardi
  • Fonction : Auteur
Remi Veillon
  • Fonction : Auteur
Hélène Doubre
  • Fonction : Auteur
Suzanna Bota
  • Fonction : Auteur
Gwenaelle Legarff
  • Fonction : Auteur
Grégoire Justeau
  • Fonction : Auteur
Oliver Bylicki
  • Fonction : Auteur
Magali Roa
  • Fonction : Auteur
Renaud Descourt
  • Fonction : Auteur
Christos Chouaïd

Résumé

Background: Pembrolizumab alone is a first-line therapeutic option for patients with metastatic non-small cell lung cancer (NSCLC) with ≥ 50% PD-L1 expression, but few data are available for elderly patients, specifically octogenarians. Methods: This retrospective, multicenter study included all consecutive patients with metastatic NSCLC PD-L1 ≥ 50% treated with first-line pembrolizumab monotherapy between May 2017 and November 2019. Information was collected from medical files with local evaluation of therapeutic response and progression-free survival (PFS). Results: Among the 844 patients included, 73 (8.4%) were ≥ 80 (median: 82) years old, 74% men, 23.3% with ECOG-PS ≥ 2, 26% had ≥ 5% weight loss, PD-L1 50%-75%/≥ 75%: 45.2%/46.6%, respectively, with significantly more nonsmokers and (17.4% vs. 5.6%, P = .0002) and fewer adenocarcinomas (57.5% vs. 70.8%, P = .0217) than those < 80 years. After median follow-up of 45.7 (95% CI: 43.0-49.1) months, respective median overall survival (OS) for octogenarians versus younger patients lasted 12.0 (95% CI: 7.7-16.2) versus 23.9 (95% CI: 19.5-27.4) months (P = .0002), and median PFS for 5.0 (95% CI: 2.8-9.2) versus 8.3 (95% CI: 7.2-9.8) months (P = .039). Their respective objective response rates did not differ significantly: 42% (95% CI: 24-60) vs. 49% (95% CI: 43-54). Conclusions: Based on the results of this large multicenter population, first-line pembrolizumab efficacy against NSCLCs expressing ≥ 50% PD-L1 in octogenarians seems inferior to that obtained in younger patients. The higher percentage of nonsmokers and fewer adenocarcinomas could partially explain that finding. Keywords: Elderly; Immunotherapy; Lung cancer; Octogenarians; Senescence.

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Dates et versions

hal-05478980 , version 1 (27-01-2026)

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Romain Corre, Chantal Decroisette, Jean-Bernard Auliac, Lionel Falchero, Hubert Curcio, et al.. First-Line Pembrolizumab Efficacy in Octogenarians With NSCLCs Expressing ≥ 50% PD-L1 (ESCKEYP GFPC 05-2018). Clinical Lung Cancer, 2025, 26 (4), pp.331-337. ⟨10.1016/j.cllc.2025.03.001⟩. ⟨hal-05478980⟩
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