Efficacy and safety of induction chemoimmunotherapy in older patients with unresectable stage III NSCLC: a real-world multicenter study

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Background: The benefit of adding immunotherapy to induction chemotherapy before definitive chemoradiotherapy (CRT) in older patients with unresectable stage III non-small-cell lung cancer (NSCLC) remains unclear. Objectives: This real-world study aimed to evaluate the efficacy and safety of induction chemoimmunotherapy followed by CRT in this patient population. Design: A real-world multicenter study. Methods: In this retrospective, multicenter study, we enrolled patients aged ⩾65 years with unresectable stage III NSCLC who received CRT between January 2014 and June 2024. Patients were stratified into two groups: the induction chemoimmunotherapy group (I-CRT), who received PD-1/PD-L1 inhibitors plus chemotherapy before CRT, and the control group (Non-I-CRT), who received CRT without any prior immunotherapy. Propensity score matching (PSM) was used to balance baseline characteristics. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Results: Among 260 patients, 141 received I-CRT and 119 constituted the Non-I-CRT control group. After 1:1 PSM (97 patients per group), the I-CRT group showed significantly improved outcomes compared to the Non-I-CRT group: median PFS was 23.4 versus 11.6 months ( p < 0.001), and median OS was 46.0 versus 24.4 months ( p = 0.009). The incidence of Grade 3/4 adverse events was comparable between the matched groups (20.6% vs 28.9%, p = 0.52). Conclusion: Induction chemoimmunotherapy before CRT is feasible in selected older NSCLC patients, offering survival benefits without significant safety concerns.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.