Efficacy and adverse effects of different immunotherapy in the elderly

We rely on the Food and Drug Adverse Event Reporting System (FAERS) database to evaluate the medication status of immunotherapy in the elderly, and the efficacy and safety of different immunotherapy strategies by mining large samples and real-world data. The present study included 19,446 patients over 65 years of age with NSCLC in the FAERS database from January 2015 to December 2022. The definition of adverse events (AEs) relied on the Medical Dictionary for Regulatory Activities (MedDRA). Statistical analysis was performed, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. The 65–74 age group comprised 12,878(66.2%) individuals and 6,566(33.8%) individuals ≥ 75 years. Combined chemotherapy in the elderly ≥ 75 years and Bevacizumab in the elderly ≥ 80 years of age are optimal for both efficacy and adverse effects. Combined chemotherapy delayed disease progression and reduced mortality in ≥ 75 years of age were OR,0.68 (95% CI,0.56–0.89) and OR,0.75 (95% CI,0.57–0.99) respectively. Combined Bevacizumab delayed disease progression in ≥ 80 years of age were OR,0.24 (95% CI,0.08–0.67) although there was no statistical significance in reducing mortality. Treatment with ICIs in combination with other agents in very elderly populations has demonstrated improved survival benefits. The reason for the discrepancy with the clinical studies may be that older adults over 75 or even over 80 years of age do not meet enrollment requirements. It is expected that the upper age limit for enrollment will also increase as the aging era advances further.