中国肺癌杂志2026，Vol.29Issue(3)：190-199,10.DOI:10.3779/j.issn.1009-3419.2026.101.05
免疫衰老背景下老年晚期NSCLC患者对PD-1/PD-L1抑制剂反应的异质性及干预策略
Heterogeneity of Response to PD-1/PD-L1 Inhibitors in Elderly Patients with Advanced NSCLC under the Background of Immunosenescence and Intervention Strategies
摘要
Abstract
The proportion of elderly patients with advanced non-small cell lung cancer(NSCLC)is on the rise.While programmed death protein 1(PD-1)/programmed death ligand 1(PD-L1)inhibitors have revolutionized the management of advanced NSCLC and improved patient survival,but the elderly display prominent immunosenescence features.Age-associated thymic involution,diminished T-cell repertoire diversity,and chronic inflammation directly compromise the efficacy of immu-notherapy.Furthermore,the underrepresentation of elderly patients in clinical trials and the paucity of high-quality evidence-based data jointly contribute to significant heterogeneity in their therapeutic responses to PD-1/PD-L1 inhibitors.While patients aged 65-74 years maintain significant survival benefits from immunotherapy-whether as monotherapy or combined regimens-those aged≥75 years exhibit attenuated efficacy and heightened susceptibility to immune-related adverse events.To address these challenges,Comprehensive Geriatric Assessment(CGA)enables risk-adapted therapeutic strategies,guiding interventions such as adjusted-dose immunotherapy,selective combination therapies,and emerging approaches targeting senescence-associated im-mune dysfunction.Closing current evidence gaps,particularly for underrepresented octogenarians,remains imperative,as does advancing precision immunotherapy models founded on biological aging metrics rather than chronological age alone.Bridging these knowledge gaps will permit tailored treatment algorithms to optimize outcomes in this clinically complex population.关键词
免疫衰老/肺肿瘤/PD-1/PD-L1抑制剂/个体化治疗Key words
Immunosenescence/Lung neoplasms/PD-1/PD-L1 inhibitors/Individualized treatment引用本文复制引用
黄玉蓉,王媛,魏澳娇,熊雨露,段明智,许彤瑶,何文杰..免疫衰老背景下老年晚期NSCLC患者对PD-1/PD-L1抑制剂反应的异质性及干预策略[J].中国肺癌杂志,2026,29(3):190-199,10.基金项目
This paper was supported by the grant from Hengru Rescarch Fund of Kunming Medical University(No.YQHR-2025-M20,to Wenjie HE). 本文受昆明医科大学恒瑞科研基金项目(No.YQHR-2025-M20)资助 （No.YQHR-2025-M20,to Wenjie HE）
