Clinical efficacy and safety analysis of receiving PD-1 inhibitor-containing regimen in elderly patients with advanced gastric cancer

Abstract

Abstract Background This paper analyzes the clinical efficacy and safety of Programmed cell death protein-1(PD-1) inhibitor-containing regimens in the treatment of elderly patients with advanced gastric cancer. Methods A retrospective analysis was performed on 51 patients aged ≥ 65 years subjected to anti-PD-1 antibody therapy in the First Affiliated Hospital of Nanchang University between January 2018 and May 2021. We analyzed related factors of patients. Results Only 15.7% of all patients experienced immune-related events. Objective response rate (ORR) and disease control rate (DCR) of patients were 31.4% and 78.4%, respectively. ORR was higher in patients treated with PD-1 inhibitor-containing regimens in first-line compared to second and later-line therapy. In univariate analysis, two or more distant metastatic organs, high Lactate dehydrogenase(LDH)group, and non-excellent Lung Immune Prognostic Index (LIPI)score group were associated with poor median progression-free survival (mPFS)and median overall survival (mOS)([HR, 3.745; CI, (1.667–7.244); P < 0.05], [HR, 2.304; CI, (1.137–4.670); P < 0.05], [HR, 2.822; CI, (1.314–6.059); P < 0.01], [HR, 3.024; CI, (1.191–7.677); p < 0.05], [HR, 3.050; CI, (1.302–7.147); p < 0.05], [HR, 2.607; CI, (1.060–6.407); P < 0.05]. First-line therapy was associated with better overall survival (OS)compared to second and later-line therapy (P < 0.05). Additionally, the number of distant metastatic organs was an independent prognostic risk factor for progression-free survival(PFS). Conclusions In summary, PD-1 inhibitor-containing regimens are safe and effective in elderly patients with advanced gastric cancer. The use of PD-1 inhibitor-containing regimens for first-line therapy may result in a greater survival benefit for elderly patients with advanced gastric cancer than later-line therapy.