{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T20:22:05Z","timestamp":1784146925359,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,1,14]],"date-time":"2020-01-14T00:00:00Z","timestamp":1578960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["ME\u20101306\u201003758"],"award-info":[{"award-number":["ME\u20101306\u201003758"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["ME\u20101502\u201027794"],"award-info":[{"award-number":["ME\u20101502\u201027794"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002590","name":"American Lung Association","doi-asserted-by":"publisher","award":["LH\u2010568155"],"award-info":[{"award-number":["LH\u2010568155"]}],"id":[{"id":"10.13039\/100002590","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Limited data exist regarding the characteristics and survival outcomes of older adults with non\u2013small cell lung cancer (NSCLC) who receive immune checkpoint inhibitors in routine oncology practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the Surveillance, Epidemiology, and End Results\u2013Medicare linked database, we identified 1256 patients aged \u226565\u00a0years who were diagnosed with pathologically confirmed stage I to stage IV NSCLC between 2002 and 2015 and initiated nivolumab or pembrolizumab in 2016. We examined patient characteristics and overall survival from the time of immune checkpoint inhibitor initiation through December 31, 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median patient age at the time of immune checkpoint inhibitor initiatiton was 75.3\u00a0years (interquartile range, 8.5). A substantial percentage of patients were initially diagnosed with stage IV disease (42.6%) and had \u22652 comorbid conditions (48.7%). Using a claims\u2010based proxy, 11.5% of patients had poor performance status and 12.6% had a history of autoimmune conditions. The median overall survival after initiation of immune checkpoint inhibitor was 9.3\u00a0months (95% CI, 8.5\u201010.5\u00a0months). The 1\u2010year survival rate was 43.0% (95% CI, 40.2\u201045.7%). In multivariable analyses, multiple comorbid conditions, squamous histology, a history of nonplatinum doublet systemic therapy, recent radiotherapy, and a shorter time from initial diagnosis to treatment initiation were found to be statistically significantly associated with an increased hazard of death. Demographics, poor performance status, and prior autoimmune conditions were not significantly associated with the hazard of death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Many older adults with NSCLC who initiated immune checkpoint inhibitors had multiple comorbidities, a history of autoimmune disease, or poor performance status. Factors associated with poor prognosis among patients with advanced NSCLC were also associated with worse survival in older adults treated with immune checkpoint inhibitors.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.32624","type":"journal-article","created":{"date-parts":[[2020,1,14]],"date-time":"2020-01-14T08:21:42Z","timestamp":1578990102000},"page":"978-985","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Real\u2010world use and survival outcomes of immune checkpoint inhibitors in older adults with non\u2013small cell lung cancer"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2870-976X","authenticated-orcid":false,"given":"Bora","family":"Youn","sequence":"first","affiliation":[{"name":"Department of Health Services, Policy, and Practice Brown University School of Public Health Providence Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8611-2182","authenticated-orcid":false,"given":"Nikolaos A.","family":"Trikalinos","sequence":"additional","affiliation":[{"name":"Division of Oncology Washington University in St Louis St Louis Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Mor","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy, and Practice Brown University School of Public Health Providence Rhode Island"},{"name":"Providence Veterans Affairs Medical Center Providence Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ira B.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy, and Practice Brown University School of Public Health Providence Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2215-9931","authenticated-orcid":false,"given":"Issa J.","family":"Dahabreh","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy, and Practice Brown University School of Public Health Providence Rhode Island"},{"name":"Center for Evidence Synthesis in Health Brown University Providence Rhode Island"},{"name":"Department of Epidemiology Brown University School of Public Health Providence Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1507643"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504627"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01281-7"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1606774"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq433"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(92)90133-8"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2012.12.005"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000122"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.60.2094"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-009-9943-z"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djy202"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.25.4052"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S17191"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2018-0307"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30642"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-17-1087"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2014.08.001"},{"key":"e_1_2_8_20_1","unstructured":"Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention.Current Cigarette Use Among Adults (Behavior Risk Factor Surveillance System) 2017. 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