{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:09:45Z","timestamp":1785247785494,"version":"3.55.0"},"reference-count":22,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Chemoimmunotherapy combinations represent the standard first-line treatment for non-oncogene addicted metastatic NSCLC (mNSCLC). However, evidence in elderly patients remains limited and conflicting. We conducted an analysis of the efficacy and safety of chemoimmunotherapy in patients aged \u226575 years enrolled in the Real-Combo Lung study, an observational study including patients with non-oncogene-addicted mNSCLC and PD-L1 expression &lt; 50%. Patients and Methods: The primary objective of the study was to compare progression-free survival (PFS) and overall survival (OS) between patients aged \u226575 (elderly cohort) and those aged &lt;75 years (non-elderly cohort). Safety outcomes were evaluated as a secondary objective. Results: A total of 495 patients were enrolled, with 89 (18%) aged \u226575 and 406 (82%) aged &lt;75 years. No significant differences in PFS and OS were observed between the two cohorts. The median PFS was 13.3 months (95% CI: 9.3\u2013NR) in the elderly cohort and 10.5 months (95% CI: 9.5\u201312.9) in the non-elderly cohort (unadjusted HR 0.84, 95% CI: 0.61\u20131.16, p = 0.29). The median OS was 17.5 months (95% CI: 14.7\u2013NR) versus 21.4 months (95% CI: 17\u2013NR), respectively (unadjusted HR 1.09, 95% CI: 0.76\u20131.56, p = 0.63). In multivariable analysis, ECOG PS \u2265 2 and baseline use of steroids were significantly associated with a worse outcome in the elderly cohort for both PFS and OS. Safety data did not differ significantly between cohorts. Conclusions: In this real-world study, elderly patients with mNSCLC derived outcomes comparable to those of younger patients, with similar efficacy and a manageable safety profile when treated with chemoimmunotherapy combinations.<\/jats:p>","DOI":"10.3390\/jcm15031165","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T14:12:46Z","timestamp":1770041566000},"page":"1165","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Chemoimmunotherapy Combinations in Elderly Patients with Metastatic Non-Small Cell Lung Cancer and PD-L1 Expression &lt; 50%: Results from an Italian Real-World Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8804-7094","authenticated-orcid":false,"given":"Antonello","family":"Veccia","sequence":"first","affiliation":[{"name":"Medical Oncology, Santa Chiara Hospital, 38122 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ettore","family":"D\u2019Argento","sequence":"additional","affiliation":[{"name":"Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floriana","family":"Morgillo","sequence":"additional","affiliation":[{"name":"Department of Precision Medicine, Universit\u00e0 Degli Studi Della Campania \u201cLuigi Vanvitelli\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1440-1820","authenticated-orcid":false,"given":"Elio Gregory","family":"Pizzutilo","sequence":"additional","affiliation":[{"name":"S.C. Oncologia Falck, Dipartimento Ematologia, Oncologia e Medicina Molecolare, Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Vitiello","sequence":"additional","affiliation":[{"name":"Pulmonary Oncology Unit, Department of Pneumology and Oncology, A.O. Dei Colli Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4695-0100","authenticated-orcid":false,"given":"Alberto","family":"Pavan","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, AULSS 3 Serenissima, Dell\u2019Angelo General Hospital, Mestre and SS Giovanni e Paolo General Hospital, 30174 Venice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiorella","family":"Lombardo","sequence":"additional","affiliation":[{"name":"Lung Unit, Ospedale Pederzoli, Peschiera del Garda, 37019 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Russano","sequence":"additional","affiliation":[{"name":"Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1319-9608","authenticated-orcid":false,"given":"Alessandro","family":"Morabito","sequence":"additional","affiliation":[{"name":"Thoracic Medical Oncology, Istituto Nazionale Tumori\u2014IRCCS-Fondazione G. Pascale, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1665-3367","authenticated-orcid":false,"given":"Eleonora","family":"Gariazzo","sequence":"additional","affiliation":[{"name":"Medical Oncology, Santa Maria della Misericordia Hospital, University of Perugia, 06123 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3690-8582","authenticated-orcid":false,"given":"Carlo","family":"Genova","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Specialties, University of Genoa, 16126 Genoa, Italy"},{"name":"Academic Medical Oncology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Chiari","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, AST1, 61121 Pesaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Cristofano","sequence":"additional","affiliation":[{"name":"Oncology and Onco-Hematology Department, Ospedale Generale Regionale F. Miulli, Acquaviva Delle Fonti, 70021 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1763-0335","authenticated-orcid":false,"given":"Alessandro","family":"Delconte","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, CRO di Aviano, National Cancer Institute, IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Vattemi","sequence":"additional","affiliation":[{"name":"Medical Oncology, Azienda Sanitaria Dell\u2019alto Adige, 39100 Bolzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Dessi","sequence":"additional","affiliation":[{"name":"S.C. Oncologia Medica, Ospedale Armando Businco ARNAS Brotzu, 09121 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7917-1886","authenticated-orcid":false,"given":"Daniele","family":"Galanti","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, Ospedale Buccheri La Ferla Fatebenefratelli, 90123 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Busato","sequence":"additional","affiliation":[{"name":"Medical Oncology and Hematology, AULSS 3 Serenissima, 30015 Venice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Palazzolo","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, AULSS 6 Cittadella, 35013 Cittadella, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clementina","family":"Savastano","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, San Giovanni di Dio e Ruggi D\u2019aragona, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Azzarello","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, AULSS 3 Serenissima, 30174 Venice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Verderame","sequence":"additional","affiliation":[{"name":"Oncology Unit, AO Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, 90146 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4561-3447","authenticated-orcid":false,"given":"Cristina","family":"Mazzi","sequence":"additional","affiliation":[{"name":"Clinical Research Unit, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3508-3355","authenticated-orcid":false,"given":"Daniela","family":"Bencardino","sequence":"additional","affiliation":[{"name":"Scientific Direction, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariachiara","family":"Dipasquale","sequence":"additional","affiliation":[{"name":"Medical Oncology, Santa Chiara Hospital, 38122 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Scala","sequence":"additional","affiliation":[{"name":"Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3396-8099","authenticated-orcid":false,"given":"Carminia Maria","family":"Della Corte","sequence":"additional","affiliation":[{"name":"Department of Precision Medicine, Universit\u00e0 Degli Studi Della Campania \u201cLuigi Vanvitelli\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Piscazzi","sequence":"additional","affiliation":[{"name":"S.C. Oncologia Falck, Dipartimento Ematologia, Oncologia e Medicina Molecolare, Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Gilli","sequence":"additional","affiliation":[{"name":"Pulmonary Oncology Unit, Department of Pneumology and Oncology, A.O. Dei Colli Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Bria","sequence":"additional","affiliation":[{"name":"Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Ospedale Isola Tiberina-Gemelli Isola, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7968-2531","authenticated-orcid":false,"given":"Orazio","family":"Caffo","sequence":"additional","affiliation":[{"name":"Medical Oncology, Santa Chiara Hospital, 38122 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6320-405X","authenticated-orcid":false,"given":"Stefania","family":"Gori","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6331-6908","authenticated-orcid":false,"given":"Alessandro","family":"Inno","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"ref_1","first-page":"10","article-title":"Cancer statistics, 2025","volume":"75","author":"Siegel","year":"2025","journal-title":"CA Cancer J. 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