Association of Sex with Survival and Adverse Events in Non-Small Cell Lung Cancer Patients Receiving Immune Checkpoint Inhibitors: A Single-Center Experience in Türkiye

BACKGROUND In this study conducted in a single center in Türkiye, we aimed to investigate the effect of sex differences on survival and treatment adverse effects in 100 patients with advanced non-small cell lung carcinoma (NSCLC) treated with immune checkpoint inhibitors. MATERIAL AND METHODS This was a single-center, retrospective, observational study. All 100 patients with non-small cell lung carcinoma admitted to the Pulmonary and Medical Oncology Department of a Training and Research Hospital between January 2018 and March 2024 were evaluated. Demographic data, cancer characteristics, overall survival, and adverse effects of immune checkpoint inhibitors were investigated in the male and female patient groups. Patients were treated with nivolumab and atezolizumab as immune checkpoint inhibitors (ICI). RESULTS This study included 100 patients, with 88 (88%) men and 12 (12%) women. The average age of the patients was 64.3±8.5 years, 63% had adenocarcinoma, and 80.6% of all patients were stage 4. Although overall survival was significantly lower in women compared to men in univariate analysis (P=0.047), this difference disappeared in multivariate analysis (P=0.168). Adverse effects were observed in 91% of the patients. Pleural effusion (P=0.040), hypothyroidism (P=0.003), and rash (P<0.001) were more common in women, whereas tiredness (P=0.804), pneumonitis (P=0.097), and hyperthyroidism (P=0.507) were not significantly different according to sex. The average follow-up period was 33.8±22.6 months, and 25% of patients died. CONCLUSIONS The association of sex differences with adverse effects and survival in patients with NSCLC receiving ICI treatment is not fully understood. Further studies are needed to support this area of interest.