Abstract: Objective To investigate the effects of programmed death-1(PD-1)/ programmed death-ligand 1(PD-L1) inhibitor treatment on airway hyperresponsiveness and lung function in the elderly patients with non-small cell lung cancer (NSCLC) complicated with chronic obstructive pulmonary disease (COPD). Methods A total of 30 NSCLC patients who received PD-1 / PD-L1 inhibitor immunotherapy were divided into COPD group and non-COPD group. The levels of fractional exhaled nitric oxide(FeNO) and the lung function indexes were collected and compared. Results Among the 30 patients, 19 cases were complicated with COPD and 11 cases were not complicated with COPD. There was no statistical difference in the level of FeNO between the COPD group and the non-COPD group before treatment (P>0.05).The level of FeNO was increased significantly in the COPD group affter treatment, and the difference between the two groups was statistically significant(P<0.01).After treatment, the levels of FEV1 and FVC were increased significantly in the COPD group(P<0.05). However, there was no statistically significant difference in FVC and FEV1 before and after treatment in the non-COPD group (P>0.05). There were no significant differences in scores of Modified Medical Research Conncil (mMRC) questionnaire and COPD Assessment Test(CAT) between the two groups before and after treatment (P>0.05). Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) was not observed during treatment. Conclusions PD-1/PD-L1 inhibitor immunotherapy can change FeNO level and pulmonary function in the NSCLC patients with COPD, and will not worsen COPD.

Key words: programmed death-1/ programmed death-ligand 1 inhibitors, non-small cell lung cancer, chronic obstructive pulmonary disease, fractional exhaled nitric oxide, pulmonary function