Abstract: Objective To investigate the incidence of skin-immune-related adverse events(s-irAE) in the elderly patients with non-small cell lung cancer(NSCLC) undergoing treatment with programmed cell death 1 receptor(PD-1) inhibitors, and to investigate the correlation of s-irAE with survival prognosis and clinical indictors. Methods The clinical data of the elderly patients with NSCLC were collected from the Affiliated Hospital of Inner Mongolia Medical University from March 2020 to March 2023. These patients received first-line treatment with PD-1 inhibitor monotherapy. The patients were divided into s-irAE group and non-s-irAE group according to whether they presented with s-irAE. The levels of progression-free survival(PFS), overall survival(OS), neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR) and prognostic nutritional index(PNI) were compared between the two groups. Results A total of 40 patients were enrolled. The incidence rate of s-irAE was 52.5%(21/40), and the incidence rate of grade ≥3 s-irAE was 5.0%(2/40). The median occurrence treatment cycle of s-irAE was 4.0 (3.0, 5.0), and the main types of s-irAE were rash with pruritus and capillary hyperplasia. Compared with the non-s-irAE group, the s-irAE group had longer median PFS, OS (not reach vs 9.0 months, HR=0.211, 95% CI: 0.073-0.606, P=0.004), (not reach vs 12.0 months, HR=0.233, 95% CI: 0.073-0.748, P=0.014). The levels of PNI, NLR and PLR showed no significant differences between s-irAE group and non-s-irAE group(all P＞0.05). Conclusions The incidence rate of s-irAE is high in the elderly NSCLC patients receiving first-line treatment with PD-1 inhibitor monotherapy. However, the occurrence of s-irAE predicts a better survival prognosis, and predictors for the s-irAE need further study.

Key words: non-small cell lung cancer, programmed cell death 1 receptor inhibitor, skin-immune-related adverse events