The efficacy of first-line pembrolizumab monotherapy in patients with metastatic NSCLC aged ≥70 years with high PD-L1 (TPS ≥50%) expression: a multicenter real-world studyMarković, Filip (Avtor) Hochmair, Maximilian J (Avtor) Müser, Nino (Avtor) Fabikan, Hannah (Avtor) Rodriguez, Vania Mikaela (Avtor) Janžič, Urška (Avtor) Stjepanović, Mihailo (Avtor) Kontic Jovanovic, Milica (Avtor) NSCLCPD-L1real-world dataThis real-world study assessed the effectiveness of first-line pembrolizumab monotherapy in patients with metastatic non-oncogene-addicted NSCLC and PD-L1 TPS ≥50%, comparing those aged ≥70 years to younger patients. Results showed no significant differences in outcomes—objective response rate, time on treatment (ToT), and overall survival (OS)—between the two age groups. In older patients, a history of smoking and good performance status (ECOG PS 0–1) were associated with better outcomes. Poor ECOG PS (≥2) was linked to shorter ToT and OS, regardless of age. Older patients were less likely to receive second-line therapy due to comorbidities and functional decline. These findings highlight the importance of performance status over chronological age in predicting benefit from immunotherapy and support pembrolizumab monotherapy as an effective firstline option for older patients with good functional status.20252026-02-25 10:50:59Neznano27802sl© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).