Objective To investigate the application values of precise fecal microbiota transplantation (FMT) in the treatment with immune checkpoint inhibitors (ICIs) for elderly patients with advanced non⁃small cell lung cancer (NSCLC). Methods A total of 178 elderly patients with advanced NSCLC were enrolled, and they were randomly assigned to experiment group or control group, with 89 cases in each group. Both groups received ICIs (pembrolizumab or nivolumab) for single⁃drug first⁃line treatment; simultaneously, the experiment group received FMT, whereas the control group orally administrated placebo for treatment. The objective response rate, progression⁃free survival rate, and overall survival rate, as well as the incidence rate of adverse reactions were compared between the two groups. Results The experiment group exhibited the objective response rate of 48.31%, which was higher as compared with the control group (32.58%, P<0.05). The experiment group yielded higher progression⁃free survival rate and overall survival rate, whereas a lower incidence rate of therapy⁃associated adverse reactions as compared with the control group (P<0.05). Conclusion Precise FMT can improve the efficacy of ICIs therapy for elderly patients with advanced NSCLC, increase patients' survival rate, and decrease the incidence rate of ICIs therapy⁃associated adverse reactions.

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