Lawrence Kasherman1, Derrick Ho Wai Siu1, Kirsty Wai Chung Lee2, Sally Lord3, Ian Marschner4, Craig R Lewis5, Michael Friedlander5, Chee Khoon Lee6. 1. Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia. 2. Cancer Care Centre, St George Hospital, Sydney, NSW, Australia. 3. National Health and Medical Research Council (NHMRC) Clinical Trials Centre, Sydney, NSW, Australia; School of Medicine, University of Notre Dame, Sydney, Australia. 4. National Health and Medical Research Council (NHMRC) Clinical Trials Centre, Sydney, NSW, Australia; Department of Statistics, Macquarie University, Sydney, Australia. 5. Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia; Prince of Wales Hospital Clinical School, University of NSW, Sydney, Australia. 6. Cancer Care Centre, St George Hospital, Sydney, NSW, Australia; National Health and Medical Research Council (NHMRC) Clinical Trials Centre, Sydney, NSW, Australia. Electronic address: chee.lee@ctc.usyd.edu.au.
Abstract
OBJECTIVES: There is uncertainty whether older patients derive a similar benefit from immune checkpoint inhibitors (ICI) as younger patients. We performed a meta-analysis of ICI trials in advanced cancers to better estimate treatment benefit in the older population. MATERIALS AND METHODS: We performed an electronic search for randomized trials of ICI, either as monotherapy or in combination with other agents. Hazard ratios (HR) for subgroups defined by different age cut-offs were extracted. Pooled overall survival (OS) treatment estimates were calculated using the inverse variance weighted method. RESULTS: In nineteen trials comparing ICI monotherapy versus non-ICI treatment, there was no significant treatment-age interaction (age ≥ 65 years: N = 6064, HR 0.73; age < 65 years: N = 7250, HR 0.79; P-interaction = 0.27). Findings were similar at older age cut-offs of 70 years (age ≥ 70 years: N = 433, HR = 0.93; age < 70 years: N = 169, HR = 0.95; P-interaction = 0.91) and 75 years (age ≥ 75 years: N = 139, HR = 0.75; age < 75 years: N = 1133, HR = 0.61; P-interaction = 0.72) respectively, and for trials of ICI combination therapy. CONCLUSION: ICI therapy improves OS in both younger and older patients with advanced cancers, and the magnitude of improvement does not depend on age. Patient selection for ICI therapy should be done based on performance status and adequate organ function independently of age.
OBJECTIVES: There is uncertainty whether older patients derive a similar benefit from immune checkpoint inhibitors (ICI) as younger patients. We performed a meta-analysis of ICI trials in advanced cancers to better estimate treatment benefit in the older population. MATERIALS AND METHODS: We performed an electronic search for randomized trials of ICI, either as monotherapy or in combination with other agents. Hazard ratios (HR) for subgroups defined by different age cut-offs were extracted. Pooled overall survival (OS) treatment estimates were calculated using the inverse variance weighted method. RESULTS: In nineteen trials comparing ICI monotherapy versus non-ICI treatment, there was no significant treatment-age interaction (age ≥ 65 years: N = 6064, HR 0.73; age < 65 years: N = 7250, HR 0.79; P-interaction = 0.27). Findings were similar at older age cut-offs of 70 years (age ≥ 70 years: N = 433, HR = 0.93; age < 70 years: N = 169, HR = 0.95; P-interaction = 0.91) and 75 years (age ≥ 75 years: N = 139, HR = 0.75; age < 75 years: N = 1133, HR = 0.61; P-interaction = 0.72) respectively, and for trials of ICI combination therapy. CONCLUSION:ICI therapy improves OS in both younger and older patients with advanced cancers, and the magnitude of improvement does not depend on age. Patient selection for ICI therapy should be done based on performance status and adequate organ function independently of age.
Authors: Khalil Choucair; Abdul Rafeh Naqash; Caroline A Nebhan; Ryan Nipp; Douglas B Johnson; Anwaar Saeed Journal: Oncologist Date: 2022-09-02 Impact factor: 5.837
Authors: Fang Yang; Svetomir N Markovic; Julian R Molina; Thorvardur R Halfdanarson; Lance C Pagliaro; Ashish V Chintakuntlawar; Rutian Li; Jia Wei; Lifeng Wang; Baorui Liu; Grzegorz S Nowakowski; Michael L Wang; Yucai Wang Journal: JAMA Netw Open Date: 2020-08-03