Pauline Corbaux1, Denis Maillet1, Amélie Boespflug2, Myriam Locatelli-Sanchez3, Marie Perier-Muzet2, Michaël Duruisseaux4, Lize Kiakouama-Maleka5, Stéphane Dalle2, Claire Falandry6, Julien Péron7. 1. Hospices Civils de Lyon, Oncology Department, Pierre-Bénite, France; Université de Lyon, F-69000, Lyon, France; Université Lyon 1, F-69100, Villeurbanne, France; ImmuCare (Immunology Cancer Research) Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France. 2. Université de Lyon, F-69000, Lyon, France; Université Lyon 1, F-69100, Villeurbanne, France; ImmuCare (Immunology Cancer Research) Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France; Hospices Civils de Lyon, Cancer Research Center of Lyon, Dermatology Department, Pierre-Bénite, France. 3. Université de Lyon, F-69000, Lyon, France; Université Lyon 1, F-69100, Villeurbanne, France; ImmuCare (Immunology Cancer Research) Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France; Hospices Civils de Lyon, Cancer Research Center of Lyon, Department of Respiratory Medicine, Pierre-Bénite, France. 4. Université de Lyon, F-69000, Lyon, France; Université Lyon 1, F-69100, Villeurbanne, France; ImmuCare (Immunology Cancer Research) Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France; Hospices Civils de Lyon, Department of Respiratory Medicine, Groupement Hospitalier Est, Hôpital Louis-Pradel, Lyon, France. 5. Université de Lyon, F-69000, Lyon, France; Université Lyon 1, F-69100, Villeurbanne, France; ImmuCare (Immunology Cancer Research) Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France; Hospices Civils de Lyon, Department of Respiratory Medicine, Croix-Rousse Hospital, Lyon, France. 6. Université de Lyon, F-69000, Lyon, France; Université Lyon 1, F-69100, Villeurbanne, France; Hospices Civils de Lyon, Geriatrics Unit, Pierre-Bénite, France; CarMen Biomedical Research Laboratory (Cardiovascular Diseases, Metabolism, Diabetology and Nutrition) INSERM UMR 1060, Université de Lyon, Oullins, France. 7. Hospices Civils de Lyon, Oncology Department, Pierre-Bénite, France; Université de Lyon, F-69000, Lyon, France; Université Lyon 1, F-69100, Villeurbanne, France; ImmuCare (Immunology Cancer Research) Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, F-69100, Villeurbanne, France. Electronic address: julien.peron@chu-lyon.fr.
Abstract
BACKGROUND: Age-related immune dysfunction might impair the efficacy of immune checkpoint inhibitors (ICIs) in older patients. We aimed to evaluate the impact of age on clinical outcomes and tolerance of ICIs in a real-life setting. METHODS: All patients receiving a single-agent ICI (cytotoxic T-lymphocyte-associated protein 4 [CTLA-4] or programmed death(ligand)1 [PD(L)-1] inhibitors) for the standard treatment of a locally advanced or metastatic cancer were included in this retrospective multicentric series. The primary end-point was overall survival (OS). Progression-free survival (PFS) and immune-related adverse events (irAEs) were secondary end-points. The impact of age was assessed using the threshold of 70 years. RESULTS: A total of 410 patients were included, for 435 lines of treatment, including 150 lines (34%) given to patients aged 70 years or older. The primary tumour types were lung cancer (n = 304, 74%), melanoma (n = 79, 19%) and urologic cancer (n = 27, 7%). Most of the administered treatments were PD(L)-1 inhibitors (n = 356, 82%). Median follow-up reached 46 months in the CTLA-4 cohort, and 20 months in the PD(L)-1 cohort. In both treatment cohorts, age did not impact OS (respectively, HR = 0.82, 95% CI 0.5-1.4; log-rank P = 0.49 and HR = 0.9, 95% CI 0.7-1.1; log-rank P = 0.27) or PFS (HR = 0.7, 95% CI 0.4-1.1; log-rank P = 0.13 and HR = 0.9, 95% CI 0.7-1.1; log-rank P = 0.19). Grade 3-4 irAEs rates were not statistically different between older and younger patients (11% vs 12%, P = 0.87). CONCLUSION: In a large real-world series of patients treated by ICI monotherapy, the long-term clinical outcomes were not statistically different between older or younger patients, with no increased immune-related toxicity.
BACKGROUND: Age-related immune dysfunction might impair the efficacy of immune checkpoint inhibitors (ICIs) in older patients. We aimed to evaluate the impact of age on clinical outcomes and tolerance of ICIs in a real-life setting. METHODS: All patients receiving a single-agent ICI (cytotoxic T-lymphocyte-associated protein 4 [CTLA-4] or programmed death(ligand)1 [PD(L)-1] inhibitors) for the standard treatment of a locally advanced or metastatic cancer were included in this retrospective multicentric series. The primary end-point was overall survival (OS). Progression-free survival (PFS) and immune-related adverse events (irAEs) were secondary end-points. The impact of age was assessed using the threshold of 70 years. RESULTS: A total of 410 patients were included, for 435 lines of treatment, including 150 lines (34%) given to patients aged 70 years or older. The primary tumour types were lung cancer (n = 304, 74%), melanoma (n = 79, 19%) and urologic cancer (n = 27, 7%). Most of the administered treatments were PD(L)-1 inhibitors (n = 356, 82%). Median follow-up reached 46 months in the CTLA-4 cohort, and 20 months in the PD(L)-1 cohort. In both treatment cohorts, age did not impact OS (respectively, HR = 0.82, 95% CI 0.5-1.4; log-rank P = 0.49 and HR = 0.9, 95% CI 0.7-1.1; log-rank P = 0.27) or PFS (HR = 0.7, 95% CI 0.4-1.1; log-rank P = 0.13 and HR = 0.9, 95% CI 0.7-1.1; log-rank P = 0.19). Grade 3-4 irAEs rates were not statistically different between older and younger patients (11% vs 12%, P = 0.87). CONCLUSION: In a large real-world series of patients treated by ICI monotherapy, the long-term clinical outcomes were not statistically different between older or younger patients, with no increased immune-related toxicity.
Authors: Ajay Sheshadri; Alberto A Goizueta; Vickie R Shannon; David London; Guillermo Garcia-Manero; Hagop M Kantarjian; Farhad Ravandi-Kashani; Tapan M Kadia; Marina Y Konopleva; Courtney D DiNardo; Sherry Pierce; Abdulrazzak Zarifa; Aya A Albittar; Linda L Zhong; Fechukwu O Akhmedzhanov; Muhammad H Arain; Mansour Alfayez; Ahmad Alotaibi; Mehmet Altan; Aung Naing; Tito R Mendoza; Myrna C B Godoy; Girish Shroff; Sang T Kim; Saadia A Faiz; Dimitrios P Kontoyiannis; Fareed Khawaja; Kristofer Jennings; Naval G Daver Journal: Cancer Date: 2022-04-22 Impact factor: 6.921
Authors: Vincent T Ma; Christopher T Su; Miriam Hu; Jeremy M G Taylor; Stephanie Daignault-Newton; Olesia Kellezi; Megan N Dahl; Miloni A Shah; Stephanie Erickson; Jessica Lora; Reema Hamasha; Alicia Ali; Sabrina Yancey; Leah Kiros; Hannah M Balicki; Daniel C Winfield; Michael D Green; Ajjai S Alva Journal: Urol Oncol Date: 2021-01-23 Impact factor: 2.954