Hisao Imai1, Satoshi Wasamoto2, Ou Yamaguchi3, Kensuke Suzuki4, Tomohide Sugiyama5, Junji Uchino6, Hiroyuki Minemura7, Takashi Osaki8, Hisashi Ishii9, Yukihiro Umeda10, Keita Mori11, Mie Kotake12, Hiroshi Kagamu3, Nobutoshi Morozumi2, Hirokazu Taniguchi4, Takashi Kasai5, Koichi Minato12, Kyoichi Kaira3. 1. Division of Respiratory Medicine, Gunma Prefectural Cancer Center, 617-1, Takahayashinishi, Ota, Gunma, 373-8550, Japan. m06701014@gunma-u.ac.jp. 2. Division of Respiratory Medicine, Saku Central Hospital Advanced Care Center, Saku, Nagano, Japan. 3. Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama University Hospital, Hidaka, Saitama, Japan. 4. Division of Internal Medicine, Toyama Prefectural Central Hospital, Toyama, Toyama, Japan. 5. Division of Thoracic Oncology, Tochigi Cancer Center, Utsunomiya, Tochigi, Japan. 6. Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Kyoto, Japan. 7. Department of Pulmonary Medicine, Fukushima Medical University, Fukushima, Japan. 8. Division of Respirology, National Hospital Organization Shibukawa Medical Center Hospital, Shibukawa, Gunma, Japan. 9. Department of Pulmonary Medicine, Nishisaitama-Chuo National Hospital, Tokorozawa, Saitama, Japan. 10. Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan. 11. Clinical Research Promotion Unit, Clinical Research Center, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan. 12. Division of Respiratory Medicine, Gunma Prefectural Cancer Center, 617-1, Takahayashinishi, Ota, Gunma, 373-8550, Japan.
Abstract
PURPOSE: Pembrolizumab is an effective front-line treatment for advanced non-small cell lung cancer (NSCLC) in patients expressing high levels of programmed death-ligand 1 (PD-L1). However, it is unclear whether first-line pembrolizumab has similar efficacy among elderly (aged ≥ 75 years) and younger patients. This study aimed to investigate the safety and efficacy of front-line pembrolizumab monotherapy in older adults with NSCLC expressing high PD-L1. METHODS: A total of 128 patients with advanced NSCLC expressing high PD-L1, including 47 older adults, received first-line pembrolizumab monotherapy at ten institutions in Japan, between February 2017 and February 2018. Data related to patient characteristics, efficacy of pembrolizumab therapy, and the type and severity of adverse events were recorded. RESULTS: Overall, 47 patients [40 men and 7 women; median age 79 (range 75-88) years] were included in our analysis. In patients who received first-line pembrolizumab monotherapy, overall response, disease control rates, median progression-free survival (PFS), and median overall survival (OS) were 53.1%, 74.4%, 7.0 months, and not reached, respectively. Common adverse events included anorexia, fatigue, skin rash, and hypothyroidism. Two treatment-related deaths were noted, due to pneumonitis and infection. First-line pembrolizumab monotherapy was associated with improved PFS in patients with non-progressive disease (PD). In patients with non-PD and good performance status (PS), pembrolizumab monotherapy improved OS. CONCLUSIONS: Elderly patients with NSCLC expressing high PD-L1 tolerated front-line pembrolizumab monotherapy well. Their survival outcomes were equivalent to those of younger patients. In patients with non-PD, first-line pembrolizumab monotherapy may improve PFS; in conjunction with good PS, it additionally improves OS.
PURPOSE:Pembrolizumab is an effective front-line treatment for advanced non-small cell lung cancer (NSCLC) in patients expressing high levels of programmed death-ligand 1 (PD-L1). However, it is unclear whether first-line pembrolizumab has similar efficacy among elderly (aged ≥ 75 years) and younger patients. This study aimed to investigate the safety and efficacy of front-line pembrolizumab monotherapy in older adults with NSCLC expressing high PD-L1. METHODS: A total of 128 patients with advanced NSCLC expressing high PD-L1, including 47 older adults, received first-line pembrolizumab monotherapy at ten institutions in Japan, between February 2017 and February 2018. Data related to patient characteristics, efficacy of pembrolizumab therapy, and the type and severity of adverse events were recorded. RESULTS: Overall, 47 patients [40 men and 7 women; median age 79 (range 75-88) years] were included in our analysis. In patients who received first-line pembrolizumab monotherapy, overall response, disease control rates, median progression-free survival (PFS), and median overall survival (OS) were 53.1%, 74.4%, 7.0 months, and not reached, respectively. Common adverse events included anorexia, fatigue, skin rash, and hypothyroidism. Two treatment-related deaths were noted, due to pneumonitis and infection. First-line pembrolizumab monotherapy was associated with improved PFS in patients with non-progressive disease (PD). In patients with non-PD and good performance status (PS), pembrolizumab monotherapy improved OS. CONCLUSIONS: Elderly patients with NSCLC expressing high PD-L1 tolerated front-line pembrolizumab monotherapy well. Their survival outcomes were equivalent to those of younger patients. In patients with non-PD, first-line pembrolizumab monotherapy may improve PFS; in conjunction with good PS, it additionally improves OS.
Authors: Edward B Garon; Naiyer A Rizvi; Rina Hui; Natasha Leighl; Ani S Balmanoukian; Joseph Paul Eder; Amita Patnaik; Charu Aggarwal; Matthew Gubens; Leora Horn; Enric Carcereny; Myung-Ju Ahn; Enriqueta Felip; Jong-Seok Lee; Matthew D Hellmann; Omid Hamid; Jonathan W Goldman; Jean-Charles Soria; Marisa Dolled-Filhart; Ruth Z Rutledge; Jin Zhang; Jared K Lunceford; Reshma Rangwala; Gregory M Lubiniecki; Charlotte Roach; Kenneth Emancipator; Leena Gandhi Journal: N Engl J Med Date: 2015-04-19 Impact factor: 91.245
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Authors: Andrea Ardizzoni; Sergio Azevedo; Belen Rubio-Viqueira; Delvys Rodríguez-Abreu; Jorge Alatorre-Alexander; Hans J M Smit; Jinming Yu; Konstantinos Syrigos; Kerstin Trunzer; Hina Patel; Jonathan Tolson; Andres Cardona; Pablo D Perez-Moreno; Tom Newsom-Davis Journal: J Immunother Cancer Date: 2021-03 Impact factor: 13.751