Doran Ksienski1, Elaine S Wai2, Nicole S Croteau3, Ashley T Freeman2, Angela Chan4, Leathia Fiorino2, Zia Poonja2, David Fenton2, Tiffany Patterson5, Sarah Irons5, Mary Lesperance3. 1. BC Cancer- Victoria, British Columbia, Canada; University of British Columbia, British Columbia, Canada. Electronic address: dksienski@bccancer.bc.ca. 2. BC Cancer- Victoria, British Columbia, Canada; University of British Columbia, British Columbia, Canada. 3. University of Victoria, Department of Mathematics and Statistics, British Columbia, Canada. 4. University of British Columbia, British Columbia, Canada; BC Cancer- Surrey, British Columbia, Canada. 5. BC Cancer- Victoria, British Columbia, Canada.
Abstract
OBJECTIVES: To explore the association of age with development of immune related adverse events (irAE) and survival in patients with advanced nonsmall cell lung cancer (aNSCLC) receiving programmed cell death 1 antibodies (PD-1 Ab) outside of clinical trials. METHODS: A multicenter retrospective study of PD-1 Ab prescription for patients with aNSCLC between 06/2015-11/2018 at BC Cancer. Multivariable (MVA) logistic regression identified baseline variables associated with irAE manifested within 3 months of PD-1 Ab initiation. Overall survival (OS) analyzed in a propensity-score matched cohort and survival outcomes compared between age groups by stratified log-rank. Six-week landmark analysis was performed and OS compared between patients with interrupted versus continuous treatment by log-rank. RESULTS: Of 527 patients, 40.6% were age ≤ 64 years, 40.6% were 65-74 years, and 18.8% were ≥ 75 years. In MVA, ECOG performance status 2/3 (p = .034), squamous histology (p = .031), and nivolumab therapy (vs. pembrolizumab, p = .012) were associated with increased odds of irAE by 3 months of treatment. Across age groups no difference existed in any grade irAE (p = .98), hospitalization (p = 1.0), or corticosteroids use (p = .51). The propensity score-matched survival analysis comprised 77 patients from each age group; all covariates were balanced. OS did not differ significantly by age in the matched cohort (p = .17). Treatment interruption due to irAE at 6 weeks was more common in patient ≥75 years (vs. <75, p = .055) and correlated with lower OS (p = .002). CONCLUSION: In this cohort of patients with aNSCLC treated in routine clinical practice with PD-1 Ab, immune-toxicity and observed survival were similar amongst age groups.
OBJECTIVES: To explore the association of age with development of immune related adverse events (irAE) and survival in patients with advanced nonsmall cell lung cancer (aNSCLC) receiving programmed cell death 1 antibodies (PD-1 Ab) outside of clinical trials. METHODS: A multicenter retrospective study of PD-1 Ab prescription for patients with aNSCLC between 06/2015-11/2018 at BC Cancer. Multivariable (MVA) logistic regression identified baseline variables associated with irAE manifested within 3 months of PD-1 Ab initiation. Overall survival (OS) analyzed in a propensity-score matched cohort and survival outcomes compared between age groups by stratified log-rank. Six-week landmark analysis was performed and OS compared between patients with interrupted versus continuous treatment by log-rank. RESULTS: Of 527 patients, 40.6% were age ≤ 64 years, 40.6% were 65-74 years, and 18.8% were ≥ 75 years. In MVA, ECOG performance status 2/3 (p = .034), squamous histology (p = .031), and nivolumab therapy (vs. pembrolizumab, p = .012) were associated with increased odds of irAE by 3 months of treatment. Across age groups no difference existed in any grade irAE (p = .98), hospitalization (p = 1.0), or corticosteroids use (p = .51). The propensity score-matched survival analysis comprised 77 patients from each age group; all covariates were balanced. OS did not differ significantly by age in the matched cohort (p = .17). Treatment interruption due to irAE at 6 weeks was more common in patient ≥75 years (vs. <75, p = .055) and correlated with lower OS (p = .002). CONCLUSION: In this cohort of patients with aNSCLC treated in routine clinical practice with PD-1 Ab, immune-toxicity and observed survival were similar amongst age groups.
Authors: Gabriel E Molina; Leyre Zubiri; Justine V Cohen; Sienna M Durbin; Laura Petrillo; Ian M Allen; Yonina R Murciano-Goroff; Michael Dougan; Molly F Thomas; Alexander T Faje; Michelle Rengarajan; Amanda C Guidon; Steven T Chen; Daniel Okin; Benjamin D Medoff; Mazen Nasrallah; Minna J Kohler; Sara R Schoenfeld; Rebecca S Karp Leaf; Meghan E Sise; Tomas G Neilan; Daniel A Zlotoff; Jocelyn R Farmer; Meghan J Mooradian; Aditya Bardia; Minh Mai; Ryan J Sullivan; Yevgeniy R Semenov; Alexandra Chloé Villani; Kerry L Reynolds Journal: Oncologist Date: 2021-03-31
Authors: Doran Ksienski; Elaine S Wai; Deepu Alex; Nicole S Croteau; Ashley T Freeman; Angela Chan; Tiffany Patterson; Melissa Clarkson; Leathia Fiorino; Zia Poonja; David Fenton; Sarah Irons; Mary Lesperance Journal: Transl Lung Cancer Res Date: 2021-01
Authors: Mohammed Safi; Ravindran Kanesvaran; Mohammed Alradhi; Abdullah Al-Danakh; Feng Ping; Najeeb Al-Sabai; Xiu Shan; Jiwei Liu Journal: Front Oncol Date: 2020-10-22 Impact factor: 6.244