Arielle Elkrief1, Corentin Richard2, Julie Malo3, Lena Cvetkovic4, Marie Florescu3, Normand Blais3, Mustapha Tehfe3, Meriem Messaoudene4, Andréanne Gagné5, Michele Orain5, Soleine Medjebar2, Doreen Wan-Chow-Wah6, Philippe Joubert5, Catherine Labbé5, Francois Ghiringhelli2, Bertrand Routy7. 1. Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Division of Oncology, Department of Medicine Montréal, QC, Canada; McGill University Health Centre, Division of Oncology, Department of Medicine, Montreal, QC, Canada. 2. Plateform of Transfer in Cancer Biology, Department of Biology and Tumor Pathology, Georges-Francois Leclerc Center, Dijon, France. 3. Centre Hospitalier de l'Université de Montréal (CHUM), Hematology-Oncology Division, Department of Medicine, Montréal, QC, Canada. 4. Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Division of Oncology, Department of Medicine Montréal, QC, Canada. 5. Quebec Heart and Lung Institute Research Center, Department of Pathology, Quebec, QC, Canada. 6. McGill University Health Centre, Division of Oncology, Department of Medicine, Montreal, QC, Canada; McGill University Health Centre, Division of Geriatric Medicine, Department of Medicine, Montreal, QC, Canada. 7. Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Division of Oncology, Department of Medicine Montréal, QC, Canada; Centre Hospitalier de l'Université de Montréal (CHUM), Hematology-Oncology Division, Department of Medicine, Montréal, QC, Canada. Electronic address: bertrand.routy@umontreal.ca.
Abstract
BACKGROUND: Age-related immune remodelling is thought to be associated with resistance to immune checkpoint inhibitors (ICIs) in cancer. Patients older than 70 years, representing >50% of the population with non-small cell lung cancer (NSCLC) according to SEER database, are underrepresented in clinical trials exploring ICIs. The objective of this study was to determine if patients with NSCLC older than ≥70 years had inferior clinical outcomes with ICIs. METHODS: We conducted a retrospective analysis of 381 patients treated with anti-PD-(L)1 ICI for advanced NSCLC at the Dijon Cancer Center (n = 177), University of Montreal Hospital (n = 106) and Quebec Heart and Lung Institute (n = 98). Age was considered as a categorical variable. Patients' baseline characteristics were compared using the Chi-squared test. Survival curves were estimated by the Kaplan-Meier method and compared with the Log-rank test in a univariate analysis. Multivariate cox regression model was used to determine hazard ratios and 95% confidence intervals for progression-free survival (PFS) and overall survival (OS) between the groups, adjusting for other clinicopathologic features. RESULTS: Among 381 patients included, 335 (88%) received ICI after platinum chemotherapy. The median age was 66 (range 37-89) and 33% were older than 70 years of age. Considering age as a categorical variable, differences in age were not associated with PFS or OS. Subgroup analysis and multivariate cox regression did not reveal significant interaction of age with outcomes. ECOG performance status was the only significant factor in the three cohorts. CONCLUSIONS: Unlike previously described in the era of chemotherapy, age was not associated with outcomes in NSCLC patients treated with ICI.
BACKGROUND: Age-related immune remodelling is thought to be associated with resistance to immune checkpoint inhibitors (ICIs) in cancer. Patients older than 70 years, representing >50% of the population with non-small cell lung cancer (NSCLC) according to SEER database, are underrepresented in clinical trials exploring ICIs. The objective of this study was to determine if patients with NSCLC older than ≥70 years had inferior clinical outcomes with ICIs. METHODS: We conducted a retrospective analysis of 381 patients treated with anti-PD-(L)1 ICI for advanced NSCLC at the Dijon Cancer Center (n = 177), University of Montreal Hospital (n = 106) and Quebec Heart and Lung Institute (n = 98). Age was considered as a categorical variable. Patients' baseline characteristics were compared using the Chi-squared test. Survival curves were estimated by the Kaplan-Meier method and compared with the Log-rank test in a univariate analysis. Multivariate cox regression model was used to determine hazard ratios and 95% confidence intervals for progression-free survival (PFS) and overall survival (OS) between the groups, adjusting for other clinicopathologic features. RESULTS: Among 381 patients included, 335 (88%) received ICI after platinum chemotherapy. The median age was 66 (range 37-89) and 33% were older than 70 years of age. Considering age as a categorical variable, differences in age were not associated with PFS or OS. Subgroup analysis and multivariate cox regression did not reveal significant interaction of age with outcomes. ECOG performance status was the only significant factor in the three cohorts. CONCLUSIONS: Unlike previously described in the era of chemotherapy, age was not associated with outcomes in NSCLCpatients treated with ICI.
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