Efficacy and safety of Nivolumab in older patients with pretreated lung cancer: A subgroup analysis of the Galician lung cancer group

Ron, David Arias; Manrique, Maria Carmen Areses; Martinez, J. Mosquera; González, Jorge García; Afonso, Francisco Javier Afonso; Quintela, Martín Lázaro; Núñez, Natalia Fernández; Raposeiras, Cristina Azpitarte; Gancedo, Margarita Amenedo; Couto, Lucía Santomé; Campelo, M.R. García; Iglesias, J.; Bañobre, Juan Ruiz; Simó, Rafael; Rubio, Joaquín Casal; Balea, Begoña Campos; Frieiro, Iria Carou; Curbera, Guillermo Alonso-Jáudenes; Herranz, Urbano Anido; Mata, Jesús García; Pérez, José Luis Fírvida

doi:10.1016/j.jgo.2020.11.010

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…Although previous retrospective studies have investigated the efficacy or survival benefit of anti-PD-1 therapy in older patients or those with PS 2-4, 8,9 it is important to accumulate more clinical data on these cohorts and identify populations that derive clinical benefit from anti-PD-1 therapy. Thus, we examined the therapeutic benefit and safety profile of PD-1 therapy in older patients or those with poor PS.…”

Section: Introductionmentioning

confidence: 99%

Anti–PD-1 Monotherapy for Advanced NSCLC Patients with Older Age or Those with Poor Performance Status

Matsubara¹,

Seto²,

Takamori³

et al. 2021

OTT

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Anti-programmed death 1 (PD-1) antibodies have emerged as frontline treatments for patients with advanced non-small cell lung cancer (NSCLC) on the basis of global Phase III trials. However, current data regarding responses to anti-PD-1 therapy in older patients with NSCLC or those with poor performance status (PS) are limited. Therefore, we examined the therapeutic effect of anti PD-1 antibody in these patients. Patients: We retrospectively examined consecutive patients treated with anti-PD-1 monotherapy (pembrolizumab or nivolumab) from January 2016 to September 2018. Results: We enrolled 125 patients (median age, 60 years), 80.8% of whom were men. Patients aged ≥75 years were considered older patients (n = 15), and those with PS 2-3 were regarded as having poor PS (n = 11). The objective response and disease control rates were 15.4% and 46.2%, respectively, in older patients and 9.1% and 27.3%, respectively, in those with poor PS. Progression-free survival (PFS) and overall survival (OS) did not significantly differ between older and younger patients. However, poor PS was significantly associated with poor survival. High programmed death ligand 1 (PD-L1) expression in tumor specimens (≥50%) was associated with favorable survival in the entire cohort as well as patients with poor PS. Safety analyses demonstrated no significant difference in the occurrence of any adverse event, including grade ≥3 adverse events, between patients with poor PS or older age and the remaining patients. Conclusion: Anti-PD-1 therapy had similar efficacy in older and younger patients with NSCLC, whereas survival was significantly worse in patients with poor PS. However, immune checkpoint inhibitors may be considered for patients with poor PS harboring positive PD-L1 expression.

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Section: Introductionmentioning

confidence: 99%

Anti–PD-1 Monotherapy for Advanced NSCLC Patients with Older Age or Those with Poor Performance Status

Matsubara¹,

Seto²,

Takamori³

et al. 2021

OTT

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“…Similar results were reported by Ron et al, which found comparable immune-related adverse events (irAE) in patients aged below and above 70 years who were treated with immune checkpoint inhibitor nivolumab. 16 Another study done in 2018 with a sample population of 245 patients also found no relation between the incidence of irAE and age and reported similar rates of immunotherapy-related hospitalization and steroid use across different age groups. 17 …”

Section: Resultsmentioning

confidence: 95%

“… 15 A similar study done in geriatric patients with pretreated NSCLC also showed no significant differences in the clinical effectiveness of immune checkpoint inhibitor nivolumab in the older population. 16 …”

Section: Resultsmentioning

confidence: 99%

Immunotherapy in Older Patients with Cancer: A Narrative Review

Smith,

Boby,

Benny

et al. 2024

IJGM

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Purpose Immunotherapies have revolutionized cancer treatment; however, relatively little is known about their efficacy and toxicity in the elderly, a cohort accounting for more than half of total cancer cases. In this review, we aim to provide insight into the current knowledge base regarding the clinical utility and side effects of immunotherapies in the geriatric population as well as identify key gaps in the literature where further research is essential. Methods We conducted a rapid critical review of available literature, focusing on studies reporting on use of immunotherapy in cancer patients aged ≥65 years. The review assessed studies that included different types of cancer, were of multiple study types (although predominantly retrospective), had different study duration, and reported different outcomes of interest. Owing to this heterogeneity, meta-analysis and a direct comparison between studies were not feasible. Results Overall, the review findings indicate that certain malignancies have shown comparable survival rates in younger and older age groups when managed with immunotherapeutic drugs, the incidence of immunotherapy-related side effects varies only slightly by age groups, and in general there is a lack of studies on the determinants of the clinical outcomes of immunotherapy in or including geriatric patients. Conclusion Enhanced clinical benefits along with better tolerability associated with immunotherapies make it an attractive alternative to conventional chemotherapeutic drugs, especially in elderly patients. There is currently a limited number of studies assessing the clinical outcomes of immunotherapies, particularly in the elderly. Overall, our findings reflect a need for further prospective studies focussing on geriatric patients representative of the real-life population, in order to derive a more precise understanding of the clinical utility, toxicity profile, and cost-effectiveness of immune checkpoint inhibitors in older patients with cancer.

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2021

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Efficacy and safety of Nivolumab in older patients with pretreated lung cancer: A subgroup analysis of the Galician lung cancer group

Cited by 3 publications

References 27 publications

Anti–PD-1 Monotherapy for Advanced NSCLC Patients with Older Age or Those with Poor Performance Status

Anti–PD-1 Monotherapy for Advanced NSCLC Patients with Older Age or Those with Poor Performance Status

Immunotherapy in Older Patients with Cancer: A Narrative Review

Nivolumab

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