Real‐world use and survival outcomes of immune checkpoint inhibitors in older adults with non–small cell lung cancer

Youn, Bo-Ra; Trikalinos, Nikolaos A.; Mor, Vincent; Wilson, Ira B.; Dahabreh, Issa J

doi:10.1002/cncr.32624

Cited by 62 publications

(68 citation statements)

References 21 publications

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“…Except for adenocarcinomas and squamous cell histology of lung cancer, most variables demonstrate significant negative OS in the NSCLC immunotherapy era. In addition, aging is significantly linked to negative OS in patients with NSCLC who died from heart diseases; this finding was also recently shown in a SEER-Medicare study by Bora et al, who report that comorbidities and negative OS are related to old age in NSCLC patients who were started with immune checkpoint inhibitors (18). Recently, several reports indicate that the combining of chemoradiotherapy with immunotherapy has superior efficacy in producing improved anticancer activity (19).…”

Section: Discussionmentioning

confidence: 64%

Overall Survival in Heart Disease–Related Death in Non-Small Cell Lung Cancer Patients: Nonimmunotherapy Versus Immunotherapy Era: Population-Based Study

et al. 2020

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The cardiotoxicity during immunotherapy administration leads to mortality by more than 42% and heart disease-related mortality among immunotherapy-linked cancers is still considered to be underestimated. In this study, the advanced stage of non-small cell lung cancer (NSCLC) with heart disease-related death was selected in accordance with immunotherapy approval time. NSCLC was searched on the Surveillance, Epidemiology, and End Results (SEER) program. Results show that 538 advanced NSCLC cases, those dominated by men and elderly people aged more than 70 years, had a high percentage of heart disease-related death in both eras. The difference between contemporary groups was fairly nonsignificant (P = > 0.05). The overall survival (OS) of allcause mortality difference showed improved survival in the immunotherapy group (P = 0.0001). In the study of heart disease-related death survival with adjusted data, the NSCLC patients show significant lower survival in the immunotherapy era compared with the nonimmunotherapy era (P = 0.003; hazard ratio [HR] = 1.31; 95% CI = 1.099-1.57). In the multivariate analysis of NSCLC-related immunotherapy, histology revealed that the non-squamous cell type had an independent risk for lower OS than the squamous cell type (P = 0.04; HR= 0.74; CI = 0, 55-0.99). The results demonstrate the survival benefits for NSCLC in immunotherapy; however, in heart disease-related death, immunotherapy in patients with NSCLC shows decreased OS. This study highlights that NSCLC patients should be highly monitored during immunotherapy administration, and further assessment is needed.

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Section: Discussionmentioning

confidence: 64%

Overall Survival in Heart Disease–Related Death in Non-Small Cell Lung Cancer Patients: Nonimmunotherapy Versus Immunotherapy Era: Population-Based Study

et al. 2020

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“…LUSC and LUAD are the two major subtypes of lung cancer, in which LUSC progresses faster than LUAD of the same stage [28]. Tumor-related prognosis or predictive markers in the immune microenvironment significantly changed the treatment prospects of lung cancer and significantly improved the prognosis of some patients, especially those with adenocarcinoma [29][30][31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Mine TCGA Database for Tumor Microenvironment-Related Genes of Prognostic value in lung squamous cell carcinoma

Xiao

Yin

et al. 2020

Preprint

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Background: Tumor microenvironment (TME) plays a significant role in the development of cancer. However, the roles of TME in lung squamous cell carcinoma (LUSC) are not well studied. In our study, we aimed to identify differentially expressed tumor microenvironment-related genes as biomarker for predicting the prognosis of LUSC.Methods: We combined The Cancer Genome Atlas (TCGA) and Estimation of Stromal and Immune cells in Malignant Tumor tissue using Expression data (ESTIMATE) datasets to identified differentially expressed genes in lung squamous cell carcinoma microenvironment. Then, functional enrichment analysis and protein-protein interaction (PPI) network were conducted. The top six genes in the PPI network were regarded as tumor microenvironment-related hub genes. Finally, the relationship between hub genes and tumor-infiltrating immune cells was deciphered using TIMER.Results: Our study revealed that immune and stromal scores are associated with specific clinicopathologic variables in LUSC. These variables include gender, age, distant metastasis and prognosis. In addition, a total of 874 upregulated and 72 downregulated genes were identified. Functional enrichment analysis demonstrated a correlation between DEGs and the tumor microenvironment, tumor immune cells differentiation and activation. C3AR1, CSF1R, CCL2, CCR1, TYROBP, CD14were selected as the hub genes. A positive correlation was obtained between the expression of hub genes and the abundance of six immune cells.Conclusions: The results of the present study showed that ESTIMATE algorithm-based stromal and immune scores may be a reference indicator of cancer prognosis. We identified five TME-related genes, which could be used to predict the prognosis of LUSC patients.

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“…Using the SEER-Medicare database, Youn et al [38] identified 1256 patients aged ≥65 years who had NSCLC between 2002 and 2015 and initiated nivolumab or pembrolizumab in 2016. These patients had stage I (n = 229), stage II (n = 75), stage III (n = 417), or stage IV (n = 535) cancer and had received no previous systemic therapy (n = 102).…”

Section: Efficacy Of Icis For Elderly Nsclc Patients In Non-randomizementioning

confidence: 99%

Do Elderly Lung Cancer Patients Aged ≥75 Years Benefit from Immune Checkpoint Inhibitors?

Takigawa

Ochi

Nakagawa

et al. 2020

Cancers

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Lung cancer patients ≥75 years represent nearly 40% of all lung cancer patients and continue to increase. If elderly patients have a good performance status and adequate organ function, they can be treated the same as non-elderly patients. However, few comparative studies limited to elderly patients (≥75 years) have been conducted. We review the evidence on using immune check inhibitors for the treatment of elderly patients (≥75 years old) with advanced non-small cell lung cancer. Prospective randomized or non-randomized, retrospective, registrational, insurance-based, and community-based studies have shown that elderly (≥75 years) and non-elderly patients are similarly treated with immune check inhibitors effectively and safely. However, such analyses have not shown that immune check inhibitors are significantly more effective than chemotherapy alone. In addition, patient selection might be critically performed to administer immune check inhibitors in the elderly because they are more likely to have a poor performance status with comorbidities, which lead to little benefit, even in non-elderly patients. There is a need for more evidence showing the benefit of immune check inhibitors in non-small cell lung cancer patients ≥75 years.

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Real‐world use and survival outcomes of immune checkpoint inhibitors in older adults with non–small cell lung cancer

Cited by 62 publications

References 21 publications

Overall Survival in Heart Disease–Related Death in Non-Small Cell Lung Cancer Patients: Nonimmunotherapy Versus Immunotherapy Era: Population-Based Study

Overall Survival in Heart Disease–Related Death in Non-Small Cell Lung Cancer Patients: Nonimmunotherapy Versus Immunotherapy Era: Population-Based Study

Mine TCGA Database for Tumor Microenvironment-Related Genes of Prognostic value in lung squamous cell carcinoma

Do Elderly Lung Cancer Patients Aged ≥75 Years Benefit from Immune Checkpoint Inhibitors?

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