More than half of new cases of cancer are diagnosed in patients over 65 years. However only few elderly patients have so far been included into trials, despite general awareness of the need. The revolution of immune checkpoint blocker development brings new hope in older patients because of clinical efficacy and low toxicity. Clinical indications are rising steadily but very few data are available in this population where co-morbidities, reduced functional reserve and immunosenescence may affect efficacy and tolerance.
All cases of patients enrolled in immunotherapy phase I trial between January 2012 and December 2016 in the Drug Development Department (DITEP) at Gustave Roussy were retrospectively reviewed. Case-control analysis was performed in a group of patients ≥ 70 years (elderly patients EP) matched to a group of patients < 70 years (younger patients YP) by trial and treatment dose. We compared cumulative incidence, grade and type of adverse events (AEs) and survival outcomes. Cumulative incidence was calculated according to Fine and Gray method and survivals using Kaplan-Meier method.
Median age of EP and YP were respectively 75 (70 - 88) and 55 (22 - 70). Among the 46 EP and the 174 YP enrolled in 13 protocols, 10 (22%) and 23 (13%) patients experienced grade 3-4 AEs. Cumulative incidence of grade 1-2 AEs was significantly higher in EP versus YP (p
Immune checkpoint blockade appears to be a practicable option of treatment for elderly patients. The toxicity and efficacy profiles appear similar to the ones in younger patients. Dedicated studies in this population are warranted.
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All authors have declared no conflicts of interest.