Abstract 5444
Background
Immunotherapy with anti PD-1 antibodies (mAbs) is the standard of care for the treatment of advanced Non-Small-Cell Lung Cancer (NSCLC). A conspicuous group of patients with advanced NSCLC are more than 75 years old. However, no randomized controlled trial exploring anti PD-1 therapy in older individuals has been published until now and few experiences in clinical practice have been reported. We therefore performed a multicenter retrospective analysis on NSCLC elderly patients treated with anti PD-1 therapy.
Methods
We collected data from seven centers. Inclusion criteria were a diagnosis of advanced NSCLC, age ≥75 years, and treatment with anti-PD-1mAbs (pembrolizumab or nivolumab) in first or following lines. Primary end-points of the study were efficacy, in terms of Disease Control Rate (DCR), Overall Response Rate (ORR), Progression-Free Survival (PFS), and safety, by means of immune-related adverse events (irAEs).
Results
The Clinical records of 72 patients followed since 2015 were analyzed. Median age was 77 years (75-86), males ware more frequently represented (60/72, 83%). A current or previous smoking history was found in 67/72 (93%) patients. Very old individuals (> 80 years old) were 21/72 (29%) and ECOG PS was 0-1 for 49/72 patients (63%). Non-squamous histology was prevalent 45/72, (62%). Brain metastases were found in 6/72 (8%) patients. Most of the patients (58/72, 81%) received nivolumab. For 68 patients, data on DCR, ORR were available. 39/68 (54%) had a DCR, while 17/68 (24%) had an ORR. Less than 10% of the patients had oligoprogression or pseudoprogression (8,3 and 9,7 % respectively). Overall immune-related adverse events occurred in 9/72 (14%) of individuals, 4/10 (40%) of them grade 3/4, being hematological and liver toxicities the most frequent ones (4 and 3%, respectively). At time of analysis, median PFS was 4,4 months (0.5-25 SD 5,53). In the Cox regression analysis, PFS was significantly influenced by DCR and smoking status (p = 0,0001, OR 17 95% CI 5,4 -52,3 and p = 0,001, OR 11 95% CI 2,6-45, respectively).
Conclusions
In our cohort of elderly patients, anti PD-1 agents demonstrated to have a good toxicity profile and an efficacy comparable with the younger population.
Clinical trial identification
Legal entity responsible for the study
I conducted the study recording and collecting clinical data from other colleagues and computing statistical part with other specialists of the San Paolo Hospital in Milan.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4679 - Correlative analyses of serum biomarkers and efficacy outcomes in the randomized phase 2 trial of lenvatinib (LEN), everolimus (EVE), or LEN+EVE in patients with metastatic renal cell carcinoma
Presenter: Chung-Han Lee
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
5379 - End-to-end learning to predict survival in patients with gastric cancer using convolutional neural networks
Presenter: Armin Meier
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
5394 - Detection of Targetable Kinase Fusions in 7260 patients in an integrated Cancer System
Presenter: Ankur Parikh
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
5884 - Clinical and analytical validation of an FDA approved comprehensive genomic profiling (CGP) assay incorporating multiple companion diagnostics for targeted and immunotherapies
Presenter: Yali Li
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
5912 - SET overexpression promotes colorectal cancer progression and determines poor outcome in patients with localized disease.
Presenter: Blanca Torrejón
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
1168 - The functional MDM4 genetic variant in advanced lung adenocarcinoma patients treated with EGFR-TKIs
Presenter: Nasha Zhang
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
3071 - PD-L1 expression on pre-treatment circulating tumour cells, but not serum VEGF, is predictive of response to pembrolizumab in melanoma
Presenter: Muhammad Khattak
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
4062 - Olaparib plus paclitaxel sensitivity in biomarker subgroups of gastric cancer
Presenter: Yu-Zhen Liu
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
4801 - A diagnostic model for hepatitis B virus-related hepatocellular carcinoma in China: a large-scale, multi-center study
Presenter: Tian Yang
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
4874 - Dissecting Gastric Cancer biology and how and when to use immunotherapy
Presenter: Meghna Das Thakur
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract