Abstract 654P
Background
Ipilimumab and nivolumab (ipi-nivo) combination therapy is an effective first-line treatment for advanced non-small cell lung cancer (NSCLC), regardless of programmed death ligand 1 expression. However, the effectiveness and feasibility of first-line ipi-nivo therapy in elderly patients (aged ≥75 years) is unclear. Therefore, this study aimed to investigate the efficacy and safety of first-line ipi-nivo therapy in elderly patients with NSCLC.
Methods
We retrospectively evaluated the data of patients with NSCLC, aged ≥75 years, who were treated with first-line ipi-nivo from December 2020 to November 2022 at four institutes in Japan. Data on patient characteristics, efficacy of ipi-nivo therapy, and type and severity of adverse events were assessed.
Results
Fifty-seven patients (52 men and 5 women; median age, 78 years [range: 75–86]) were included in the analysis. The overall response rate was 42.1%, disease control rate was 73.6%, median progression-free survival (PFS) was 7.1 months, and median overall survival (OS) was 14.1 months. Frequent adverse events of Grade 3 or higher were pneumonitis in 7 patients (12.2%), increased aspartate transaminase in 4 patients (7.0%), increased alanine transaminase in 4 patients (7.0%), adrenal insufficiency in 3 patients (5.3%), and colitis in 3 patients (5.3%). No treatment-related deaths occurred. First-line ipi-nivo treatment was associated with PFS based on the presence or absence of immune-related adverse events (irAEs). The PFS of patients with irAEs was 11.7 months, whereas the PFS of patients without irAEs was 2.8 months.
Conclusions
First-line ipi-nivo therapy was effective in elderly patients with NSCLC. While there was a trend towards increased pneumonitis, the therapy manageable and suggested as a viable treatment option.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.