Abstract 2215
Background
Age-related immune dysfunction might impair the efficacy of immune checkpoint inhibitors (ICIs) in older patients. We aimed to evaluate, in a real-life setting, if age was associated with long-term clinical outcomes and tolerance of ICIs.
Methods
All patients receiving an ICI monotherapy [CTLA-4 or PD(L)-1 inhibitors] for the standard treatment of a locally advanced or metastatic cancer were included in this retrospective multicentric series (three hospitals in the Hospices Civils de Lyon, France). The primary endpoint was overall survival (OS). Progression-free survival (PFS) and immune-related adverse events (irAEs) were secondary endpoints. The impact of age was assessed using the threshold of 70 years.
Results
Between January 2007 and October 2017, 410 patients were included in this series, for a total of 435 lines of treatment. One hundred and fifty lines (34%) were received by patients of 70 years or older. They were administered for a lung cancer (n = 304, 74%), a melanoma (n = 79, 19%) or a urologic cancer (n = 27, 7%). Most of the administered treatments were PD(L)-1 inhibitors (n = 356, 82%). Mean follow-up duration starting at treatment initiation was 46 months in the CTLA-4 cohort, and 20 months in the PD(L)-1 cohort. For both CTLA-4 inhibitors and PD(L)-1 inhibitors, there was no statistical association between age and OS (respectively, HR 0.8, 95% CI: 0.5-1.4; log-rank P = 0.49 and HR = 0.9, 95% CI: 0.7-1.1; Log-rank P = 0.27) or PFS (respectively, HR = 0.7, 95% CI: 0.4-1.1; log-rank P = 0.13 or HR = 0.9, 95% CI: 0.7-1.1; Log-rank P = 0.19) in univariate analysis, and after adjusting on prognosis covariates. Older patients did not have more grade 3-4 irAEs (11% versus 12%, P = 0.87).
Conclusions
In this large real-world series, the long-term clinical outcomes were not statistically different between patients older or younger than 70 years who had received ICIs as a single agent in standard practice for an advanced solid tumor. Older patients did not have more severe immune-related adverse events. These data suggest that the use of ICI monotherapy for older patients may be safe with no specific monitoring.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Julien Péron.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3611 - Phase II trial of SM 88 in Non-Metastatic Biochemical Recurrent Prostate Cancer.
Presenter: Benjamin Gartrell
Session: Poster Display session 3
Resources:
Abstract
2492 - A phase 1 study of Ad5 PSA/MUC-1/Brachyury Vaccine in Patients with Metastatic Castration Resistant Prostate Cancer (mCRPC)
Presenter: Marijo Bilusic
Session: Poster Display session 3
Resources:
Abstract
3142 - Multicenter Phase I Trial of a DNA Vaccine Encoding the Androgen Receptor Ligand Binding Domain (pTVG-AR, MVI-118) in Patients with Metastatic Prostate Cancer
Presenter: Douglas McNeel
Session: Poster Display session 3
Resources:
Abstract
4327 - Impact of germline mutations in Homologous Recombination (HR) genes on the response to Radium-223 for metastatic castration resistant prostate cancer (mCRPC)
Presenter: Elena Castro
Session: Poster Display session 3
Resources:
Abstract
3600 - Serum biomarkers of bone metabolism in metastatic castration-resistant prostate cancer (mCRPC) patients (pts) treated with Radium-223 (Ra223): Results from a prospective multicentre study
Presenter: Nuria Romero Laorden
Session: Poster Display session 3
Resources:
Abstract
3742 - Prognostic value of tumor suppression genes (TP53, PTEN, Rb) in metastatic hormone sensitive prostate cancer
Presenter: Miguel Gonzalez Velez
Session: Poster Display session 3
Resources:
Abstract
2643 - Germline sequencing of advanced prostate cancer patients in the BARCODE2 trial
Presenter: Sarah Benafif
Session: Poster Display session 3
Resources:
Abstract
4349 - Impact of treatment sequence in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC): data from the prospective PROREPAIR-B study.
Presenter: Carlo Cattrini
Session: Poster Display session 3
Resources:
Abstract
3301 - Implications of Single Nucleotide Polymorphisms (SNPs) in Androgen Related-Genes in Outcome of metastatic castration-resistant prostate cancer (mCRPC) patients treated with Abiraterone (Abi) and Enzalutamide (Enza)
Presenter: Isabel Aragon
Session: Poster Display session 3
Resources:
Abstract
2275 - Activating mutations in AKT1/PIK3CA are associated with poor clinical outcomes in metastatic prostate cancer (mPC)
Presenter: Simon Fu
Session: Poster Display session 3
Resources:
Abstract