Abstract 2333
Background
The emergence of ICIs has modified the treatment of many types of cancers. However, efficacy and safety data of such agents (anti PD-1/anti PD-L1) are cruelly missing in elderly patients ⩾ 80 year-old.
Methods
A retrospective monocentric study was conducted between April 2015 and April 2019 in all ⩾ 80 year-old ICIs-treated patients, as a part of a clinical trial or standard of care. Patients/disease characteristics were collected using electronic medical records. Clinical response was assessed according to iRECIST criteria; survival was estimated according to Kaplan-Meier method and toxicity was assessed according to CTCAE v 4.0.
Results
Of the 415 patients who received an ICI, 42 (10.1%) were aged ⩾ 80 years (median: 84; range: 80-93). The most represented tumour types were NSCLC (45.2%), renal cell carcinoma (30.9%) and bladder carcinoma (16.7%). 92.9% were stage IV. ICIs were given as first-line therapy in 7 patients (16.7%) and as second-line or beyond in 35 patients (83.3%). 29 patients had nivolumab, 10 patients had pembrolizumab and 3 had atezolizumab. ICIs were given mostly as monotherapy (97.6%). A median of 7.5 doses were administered (range: 1-37). Of the 42 patients, 40.5% were PS ⩾ 2 and 88.1% had impaired G8 score. Mean Charlson Index was 3 (range: 0-6), polypharmacy was present in 26 cases and 35.7% had an albumin level < 35g/L (Mean 33.3; range: 22-44). The Objective Response Rate was 11.9% and the Disease Control Rate was 31%. The median progression-free survival was 5 months [95% CI: 2-10] and the median overall survival was 9 months [95% CI: 6-21]. 26 patients died during the treatment, 16 are still alive; 1 with complete response, 8 stable disease and 7 progressed. All-grade adverse events occurred in 100% of patients, mostly Grade 1 fatigue and anorexia. Immune-related adverse events (IrAEs) occurred in 76.2%, most of them were common and mild; dyspnea, thyroïditis, rash and diarrhea. 9 severe IrAEs occurred; colitis, pneumonitis, rash and arthralgia. Reasons for off therapy included progressive disease (n = 23; 54.8%), adverse effects (n = 5; 11.9%) and death (n = 6; 14.3%).
Conclusions
ICIs appear to be an acceptable treatment option for octogenarian patients, with manageable toxicity.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Mebarki Soraya.
Funding
Has not received any funding.
Disclosure
E. Fabre: Honoraria (self): Roche; Honoraria (self): AstraZeneca; Honoraria (self): BMS; Honoraria (self): Merck. S. Oudard: Research grant / Funding (self): Boehringer; Honoraria (self): Ipsen; Honoraria (self): Bayer; Honoraria (self), Travel / Accommodation / Expenses: Pfize; Honoraria (self), Travel / Accommodation / Expenses: MSD; Honoraria (self), Travel / Accommodation / Expenses: Astellas; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Janssen; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: BMS; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Sanofi. E. Paillaud: Honoraria (self), Advisory / Consultancy: BMS; Honoraria (self): Servier; Honoraria (self), Travel / Accommodation / Expenses: Roche. All other authors have declared no conflicts of interest.
Resources from the same session
1242 - Monalizumab in combination with cetuximab in patients (pts) with recurrent or metastatic (R/M) head and neck cancer (SCCHN) previously treated or not with PD-(L)1 inhibitors (IO): 1-year survival data.
Presenter: Roger Cohen
Session: Poster Display session 3
Resources:
Abstract
4703 - Updated results of a phase II study evaluating accelerator-based boron neutron capture therapy (AB-BNCT) with borofalan(10B) (SPM-011) in recurrent squamous cell carcinoma (R-SCC-HN) and recurrent and locally advanced non-SCC (R/LA-nSCC-HN) of the head and neck
Presenter: Katsumi Hirose
Session: Poster Display session 3
Resources:
Abstract
3638 - Phase 3 KEYNOTE-048 Study of First-Line (1L) Pembrolizumab (P) for Recurrent/Metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC): Asia vs Non-Asia Subgroup (subgrp) Analysis
Presenter: Makoto Tahara
Session: Poster Display session 3
Resources:
Abstract
2954 - Integrated data review evaluating safety, pharmacokinetics (PK) and immunogenicity of RM-1929 photoimmunotherapy (PIT) in subjects with locoregional, recurrent head and neck squamous cell carcinoma (rHNSCC).
Presenter: Jennifer Johnson
Session: Poster Display session 3
Resources:
Abstract
3629 - First line versus second line immunotherapy in recurrent/metastatic squamous cell carcinoma of the head and neck
Presenter: Caroline Even
Session: Poster Display session 3
Resources:
Abstract
767 - Sensitizing HRAS overexpressing head and neck squamous cell carcinoma (HNSCC) to chemotherapy
Presenter: Theodoros Rampias
Session: Poster Display session 3
Resources:
Abstract
4985 - A Single-Arm, Open-Label, Multicenter, Phase IIIb Clinical Trial with Nivolumab in Subjects with Recurrent or Metastatic Platinum-refractory Squamous Cell Carcinoma of the Head and Neck.
Presenter: Paolo Bossi
Session: Poster Display session 3
Resources:
Abstract
1564 - Long-term Results of Phase 2 Trial of Reduced Modified Clinical Target Volume in Low-risk Nasopharyngeal Carcinoma Treated with Intensity Modulated Radiotherapy
Presenter: Jingjing Miao
Session: Poster Display session 3
Resources:
Abstract
3356 - To compare two oral mucosa contouring methods in predicting acute oral mucocitis in nasopharyngeal carcinoma treated with helical tomotherapy
Presenter: Yuan-Yuan Chen
Session: Poster Display session 3
Resources:
Abstract
1984 - Induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) in nasopharyngeal carcinoma (NPC)
Presenter: Gizem Kaval
Session: Poster Display session 3
Resources:
Abstract