Abstract 5524
Background
The widespread introduction of ICIs in patients (pts) with metastatic disease has significantly improved outcomes. However, ICIs in the elderly requires further evaluation to determine whether outcomes differ from that observed in younger cohorts. The goal of this study is to utilize real-world data from the Canadian Melanoma Research Network Registry.
Methods
This retrospective observational study was performed in metastatic pts entered into a common clinical registry and who received ipilimumab alone (ipi) and nivolumab (nivo) or pembrolizumab (pembro) from 2008 to February 2019. Demographics, extent of disease, all treatments and adverse events (AEs) were compiled. Comparisons between pts in different age cohorts were made. The potential impact of known prognostic factors was investigated using Cox proportional multivariate analyses.
Results
144 pts over 70 were treated with ICI as 1st line. 43 patients received ipi and 101 received nivo or pembro. BRAF mutation was present in 17%. Pulmonary mets: 56%; Liver mets 34%; Brain mets: 16%. For those aged 70-99, median survival was 10 M (range: 1 M - 50 M). In a comparative cohort of pts aged 50-69, the median survival was 11.8 M (range: 1 M – 78 M). On multivariate analysis age, baseline LDH and BRAF status did not impact overall survival. Within the elderly cohort, the use of ipi was associated with significantly decreased overall survival when compared to nivo and pembro (OS ipi: 6.8 M vs anti-PD1: 10.6 M). 95 pts over 70 received ICIs as 2nd line, with a median survival of 6.3 M, which was not significantly different from the younger cohort who received second-line ICIs (median survival of 8 M). In the elderly cohort, 124 >grade 2 AEs were observed: Rash 25%; Colitis: 18%; Fatigue: 8%; Asthenia: 7%.
Conclusions
ICIs can be effectively utilized in pts over 70. Survival appears to be comparable to that achieved in younger cohorts. Elderly pts who only received ipi appeared to have a worse outcome than those pts who received nivo or pembro.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Global Melanoma Research Network.
Funding
Global Melanoma Research Network.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5218 - Elevated driver mutational burden or number of perturbed pathways and poor response to abiraterone or enzalutamide in metastatic castration-resistant prostate cancer
Presenter: Bram De Laere
Session: Poster Display session 3
Resources:
Abstract
2452 - High proportion of multiple KRAS mutations in circulating tumor DNA and tumor tissue of pancreatic ductal adenocarcinoma
Presenter: Min Kyeong Kim
Session: Poster Display session 3
Resources:
Abstract
3328 - Biological difference of tumor mutational burden (TMB) and microsatellite instability (MSI) status in patients (pts) with somatic vs. germline BRCA1/2-mutated advanced gastrointestinal (GI) cancers using cell-free DNA (cfDNA) sequencing analysis in the GOZILA study
Presenter: Yasuyuki Kawamoto
Session: Poster Display session 3
Resources:
Abstract
3022 - Cell-Free DNA to Detect Focal Versus Non-Focal MET Amplification in Metastatic Colorectal Cancer Patients: Combined Analysis from Japan and the United States
Presenter: Mishima Saori
Session: Poster Display session 3
Resources:
Abstract
2833 - Presence of circulating tumor DNA in surgically resected renal cell carcinoma is associated with advanced disease and poor patient prognosis
Presenter: Andres Correa
Session: Poster Display session 3
Resources:
Abstract
1376 - Combined genomic and epigenomic assessment of cell-free circulating tumor DNA (cfDNA) for cancer diagnosis and recurrence-risk assessment in early-stage lung cancer
Presenter: Junghee Lee
Session: Poster Display session 3
Resources:
Abstract
4050 - DEMo: a prospective evaluation of a prognostic clinico-molecular composite score in NSCLC patients treated with immunotherapy.
Presenter: Arsela Prelaj
Session: Poster Display session 3
Resources:
Abstract
4727 - Bespoke circulating tumor DNA (ctDNA) analysis as a predictive biomarker in solid tumor patients (pts) treated with single agent pembrolizumab (P)
Presenter: Cindy Yang
Session: Poster Display session 3
Resources:
Abstract
3662 - Dynamic changes in whole-genome cell-free DNA (cfDNA) to identify disease progression prior to imaging in advanced solid tumors
Presenter: Andrew Davis
Session: Poster Display session 3
Resources:
Abstract
3817 - Evaluation of Microsatellite Instability Testing Through cell-free DNA sequencing
Presenter: Shile Zhang
Session: Poster Display session 3
Resources:
Abstract