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
4596 - A Phase 2, Open-Label, Randomized, Multicenter Trial of Encorafenib + Binimetinib Evaluating a Standard-dose and a High-dose Regimen in Patients With BRAFV600-Mutant Melanoma Brain Metastasis (MBM) (POLARIS)
Presenter: Michael Davies
Session: Poster Display session 3
Resources:
Abstract
1891 - Continuation of annual screening mammograms and breast-cancer mortality in women over 70
Presenter: Xabier Garcia De Albeniz
Session: Poster Display session 3
Resources:
Abstract
5587 - Introducing standardized medical procedure and dynamic decision support program in precision oncology for the community of practice
Presenter: Istvan Petak
Session: Poster Display session 3
Resources:
Abstract
4757 - Effectively using primary care givers in oncology care through capacity building, task sharing and techno-mentoring.
Presenter: Dinesh Pendharkar
Session: Poster Display session 3
Resources:
Abstract
4497 - A single institution review of capecitabine related acute admissions and cost analysis
Presenter: Gemma Dart
Session: Poster Display session 3
Resources:
Abstract
2187 - Health status of middle-aged and older cancer survivors in China: results from the China Health and Retirement Longitudinal Study (CHARLS)
Presenter: Jiarui Li
Session: Poster Display session 3
Resources:
Abstract
5101 - Crossed looks on lung cancer perception and knowledge from general public and physicians in France: results of a two-fold survey
Presenter: Céline Mascaux
Session: Poster Display session 3
Resources:
Abstract
4354 - Knowledge and perception of clinical trials (CTs) and attitude towards participation among Polish oncological patients - A pilot survey
Presenter: Artur Kotowski
Session: Poster Display session 3
Resources:
Abstract
3499 - Achieving best possible cancer treatment outcomes in care pathways through benchmarking; ABC-Benchmarking
Presenter: Anke Wind
Session: Poster Display session 3
Resources:
Abstract
2270 - Impact of 10-day Fulbright Specialist Program (FSP) and Project Pink Blue (PPB) Education Sessions on Medical Oncology knowledge among Doctors that treat cancer in Nigeria
Presenter: Mike Martin
Session: Poster Display session 3
Resources:
Abstract