Abstract 971P
Background
Combination therapy with nivolumab + ipilimumab (Nivo+Ipi) has been widely used for clinical treatment in recent years, which has a better survival benefit. However, not all patients can derive clinical benefit from this combination immunotherapy.
Methods
We performed an age subgroup analysis of published randomized control trials concerning "Nivo+Ipi" versus standard therapy in patients with advanced solid tumours. Overall Survival (OS) among the elderly (≥ 75 years) was compared with that of younger patients (≥ 65 to < 75 years). Hazard ratios (HRs) with their 95% confidence interval (CI) were collected from the studies and pooled. A fixed-effect model was used.
Results
Few studies have been published corresponding to our inclusion criteria. Two studies (CheckMate 9LA and CheckMate 227) assessed "Nivo+Ipi" in Non-Small Cell Lung Cancer (NSCLC), one study (CheckMate 214) assessed "Nivo+Ipi" in Renal-Cell Carcinoma (RCC); the last one (CheckMate 743) assessed "Nivo+Ipi" in Malignant Pleural Mesothelioma. Our pooled-analysis included 373 patients older than 75 years (308 with thoracic cancers and 65 with RCC) and 1140 patients between 65 and 75 years (882 thoracic cancers and 258 RCC). All patients were mostly men (68%), with good Performance Status (0 or 1). For patients ≥75 years, OS of the "Nivo+Ipi" arm was similar to that of the control arm (HR = 0.98; 95% CI 0.76-1.26; p = 0.86). Conversely, among younger patients (≥65 to < 75 years), a statistically significant OS benefit was observed with "Nivo+Ipi" (HR = 0.74; 95 % CI 0.64-0.85; p < 0.0001). However, the difference observed between subgroups was not statistically significant (p= 0.06).
Conclusions
Due to the low number of elderly patients in clinical trials, there is an uncertainty to prescribe the combination "Nivo+Ipi" for older population (≥75 years). Further studies are warranted.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
T. Landre.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.