ESMO Congress 2023 | OncologyPRO

Abstract 2169P

Background

The incidence of cancer increases with age, advanced age remains the most important risk factor for most cancers. According to epidemiological statistics, the probability of developing invasive cancer in each age group is highest in the 70 years and older group, reaching 1/4 to 1/3. Immunotherapy is increasingly indicated for solid tumors, but toxicity and efficacy in older adults [age ≥70 years(y)] are unknown. The purpose of this study was to determine age-based differences in OS and treatment-related side effects.

Methods

This is a multicenter retrospective cohort study of patients with advanced cancer. Patients who received ≥1 dose of IO from January 1, 2019 to October 1, 2021 at three centers in China were collected to extract important information from the medical records. The primary outcome was PFS and OS since the start of the first IO treatment, compared between patients of different ages.

Results

We included 302 patients aged 60 to 99 years, of whom 157 were 60-69 years (younger group,YG) and 145 were 70 years and older (older group,OG), including 31 patients aged 80 years and older (senior group,SG). In all age groups, the proportion of patients in the OG group treated with immune combination therapy was relatively less than in the two younger age groups. Adverse event (AE) associated with immunotherapy was not higher in the older group than in the relatively younger cohort. there were no statistical differences in PFS and OS between the YG and OG groups, with median PFS of 12 months vs. 10 months, P=0.5465; median OS NA vs. 32 months, P=0.1429. Further subgroup analysis showed that the SG group had a median PFS of 10 months and median OS of 23 months, which was also not statistically different compared with other groups.

Table: 2169P

Immunotherapy-related adverse events

	N (%) of 60-69 N=157	N (%) of 70 and older cohort N=145	P
Any grade toxicity	31.8%	37.9%	0.2788
>=Grade 3 toxicity	10.8%	9.0%	0.7010
>=Grade 3 toxicity types
Dermatitis	1.9%	4.1%	0.2555
Colitis	2.5%	2.1%	0.7823
Abnormal thyroid function	1.9%	2.8%	0.7140
Hepatitis	3.8%	1.4%	0.2856
Pneumonitis	4.5%	2.8%	0.5449
Other	1.3%	0.7%	0.6049

Conclusions

IO-based therapy is relatively safe in elderly patients and provides a survival benefit in this group, allowing for prospective clinical studies in older patients to further determine the value of immunotherapy.