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e-Poster Display Session

60P - Real-world experience of immunotherapy in elderly cancer patients in a UK cancer centre

Date

09 Dec 2020

Session

e-Poster Display Session

Topics

Immunotherapy

Tumour Site

Presenters

Shagufta Mirza

Citation

Annals of Oncology (2020) 31 (suppl_7): S1428-S1440. 10.1016/annonc/annonc391

Authors

S. Mirza1, F. Haque2, S. Hodgson2, M. Lind2, A. Maraveyas2

Author affiliations

  • 1 Medical Oncology, Castle Hill Hospital, Hull University Teaching Hospital NHS Trust, HU16 5AD - York/GB
  • 2 Castle Hill Hospital, Hull University Teaching Hospital NHS Trust, York/GB
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Abstract 60P

Background

Cancer tends to affect the elderly; however, they are less represented in clinical trials. Therefore, real-world data of Immune-related adverse events (irAEs) of patients on immune checkpoint inhibitor (ICIs) can be a useful tool to guide clinical practice.

Methods

Patients aged ≥65 yrs, with non-small cell lung cancer (NSCLC), malignant melanoma (MM) or renal cell carcinoma (RCC) on ICI ( non- curative intent) either as monotherapy (MT) or in combination (CT), between 2016 – 2018 at Castle Hill Hospital were included in this retrospective analysis to review irAEs and outcome (analyses performed with SPSS v25).

Results

Of 90 patients identified; 43 were NSCLC, 30 MM and 17 RCC. 87.8% received αPD-1, 6.7% αCTLA-4, 3.3% αPDL-1 combination αPD-1/αCTLA-4 and 2.2% combination αPD-1/αCTLA-4. Median age was 71 yrs. 92.2% had ECOG performance status of 0-1. Median follow up was 14.5 months. 35/90 (38.8%) had an irAE; 94.2% (33/35) on MT and 5.8% (2/35) on CT. Clinically significant irAE was observed in 30/90 (33.3%) patients with near 1/5th (20/90) suffering from Grade 3 toxicities. 12.2% (11/90) of patients had pre-existing autoimmune disease, 45.4% (5/11) of them experienced irAE. Most common IrAEs witnessed were colitis12 (13.3%), thyroiditis 5 (5.6%), pneumonitis 5 (5.6%) and dermatitis 3 (3.3%). There were 2 cases of grade 5 irAE with αPD-1 MT (1 pneumonitis,1 nephritis). 86.6% (26/30) with clinically significant irAE required corticosteroids with almost half of them needing systemic corticosteroids. Steroid sparing immunosuppression was used in 13.3% (4/30). 63.3% (19/30) had admission, average stay of 12.3 days accounting for 233 bed days. This rate is higher compared to all age group (42%). Colitis 11/19 and pneumonitis 3/19 led to most admissions. Progression free survival (PFS) and overall survival (OS) was higher in patients with irAE Vs no irAE ( PFS 16.3 months [95% CI 7.9, 24.8] Vs 4.6 months [95% CI 1.7, 7.6], p= 0.003; OS 30 months [95% CI 18, 41.9] Vs 7.4 months [95% CI 3.2, 11.6], p=0.01).

Conclusions

Incidence of irAE in elderly were comparable to our cohort of patient that includes all age group though more inpatient care observed in this group. There appears to be a toxicity-efficacy relationship with irAEs; however, larger studies are required to validate this.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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