Abstract 1117P
Background
Immunotherapy with anti-programmed cell death-1 (PD-1) agents is an effective treatment for metastatic melanoma. Research indicates that the response to treatment with anti-PD-1 in patients over 65 years of age is better. Octogenarian and nonagenarian represent a significant proportion of patients and are a clinical challenge.
Methods
Our multicenter retrospective analysis included 499 patients treated with anti-PD-1 agents (nivolumab or pembrolizumab) between 2017 and 2019. 208 patients were aged <65 years, 218 patients were aged 65-79 years, and 73 patients were aged 80-100 years. We analysed the efficacy and toxicity of anti-PD-1 therapy at the age of 80-100 years compared to the age of 65-79 years and to <65 years. Baseline parameters, response rate (overall response rate -ORR), best response, progression-free survival (PFS), melanoma-specific survival (MSS) and immune-related adverse events were analysed. The Kaplan–Meier method was used to estimate PFS and MSS, Cox regression, t test, and chi-square test were used for statistical analysis.
Results
Baseline parameters were comparable. There was no statistically significant difference between the groups aged <65 years, aged 65-79 years and aged 80-100 years of MSS (p=0.2781), PFS (p=0.5373), the number of responses to treatment (p=0.155) and the occurrence of irAE (p= 0.821). In the multivariate analysis, the presence of brain metastases, elevated LDH levels, and the occurrence of at least one irAE had a statistically significant impact on OS and PFS. The age, gender, BRAF mutation, primary lesion location, type of anti-PD-1 therapy had no statistically significant effect on MSS and PFS in the multivariate analysis. Toxicity for all groups was similar. Immune related adverse events in grade 3 or 4 were reported in 5%, 5.5% and 4% of patients in the groups aged <65 years, aged 65-79 years and aged 80-100 years, respectively.
Conclusions
Anti PD-1 therapy in octogenarian and nonagenarian metastatic melanoma patients has similar efficacy and toxicity compared to patients aged <65 years and 65-79 years. The patient's age cannot be the reason for disqualification from anti-PD-1 treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Bożena Cybulska-Stopa.
Funding
Has not received any funding.
Disclosure
B. Cybulska-Stopa: Advisory/Consultancy, Travel/Accommodation/Expenses: BMS, Novartis, Roche, Pierre Fabre, MSD. M. Ziętek: Travel/Accommodation/Expenses: BMS, Novartis, Roche, Pierre Fabre, MSD. A.M.M. Czarnecka: Honoraria (self): BMS, Novartis, Roche, Pierre Fabre, MSD. J. Calik: Honoraria (self), Travel/Accommodation/Expenses: BMS, Novartis, Roche, Pierre Fabre, MSD. T. Kubiatowski: Honoraria (self), Research grant/Funding (self): BMS, Novartis, Roche, Pierre Fabre, MSD. R. Suwinski: Honoraria (self), Travel/Accommodation/Expenses: BMS, Novartis, Roche, Pierre Fabre, MSD. J. Mackiewicz: Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: BMS, Novartis, Roche, Pierre Fabre, MSD. P. Rutkowski: Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: BMS, Novartis, Roche, Pierre Fabre, MSD. All other authors have declared no conflicts of interest.