Anti-PD1 antibodies in patients aged ≥ 75 years with metastatic melanoma: A retrospective multicentre study.

Publication date: Jan 09, 2020

Advanced age is associated with comorbidities and immune system impairment, which may influence the efficacy and tolerability of immune checkpoint inhibitors. There is evidence that anti-PD1 antibodies in advanced melanoma are equally effective in patients >65 years. However, data on patients >75 years are lacking as co-morbidities and logistics often exclude them from clinical trials.

We retrospectively reviewed the clinical records of older patients with advanced melanoma undergoing any-line treatment with an anti-PD1 (nivolumab/pembrolizumab) to investigate its clinical effectiveness and toxicity in a real-life setting. Clinical response was assessed using RECIST criteria and toxicity was evaluated according to CTCAE 4.0. Progression-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method and the Cox model was used to assess potential prognostic factors.

174 patients were considered; 59.2% males, median age 79 years (range 75-93). The majority had a performance status of 0 and normal lactate dehydrogenase (LDH) levels (55.2% and 52.4%, respectively). 69.1% had multiple co-morbidities. 56.9% received nivolumab. 36.7% of cases showed an objective response and the disease control rate was 56.3%. Median OS was 17.2 months [95% CI: 8.87-not reached] and a better prognosis was observed for patients with normal LDH (p

Ridolfi, L., De Rosa, F., Petracci, E., Tanda, E.T., Marra, E., Pigozzo, J., Marconcini, R., Guida, M., Cappellini, G.C.A., Gallizzi, G., Occelli, M., Pala, L., Gambale, E., Bersanelli, M., Galdo, G., Cortellini, A., Morgese, F., Zoratto, F., Stucci, L.S., Strippoli, S., Guidoboni, M., and (IMI), Italian Melanoma. Intergroup. Anti-PD1 antibodies in patients aged >= 75 years with metastatic melanoma: A retrospective multicentre study. 25441. 2020 J Geriatr Oncol.

Concepts Keywords
Antibodies Older advanced melanoma
Clinical Trials Years metastatic melanoma
Comorbidities Medicine
Immune System Clinical medicine
Lactate Dehydrogenase Cancer treatments
LDH Immune system
Logistics Antineoplastic drugs
Median Breakthrough therapy
Melanoma Monoclonal antibodies
Prognosis Bristol-Myers Squibb
Tolerability Nivolumab
Toxicity Checkpoint inhibitor
Melanoma
Immune checkpoint
Antibodies

Semantics

Type Source Name
disease MESH melanoma
pathway KEGG Melanoma
pathway REACTOME Immune System
drug DRUGBANK Nivolumab
drug DRUGBANK Pembrolizumab
disease MESH multiple
drug DRUGBANK Tropicamide
disease MESH Aging

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