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.
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