Immune Checkpoint Inhibitors Safe, Effective for Older Patients With Cancer

Study findings suggest that immune checkpoint inhibitors (ICIs) can be safely administered in older patients with cancer and produce similar survival outcomes as those observed in younger patients (Drugs Aging. 2021. doi:10.1007/s40266-021-00899-7).   

“Over recent years, ICIs have changed the clinical management and prognosis for most cancers,” wrote Andrea Luciani, MD, PhD, Oncology Unit, Medical Sciences Department, ASST Bergamo Ovest, Treviglio, BG, Italy, and colleagues, adding, “however, data on older patients in clinical trials are scarce.”

A systematic review and pooled analysis of real-world studies were conducted in order to analyze the efficacy and toxicity of ICIs in unselected older individuals in multiple tumor settings treated outside of clinical trials.

Authors researched articles published in English from 2010 to October 2020 in PubMed, MEDLINE, the Cochrane Library, and EMBASE, excluding hematological malignancies.

A total of 48 studies, including 5524 patients, were included in the study. For patients with non-small cell lung cancer, the pooled median overall survival (OS) was 8.9 months. For patients with melanoma, the pooled median OS was 14.3 months. The median progression-free survival was 3.2 months in both groups.

Pooled rates for grade 1-5 adverse events were 5.3% for hepatitis, 6% for pneumonitis, 8.3% for hypothyroidism, and 7.6% for diarrhea.

“Our findings suggest that ICIs could be safely administered in older individuals with comparable survival outcomes with respect to younger individuals,” concluded Dr Luciani and colleagues, adding, “future studies should include some form of geriatric assessment to improve patient stratification.”