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Efficacy of immune checkpoint inhibitor monotherapy in elderly patients with non-small-cell lung cancer
Toshio Kubo1, Eiki Ichihara2, Daijiro Harada3
1Center for Clinical Oncology, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Background:
Limited information on anticancer therapy for super-elderly patients with non-small-cell lung cancer is available. Immune checkpoint inhibitors offer long-term survival to elderly patients aged ≥65 years with non-small-cell lung cancer. However, the efficacy and safety of immune checkpoint inhibitors in more elderly patients are not well understood.
Methods:
We retrospectively evaluated the efficacy and safety of immune checkpoint inhibitors in patients aged ≥85 years with advanced non-small-cell lung cancer at nine centers using the Okayama Lung Cancer Study Group-Immunotherapy Database.
Results:
Among 531 patients who received immune checkpoint inhibitors, 16 were aged ≥85 years (median, 86.5 years; range, 85-93 years). Many had high programmed death-ligand 1 expression and received pembrolizumab as first-line therapy. The objective response rate, median progression-free survival, and median survival time were 25% (95% confidence interval: 1-49), 2.8 months (95% confidence interval: 1.7-4.5), and not reached (95% confidence interval: 4.7-not reached), respectively. Moreover, the 4-year overall survival rate was 60.8% (95% confidence interval: 29.3-81.7), and a long-lasting effect of immune checkpoint inhibitors was observed even in patients aged ≥85 years. The incidence of immune-related and grade ≥3 immune-related adverse events was 32% and 6%, respectively.
Conclusions:
The effect and toxicity of immune checkpoint inhibitors for patients aged ≥85 years were acceptable. Immune checkpoint inhibitors may be a treatment option for patients aged ≥85 years.
Insights
Immune checkpoint inhibitors show acceptable efficacy and safety in super-elderly patients (≥85 years) with advanced non-small-cell lung cancer. These inhibitors offer a potential treatment option, demonstrating long-lasting effects even in this population.
Area of Science:
- Oncology
- Immunotherapy
- Geriatric Medicine
Background:
- Limited data exists on anticancer therapies for super-elderly patients (≥85 years) with non-small-cell lung cancer (NSCLC).
- Immune checkpoint inhibitors (ICIs) have shown efficacy in elderly NSCLC patients (≥65 years), but their use in the very elderly is less understood.
Purpose of the Study:
- To evaluate the efficacy and safety of immune checkpoint inhibitors in patients aged 85 years and older with advanced non-small-cell lung cancer.
Main Methods:
- Retrospective analysis of 16 patients aged ≥85 years treated with ICIs at nine centers.
- Data collected from the Okayama Lung Cancer Study Group-Immunotherapy Database.
Main Results:
- An objective response rate of 25% and a median progression-free survival of 2.8 months were observed.
- The 4-year overall survival rate was 60.8%, indicating long-lasting effects.
- Immune-related adverse events occurred in 32% of patients, with 6% being grade ≥3.
Conclusions:
- Immune checkpoint inhibitors demonstrate acceptable efficacy and toxicity in super-elderly patients (≥85 years) with advanced NSCLC.
- ICIs represent a viable treatment option for this specific patient group.
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