Related Experiment Video
Updated: Mar 14, 2026
Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
Published on: May 24, 2024
PD-1 inhibitor treatment outcomes for cutaneous squamous cell carcinoma in patients over 85: a comparative analysis
Ido Amir1,2, Nofar Edri1,2, Itamar Averbuch2,3
1Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Petah Tikva 4941492, Israel.
Background:
Programmed-cell death protein 1 (PD-1) inhibitors have become standard of care in the treatment of advanced or metastatic cutaneous squamous cell carcinoma (cSCC). However, insufficient data exists regarding treatment outcomes and safety among elderly patients, including patients aged >85.
Patients And Methods:
We retrospectively reviewed patients aged >85 (n = 52) and compared them with two control groups: 46 patients aged 71-84 and 32 patients <70, treated with cemiplimab for cSCC. Demographics, treatment characteristics, outcomes and toxicity were evaluated. Inverse probability of treatment weighting (IPTW) was applied when comparing survival outcomes.
Results:
Although patients >85 had worse ECOG scores and less inclined to undergo surgery, no significant differences were noted in the overall response rates (68.8% and 76.1% for <70 and 71-84, respectively vs. 73.1% for >85, P = .744) or disease control rates (75% and 82.6% for <70 and 71-84, respectively vs. 75% for >85, P = .627). After IPTW adjustment, progression-free survival (PFS) did not differ between groups (HR = 1.08, 95% CI 0.55-2.13, P = .82). Cancer specific survival (CSS) also did not differ between groups (HR = 1.05, 95% CI 0.22-4.87, P = .955). However, overall survival (OS) was shorter among patients >85 (HR = 2.64, 95% CI 1.43-4.86, P = .002). Toxicity profiles were similar, although toxicity-related deaths occurred more frequently in the >85 cohort.
Conclusion:
Cemiplimab showed comparable efficacy and tolerability across age groups, with no significant difference in PFS and CSS, but shorter OS among very elderly patients with cSCC, reflecting competing non-cancer mortality rather than reduced treatment efficacy.
Insights
Cemiplimab demonstrates comparable efficacy and tolerability for advanced cutaneous squamous cell carcinoma (cSCC) across age groups. Very elderly patients (>85) showed shorter overall survival due to non-cancer causes, not reduced treatment effectiveness.
Area of Science:
- Oncology
- Immunotherapy
- Geriatric Medicine
Background:
- Programmed-cell death protein 1 (PD-1) inhibitors are standard for advanced cutaneous squamous cell carcinoma (cSCC).
- Limited data exists on PD-1 inhibitor outcomes and safety in elderly patients, especially those over 85.
Purpose of the Study:
- To evaluate the efficacy and safety of cemiplimab in very elderly patients (>85) with cSCC.
- To compare treatment outcomes in patients >85 with younger cohorts (71-84 and <70).
Main Methods:
- Retrospective review of 52 patients aged >85 treated with cemiplimab for cSCC.
- Comparison with two control groups: 46 patients aged 71-84 and 32 patients <70.
- Analysis of demographics, treatment characteristics, outcomes, and toxicity, using Inverse Probability of Treatment Weighting (IPTW) for survival analysis.
Main Results:
- No significant differences in overall response rates (73.1% vs. 68.8-76.1%) or disease control rates (75% vs. 75-82.6%) were observed across age groups.
- Progression-free survival (PFS) and cancer-specific survival (CSS) did not differ significantly between the groups after IPTW adjustment.
- Overall survival (OS) was shorter in the >85 group (HR=2.64), with similar toxicity profiles but higher toxicity-related deaths.
Conclusions:
- Cemiplimab exhibits comparable efficacy (PFS, CSS) and tolerability in very elderly patients (>85) with cSCC.
- Shorter OS in the >85 group is attributed to competing non-cancer mortality, not diminished treatment efficacy.
- Cemiplimab is a viable treatment option for advanced cSCC across age demographics, including the very elderly.
