Association of age with differences in immune related adverse events and survival of patients with advanced nonsmall cell lung cancer receiving pembrolizumab or nivolumab.
Age Factors
Antibodies, Monoclonal, Humanized
/ administration & dosage
Antineoplastic Agents, Immunological
/ administration & dosage
Carcinoma, Non-Small-Cell Lung
/ drug therapy
Humans
Immune Checkpoint Inhibitors
/ administration & dosage
Lung Neoplasms
/ drug therapy
Nivolumab
/ administration & dosage
Programmed Cell Death 1 Receptor
/ antagonists & inhibitors
Retrospective Studies
Advanced nonsmall cell lung cancer
Nivolumab
Pembrolizumab
Survival
Toxicity
Journal
Journal of geriatric oncology
ISSN: 1879-4076
Titre abrégé: J Geriatr Oncol
Pays: Netherlands
ID NLM: 101534770
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
26
08
2019
revised:
30
12
2019
accepted:
08
01
2020
pubmed:
16
1
2020
medline:
25
6
2021
entrez:
16
1
2020
Statut:
ppublish
Résumé
To explore the association of age with development of immune related adverse events (irAE) and survival in patients with advanced nonsmall cell lung cancer (aNSCLC) receiving programmed cell death 1 antibodies (PD-1 Ab) outside of clinical trials. A multicenter retrospective study of PD-1 Ab prescription for patients with aNSCLC between 06/2015-11/2018 at BC Cancer. Multivariable (MVA) logistic regression identified baseline variables associated with irAE manifested within 3 months of PD-1 Ab initiation. Overall survival (OS) analyzed in a propensity-score matched cohort and survival outcomes compared between age groups by stratified log-rank. Six-week landmark analysis was performed and OS compared between patients with interrupted versus continuous treatment by log-rank. Of 527 patients, 40.6% were age ≤ 64 years, 40.6% were 65-74 years, and 18.8% were ≥ 75 years. In MVA, ECOG performance status 2/3 (p = .034), squamous histology (p = .031), and nivolumab therapy (vs. pembrolizumab, p = .012) were associated with increased odds of irAE by 3 months of treatment. Across age groups no difference existed in any grade irAE (p = .98), hospitalization (p = 1.0), or corticosteroids use (p = .51). The propensity score-matched survival analysis comprised 77 patients from each age group; all covariates were balanced. OS did not differ significantly by age in the matched cohort (p = .17). Treatment interruption due to irAE at 6 weeks was more common in patient ≥75 years (vs. <75, p = .055) and correlated with lower OS (p = .002). In this cohort of patients with aNSCLC treated in routine clinical practice with PD-1 Ab, immune-toxicity and observed survival were similar amongst age groups.
Identifiants
pubmed: 31937494
pii: S1879-4068(19)30406-0
doi: 10.1016/j.jgo.2020.01.006
pii:
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
Antineoplastic Agents, Immunological
0
Immune Checkpoint Inhibitors
0
PDCD1 protein, human
0
Programmed Cell Death 1 Receptor
0
Nivolumab
31YO63LBSN
pembrolizumab
DPT0O3T46P
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
807-813Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Dr. Doran Ksienski- honoraria for continuing medical education events from Merck Canada and Bristol Myers Squibb Canada. Unrestricted education grant received from AstraZeneca Canada. Dr. Zia Poonja- honoraria for continuing medical education events from Merck Canada, Bristol Myers Squibb Canada, and AstraZeneca Canada. Dr. Angela Chan- Honoria for continuing medical education events from Merck Canada, Bristol Myers Squibb Canada, AstraZeneca Canada, Genomic Health, Sanofi-Aventis Canada, EMD Serono, Genomic Health, Novartis, Pfizer, Roche, Takeda.