Introduction: Increased immune checkpoint inhibitor (ICI) use in various advanced cancer types has led to a parallel rise in immune-related adverse events (irAEs). Despite widespread use, ICI data in older patients remains limited. We investigate irAE prevalence in older patients receiving ICI and whether irAEs and survival are associated.
Materials And Methods: Our retrospective study included patients aged ≥65 years with advanced malignancies who had ≥1 dose of ICI from January 2011 through September 2019. We evaluated irAE cases and their respective grades and assessed oncological response by progression-free survival (PFS) and overall survival (OS).
Results: Mean age of 210 patients was 75.0 ± 7.2 years, 58.1% were men, and most were white. IrAE prevalence was 41.4% (n = 87); 9.5% (n = 20) developed multisystem irAE. Most irAEs were grades 1 and 2 (27.6% and 49.4%, respectively), while grades 3 and 4 accounted for 17.2% and 5.8%, respectively. No grade 5 irAE occurred. Compared with patients with no irAEs, those with irAEs had improved OS (HR [hazard ratio], 0.41; 95% CI [confidence interval], 0.282-0.597; p < 0.0001) and PFS (HR, 0.311; 95% CI: 0.213-0.453; p < 0.0001). Improved OS was seen with irAE grades 1 and 2 versus grades 3 and 4 (HR, 0.344; 95% CI: 0.171-0.694; p = 0.0029). Similarly, improved PFS was seen with lower grade irAE (HR, 0.489; 95% CI: 0.247-0.965; p = 0.0391).
Discussion: The irAE prevalence in older patients was similar to that in younger patients. To our knowledge, this is one of few studies that confirms a positive association of irAE on both OS and PFS in older patients with cancer, and improved OS and PFS with lower versus higher grade irAE.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jgo.2022.05.007 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
High-Cost Cancer Drug Use in Medicare Advantage and Traditional Medicare.
JAMA Health Forum
January 2025
Department of Health Systems, Management, and Policy, University of Colorado Cancer Center, Aurora.
Importance: Medicare Advantage (MA) plans are designed to incentivize the use of less expensive drugs through capitated payments, formulary control, and preauthorizations for certain drugs. These conditions may reduce spending on high-cost therapies for conditions such as cancer, a condition that is among the most expensive to treat.
Objective: To determine whether patients insured by MA plans receive less high-cost drugs than those insured by traditional Medicare (TM).
Strategies to enhance management of HER2-positive breast cancer in the elderly: an expert consensus perspective.
Clin Transl Oncol
January 2025
Medical Oncology Department, Hospital del Mar, Parc de Salut Mar, Spanish Group for Breast Cancer Research (GEICAM), Barcelona, Spain.
Therapeutic decision-making for older patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer highlights the importance of a comprehensive geriatric assessment (CGA). This assessment considers the functional status, comorbidities, and relevant conditions of the patient, and allows for an estimation of life expectancy, but it does not facilitate individualized treatment plans. There are also other challenges to consider related to the cardiac toxicity of the treatments and the under-representation of older patients in clinical trials.
View Article and Find Full Text PDFClinical Characteristics of Primary and Overlap Sjögren's Syndrome-Associated Pulmonary Arterial Hypertension: A Multicenter Retrospective Study.
Rheumatology (Oxford)
January 2025
The Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Objective: To explore the clinical characteristics and risk factors for adverse outcomes in patients with Sjögren's Syndrome-associated pulmonary arterial hypertension (SS-PAH).
Methods: A retrospective analysis was conducted on SS-PAH patients diagnosed by right heart catheterization (RHC) between March 2013 and March 2024 across four Chinese medical centers. Patients were categorized into primary SS-PAH (pSS-PAH) and overlap SS-PAH, based on the presence of additional autoimmune diseases.
Association of Craniofacial Skeletal and Soft Tissue Characteristics With Severe Obstructive Sleep Apnea in Age-specific and BMI-specific Patient Groups.
J Craniofac Surg
January 2025
Beijing Anzhen Hospital Centre for Sleep Medicine and Science, Capital Medical University.
Purpose: To identify the key craniofacial anatomic characteristics associated with the prevalence of severe obstructive sleep apnea (OSA) in patient cohorts stratified by age and body mass index (BMI).
Methods: This prospective study was conducted at the Beijing Anzhen Hospital Center for Sleep Medicine and Science between December 2023 and March 2024. Patients suspected of having OSA underwent overnight polysomnography, along with computed tomography scans of the head and neck, to evaluate the skeletal and soft tissue characteristics.
Objectives: To compare lag-screw slide and revision surgery rate between two generations of the Stryker Gamma cephalomedullary nail (Stryker, Kalamazoo, MI).
Methods: Design: Retrospective chart review.
Setting: Single academic, Level-1 Trauma Center.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!