Immune checkpoint inhibitors therapy in older patients (≥ 70 years) with metastatic melanoma: a multicentre study
| Autor: | Tomasz Świtaj, Anna Klimczak, Katarzyna Kozak, Iwona Ługowska, Agnieszka Roman, Tomasz Zemełka, Paulina Jagodzińska-Mucha, Marek Ziobro, Piotr Rutkowski, Bożena Cybulska-Stopa, Marcin Rajczykowski, Rafał Suwiński, Hanna Koseła-Paterczyk, Sławomir Falkowski, Maciej Niemiec |
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| Rok vydání: | 2019 |
| Předmět: |
Oncology
medicine.medical_specialty anti-PD-L1 Metastatic melanoma Immune checkpoint inhibitors medicine.medical_treatment Population Dermatology 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Older patients Internal medicine Diabetes mellitus melanoma Immunology and Allergy Medicine In patient education Original Paper education.field_of_study business.industry Melanoma Immunotherapy medicine.disease older patients anti-CTLA-4 anti-PD-1 immunotherapy business checkpoint inhibitors |
| Zdroj: | Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii |
| ISSN: | 1642-395X |
| Popis: | Introduction The use of immunotherapy in older patients remains challenging due to very few data on the efficacy and safety of treatment in this group. Aim To analyse the efficacy and safety of immunotherapy with checkpoint inhibitors in older patients (≥ 70 years) with metastatic melanoma. Material and methods In the Maria Skłodowska-Curie Institute – Oncology Centre, between 2011 and 2017, 318 non-resectable or metastatic melanoma patients were treated with immune checkpoint inhibitors: anti-CTLA-4 or/and anti-PD-1. Eighty-two patients were ≥ 70 years (median age: 76 years; range: 70–90 years). Among this group 10% of patients had brain metastases, 24% of patients had BRAF mutant melanoma, and co-morbidities were present in 86% of patients (mainly hypertension, cardiovascular diseases and/or diabetes). Results Median PFS and OS were similar in patients < 70 years and ≥ 70 years. In the group of patients ≥ 70 years old, the 2-year OS rate (from the start of immunotherapy) was 27%, and in patients aged < 70 it was 28% (p = NS). Two-year progression-free survival was 13.7% in the group of patients ≥ 70 years old and in patients aged < 70 it was 13% (p = NS). Patients ≥ 70 years of age were significantly less likely to have a BRAF mutation (p = 0.020). The presence of co-morbidities was not associated with an increased risk of immunotherapy (p = 0.790). Conclusions The survival and toxicity profile in the older patients treated with immune checkpoint inhibitors are similar to younger patients. Therefore, the age as a clinical factor should not exclude this population from the most effective therapy used nowadays in melanoma treatment. |
| Databáze: | OpenAIRE |
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