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Comparison of efficacy of immune checkpoint inhibitors between younger and older patients


Immune checkpoint inhibitors rely on the presence of ongoing immune response to exert their antitumor effect.
Little is known whether an age-related decline in immune function negatively influences antitumor response and in so doing diminishes the efficacy of immune checkpoint inhibitors in elderly subjects.

Researchers have performed a meta-analysis to compare the efficacy of immune checkpoint inhibitors between younger and older patients.

PubMed and the ASCO databases were searched up to September 2015.

Randomized controlled trials ( RCTs ) of immune checkpoint inhibitors ( Ipilimumab, Tremelimumab, Nivolumab and Pembrolizumab ) reporting subgroup comparison of overall survival ( OS ) and/or progression-free survival ( PFS ) based on age cutoffs were included.

A total of 5265 patients from nine RCTs of immune checkpoint inhibitors were included.

When patients were dichotomized into younger and older groups with an age cut-off of 65-70 years, immune checkpoint inhibitors improved overall survival in both younger ( hazard ratio, HR, 0.75; 95% CI, 0.68-0.82 ) and older ( HR, 0.73; 95% CI, 0.62-0.87 ) groups.

An improvement in progression-free survival was observed in younger ( HR, 0.58; 95% CI, 0.40-0.84 ) and older ( HR, 0.77; 95% CI, 0.58-1.01 ) patients.

Subgroup analyses according to immune checkpoint inhibitors and tumor type showed a consistent survival benefit in both younger and older groups except for the subgroup of older patients treated in 4 trials of anti-programmed cell death protein-1 ( PD-1 ) monoclonal antibody ( HR, 0.86; 95% CI, 0.41-1.83 ).

In conclusion, a benefit in overall survival with immune checkpoint inhibitors was significant in both younger and older patients with a cut-off age of 65-70 years. ( Xagena )

Nishijima TF et al, Cancer Treat Rev 2016; 45:30-37

XagenaMedicine_2016



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