Monoclonal antibodies targeting PD-1/PD-L1 have revolutionized melanoma treatment, yet data regarding effectiveness and tolerability across age groups is limited.
Researchers sought to determine the impact of age on overall survival ( OS ), progression-free survival ( PFS ), and rates of immune-mediated toxicities in patients treated with anti-PD-1/anti-PD-L1 monoclonal antibodies at two academic medical centers.
Data on all patients with metastatic melanoma treated with anti-PD-1/PD-L1 monoclonal antibodies between May 2009 and April 2015 were retrospectively collected.
Of 254 patients, 57 ( 22.4% ) were less than 50 years old, 85 ( 33.5% ) were age 50-64, 65 ( 25.6% ) were age 65-74, and 47 ( 18.5% ) were greater than or equal to 75 years.
Across age groups, no differences existed in median overall survival ( age less than 50: 22.9 months, age 50-64: 25.3 months, age 65-74: 22.0 months, age greater than or equal to 75: 24.3 months ) or progression-free survival ( age less than 50: 4.1 months, age 50-64: 6.5 months, age 65-74: 5.4 months, age greater than or equal to 75: 7.9 months ).
The presence of liver metastases and elevated pre-treatment lactate dehydrogenase ( LDH ) were associated with reduced overall survival.
Presence of liver metastasis, pretreatment LDH, BRAF mutation, and type of melanoma correlated with progression-free survival.
Overall, 110 patients ( 43.3% ) experienced immune-mediated toxicities; 25 ( 9.8% ) had colitis and 26 ( 10.2% ) had endocrine toxicity.
Rates of colitis, hepatitis, and pneumonitis did not differ across age groups.
In conclusion, the study has demonstrated that patients could safely tolerate anti-PD1/PDL-1 monoclonal antibodies therapy and achieve similar outcomes regardless of their age. ( Xagena )
Betof AS et al, Oncologist 2017; Epub ahead of print