1289P - Efficacy and safety of immune checkpoint inhibitors (ICIs) for treatment of advanced solid tumours in octogenarian patients

• Published in: Annals of oncology Vol. 30; pp. v524 - v525
• Main Authors: Mebarki, S., Gisselbrecht, M., Fabre, E., Mercadier, E., Oudard, S., Paillaud, E.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-10-2019
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdz253.114

The emergence of ICIs has modified the treatment of many types of cancers. However, efficacy and safety data of such agents (anti PD-1/anti PD-L1) are cruelly missing in elderly patients ⩾ 80 year-old.
A retrospective monocentric study was conducted between April 2015 and April 2019 in all ⩾ 80 year-old ICIs-treated patients, as a part of a clinical trial or standard of care. Patients/disease characteristics were collected using electronic medical records. Clinical response was assessed according to iRECIST criteria; survival was estimated according to Kaplan-Meier method and toxicity was assessed according to CTCAE v 4.0.
Of the 415 patients who received an ICI, 42 (10.1%) were aged ⩾ 80 years (median: 84; range: 80-93). The most represented tumour types were NSCLC (45.2%), renal cell carcinoma (30.9%) and bladder carcinoma (16.7%). 92.9% were stage IV. ICIs were given as first-line therapy in 7 patients (16.7%) and as second-line or beyond in 35 patients (83.3%). 29 patients had nivolumab, 10 patients had pembrolizumab and 3 had atezolizumab. ICIs were given mostly as monotherapy (97.6%). A median of 7.5 doses were administered (range: 1-37). Of the 42 patients, 40.5% were PS ⩾ 2 and 88.1% had impaired G8 score. Mean Charlson Index was 3 (range: 0-6), polypharmacy was present in 26 cases and 35.7% had an albumin level < 35g/L (Mean 33.3; range: 22-44). The Objective Response Rate was 11.9% and the Disease Control Rate was 31%. The median progression-free survival was 5 months [95% CI: 2-10] and the median overall survival was 9 months [95% CI: 6-21]. 26 patients died during the treatment, 16 are still alive; 1 with complete response, 8 stable disease and 7 progressed. All-grade adverse events occurred in 100% of patients, mostly Grade 1 fatigue and anorexia. Immune-related adverse events (IrAEs) occurred in 76.2%, most of them were common and mild; dyspnea, thyroïditis, rash and diarrhea. 9 severe IrAEs occurred; colitis, pneumonitis, rash and arthralgia. Reasons for off therapy included progressive disease (n=23; 54.8%), adverse effects (n=5; 11.9%) and death (n=6; 14.3%).
ICIs appear to be an acceptable treatment option for octogenarian patients, with manageable toxicity.
Mebarki Soraya.
Has not received any funding.
E. Fabre: Honoraria (self): Roche; Honoraria (self): AstraZeneca; Honoraria (self): BMS; Honoraria (self): Merck. S. Oudard: Research grant / Funding (self): Boehringer; Honoraria (self): Ipsen; Honoraria (self): Bayer; Honoraria (self), Travel / Accommodation / Expenses: Pfize; Honoraria (self), Travel / Accommodation / Expenses: MSD; Honoraria (self), Travel / Accommodation / Expenses: Astellas; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Janssen; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: BMS; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Sanofi. E. Paillaud: Honoraria (self), Advisory / Consultancy: BMS; Honoraria (self): Servier; Honoraria (self), Travel / Accommodation / Expenses: Roche. All other authors have declared no conflicts of interest.