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Anti-PD1 antibodies in patients aged ≥ 75 years with metastatic melanoma: A retrospective multicentre study.

年龄 ≥ 75 岁转移性黑色素瘤患者的 Anti-PD1 抗体: 一项回顾性多中心研究。

  • 影响因子:3.09
  • DOI:10.1016/j.jgo.2019.12.012
  • 作者列表:"Ridolfi L","De Rosa F","Petracci E","Tanda ET","Marra E","Pigozzo J","Marconcini R","Guida M","Cappellini GCA","Gallizzi G","Occelli M","Pala L","Gambale E","Bersanelli M","Galdo G","Cortellini A","Morgese F","Zoratto F","Stucci LS","Strippoli S","Guidoboni M","Italian Melanoma Intergroup (IMI).
  • 发表时间:2020-01-09
Abstract

BACKGROUND:Advanced age is associated with comorbidities and immune system impairment, which may influence the efficacy and tolerability of immune checkpoint inhibitors. There is evidence that anti-PD1 antibodies in advanced melanoma are equally effective in patients >65 years. However, data on patients >75 years are lacking as co-morbidities and logistics often exclude them from clinical trials. METHODS:We retrospectively reviewed the clinical records of older patients with advanced melanoma undergoing any-line treatment with an anti-PD1 (nivolumab/pembrolizumab) to investigate its clinical effectiveness and toxicity in a real-life setting. Clinical response was assessed using RECIST criteria and toxicity was evaluated according to CTCAE 4.0. Progression-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method and the Cox model was used to assess potential prognostic factors. RESULTS:174 patients were considered; 59.2% males, median age 79 years (range 75-93). The majority had a performance status of 0 and normal lactate dehydrogenase (LDH) levels (55.2% and 52.4%, respectively). 69.1% had multiple co-morbidities. 56.9% received nivolumab. 36.7% of cases showed an objective response and the disease control rate was 56.3%. Median OS was 17.2 months [95% CI: 8.87-not reached] and a better prognosis was observed for patients with normal LDH (p < .001) and lower performance status (p < .001). Treatment was well tolerated, only 11 patients experiencing severe (grade 3/4) toxicity. There were no treatment-related deaths. Adverse events were managed with corticosteroids and additional immunosuppressive agents were unnecessary. CONCLUSIONS:Anti-PD1 antibodies appear effective and well tolerated in older patients with advanced melanoma.

摘要

背景: 高龄与合并症和免疫系统损害相关,可能影响免疫检查点抑制剂的疗效和耐受性。有证据表明,晚期黑色素瘤的 anti-PD1 抗体对&gt; 65 岁的患者同样有效。然而,由于合并症,缺乏&gt; 75 岁患者的数据,logistics 往往将其排除在临床试验之外。 方法: 我们回顾性分析了接受 anti-PD1 (nivolumab/pembrolizumab) 治疗的老年晚期黑色素瘤患者的临床记录。研究其在现实生活中的临床有效性和毒性。使用 RECIST 标准评估临床反应,并根据 CTCAE 4.0 评估毒性。使用 Kaplan-Meier 法估计无进展生存期 (PFS) 和总生存期 (OS),并使用 Cox 模型评估潜在的预后因素。 结果: 174 例患者被考虑; 59.2% 例男性,中位年龄 79 岁 (范围 75-93)。大多数表现状态为 0,乳酸脱氢酶 (LDH) 水平正常 (分别为 55.2% 和 52.4%)。69.1% 有多种合并症。56.9% 收到 nivolumab。36.7% 的病例表现为客观反应,疾病控制率为 56.3%。中位 OS 为 17.2 个月 [95% CI: 8.87-未达到],LDH 正常患者预后较好 (p

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DOI:10.1002/JLB.MR0519-143R
作者列表:["Hume DA","Caruso M","Ferrari-Cestari M","Summers KM","Pridans C","Irvine KM"]

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影响因子:6.50
发表时间:2020-01-01
DOI:10.1007/s00018-019-03257-4
作者列表:["Riuzzi F","Chiappalupi S","Arcuri C","Giambanco I","Sorci G","Donato R"]

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