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Mónica Fernández Navarro
EP1.04 - Immuno-oncology (ID 194)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
EP1.04-05 - Outcomes of Immunotherapy in Elderly Patients. Retrospective Study of Clinical Characteristics in a Single-Center and a 4-Year Experience (ID 2961)
08:00 - 18:00 | Author(s): Mónica Fernández Navarro
Median age of patients with lung cancer is 71 years old. We have study outcomes of NSCLC patients with more than 75 years that have receive immunotherapy since 2014Method
We have performed a retrospective observational study, reviewing all patients with lung cancer treated in Medical Oncology in our institution (tertiary center in Spain) in a 4-year period (2015 to 2019), and followed until April 2019. The inclusion criteria are: 1) Age of 75 years or older at the time of diagnosis of the lung cancer, and 2) Receiving any anti PD-1 or anti PD-L1 therapy in advance disease. We included 16 patients.Result
Most patients were male, 79.2%, and average age is 77 years (75-84). They represent a 14.7% of all patients with advanced NSCLC that received any anti PD-1 or anti PD-L1 therapy in our institution (19 patients from a total of 128 patients, in a 4-year period). Squamous cell carcinomas represent a 57% of total, and adenocarcinoma a 39%. None of this patient harbour an oncogenic driver mutation. 51% of patients were diagnosed in stages II-III, and 49% in stage IV; but only 15% patients had a curative-intent therapy at the diagnosis. We study also the pattern of treatment in patients under active cancer therapy. Median survival time is 11.6 months (p-value: 0.001). Longer survival was seen in ECOG 0-1 patients (15.8 months) than in ECOG 2 patients (7 months)
Most patients received immunotherapy in second line (16 patients, 2 in first line and 1 in third line). The drugs used were nivolumab (9 patients, 56.2%), followed by atezolizumab (7 patients, 37.5%) and pembrolizumab (3 patients, 6.2%). Median number of cycles received was 4 cycles (1-21). In terms of PD-1 status in biopsy, 5 patients were unknown, 8 patients were PD-1 negative and 6 patients were PD-1 positive (2 of them more than 50%). Most common adverse events related to immunotherapy were hypothyroidism (4 cases, 1 grade 1 and 3 grade 2), pneumonitis (3 cases, 2 grade 1 and 1 grade 2) and diarrhea (2 cases, grade 1). There were also dermatitis, adrenal insufficiency and xerostomia (1 case each).
Although our cohort is small, we can suggest that immunotherapy is slightly underused in this cohort of patients, because patients of 75 years and older are a 21% of all our patients, and only a 14% of patients received an anti PD-1/PD-L1 drug. Survival rates seems very similar that communicated in younger patients, and they are clearly lower in ECOG 2 patients.