Alyssa A Guo, Mary-Peyton Knapp, Joni K Evans, Andrew T Faucheux, Sarah N Price, Heidi D Klepin, Beverly Levine, Alexander Quattlebaum, Chance Bloomer, Lara Khoury, John C Hunting, Catherine A Elko, Eric Olson, Thomas W Lycan
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引用次数: 0
摘要
背景：近一半的癌症患者被诊断为70岁或以上，这给癌症护理带来了挑战，因为他们的高合并症负担和该年龄组在临床试验中的代表性不足。这项回顾性研究评估了老年人共病负担与免疫检查点抑制剂（ICIs）治疗结果之间的关系。方法：收集2011年至2022年诊断时年龄≥70岁且接受ICIs治疗的患者数据。主要临床结局包括运动状态、总生存期（OS）、无进展生存期（PFS）和免疫相关不良事件（irAEs）的变化，并比较低基线Charlson共病指数（CCI）和高基线Charlson共病指数（CCI）(结果：在1223例患者中，CCI评分≥4的患者（n = 300）的OS明显较短（11.4个月vs 13.6个月，p = 0.0461），但PFS与CCI评分p = 0.14的患者相似（8.0个月vs 7.7个月，p = 0.258），两组之间的irAE患病率相似（39.3% vs 38.3%, p = 0.786）。结论：我们的研究表明，对于具有高合并症负担的患者，ICIs是安全的，但治疗前合并症的存在会降低总生存率。
Impact of comorbidity on immune-related adverse events and survival in older cancer patients treated with immunotherapy.
Background: Nearly half of patients with cancer are diagnosed at 70 years or older, which presents challenges in cancer care due to their high comorbidity burden and the underrepresentation of this age group in clinical trials. This retrospective study evaluated the association between comorbidity burden and immune checkpoint inhibitors (ICIs) treatment outcomes among older adults.
Methods: Data were collected from patients aged 70 years or older at the time of diagnosis who were treated with ICIs from 2011 to 2022. Key clinical outcomes include changes in performance status, overall survival (OS), progression-free survival (PFS), and immune-related adverse events (irAEs) and were compared between low baseline Charlson Comorbidity Index (CCI) and high CCI (<4 vs. ≥4) groups.
Results: Among 1,223 patients, patients with CCI scores ≥4 (n = 300) had a significantly shorter OS (11.4 vs. 13.6 months, p = 0.0461) but similar PFS (8.0 vs. 7.7 months, p = 0.258) compared to patients with CCI scores <4. There was no significant difference in changes in performance status pre- and post-treatment (p = 0.14) or in the irAE prevalence between the two groups (39.3% vs. 38.3%, p = 0.786).
Conclusion: Our study suggests that ICIs are safe in patients with high comorbidity burden but that the presence of pre-treatment comorbidities decreases overall survival.
期刊介绍：
Future Oncology (ISSN 1479-6694) provides a forum for a new era of cancer care. The journal focuses on the most important advances and highlights their relevance in the clinical setting. Furthermore, Future Oncology delivers essential information in concise, at-a-glance article formats - vital in delivering information to an increasingly time-constrained community.
The journal takes a forward-looking stance toward the scientific and clinical issues, together with the economic and policy issues that confront us in this new era of cancer care. The journal includes literature awareness such as the latest developments in radiotherapy and immunotherapy, concise commentary and analysis, and full review articles all of which provide key findings, translational to the clinical setting.
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