PMID- 30661086
OWN - NLM
STAT- MEDLINE
DCOM- 20190416
LR  - 20240426
IS  - 1432-0851 (Electronic)
IS  - 0340-7004 (Print)
IS  - 0340-7004 (Linking)
VI  - 68
IP  - 4
DP  - 2019 Apr
TI  - Adverse events need for hospitalization and systemic immunosuppression in very 
      elderly patients (over 80 years) treated with ipilimumab for metastatic melanoma.
PG  - 545-551
LID - 10.1007/s00262-019-02298-9 [doi]
AB  - BACKGROUND: Checkpoint inhibitors are first-line therapies in melanoma, but 
      safety in older adults has not yet been assessed. Ipilimumab improves survival, 
      but immunologic-related adverse events (AEs) can be threatening, and its use in 
      elderly people raises questions. AIM: To assess safety in a cohort of very 
      elderly patients treated with ipilimumab. METHODS: All patients over 80 years 
      treated with ipilimumab for melanoma were retrospectively included. AE 
      occurrence, management, and outcome, as well as response rate at week 16 and 
      overall survival were recorded, and compared to data for a group of younger 
      patients treated in our institution during the same period. RESULTS: In the 
      elderly group, 23 patients were included with a median age of 82 years [80-90]. 
      AEs amounting to 23 occurred in 15 patients (65%) with 5 grade 3 (22%) and 1 
      grade 5 (opportunistic infection) AEs. Corticosteroids were required for five 
      (22%) patients, additive immunosuppressive therapy for two, hospitalization for 
      four, and definitive interruption of ipilimumab for three. Median overall 
      survival was 14 months. In the younger group, 29 patients were included with a 
      median age of 58 years. AEs occurred in 15/29 (52%) with 4 grade 3 (19%) and 1 
      grade 4 (7%). Median OS was 17 months. CONCLUSION: Serious AEs occurred in 
      80 + adults at the same rate as observed in our younger patients and as 
      previously reported in younger populations. Ipilimumab can be an option in 
      elderly patients, as patients may benefit from therapy and safety seems to be 
      manageable.
FAU - Leroy, Vaianu
AU  - Leroy V
AD  - Hopital Saint Andre, service de Dermatologie, University Hospital of Bordeaux, 1 
      rue Jean Burguet, 33000, Bordeaux, France.
FAU - Gerard, Emilie
AU  - Gerard E
AD  - Hopital Saint Andre, service de Dermatologie, University Hospital of Bordeaux, 1 
      rue Jean Burguet, 33000, Bordeaux, France.
FAU - Dutriaux, Caroline
AU  - Dutriaux C
AD  - Hopital Saint Andre, service de Dermatologie, University Hospital of Bordeaux, 1 
      rue Jean Burguet, 33000, Bordeaux, France.
FAU - Prey, Sorilla
AU  - Prey S
AD  - Hopital Saint Andre, service de Dermatologie, University Hospital of Bordeaux, 1 
      rue Jean Burguet, 33000, Bordeaux, France.
FAU - Gey, Aurelia
AU  - Gey A
AD  - Hopital Saint Andre, service de Dermatologie, University Hospital of Bordeaux, 1 
      rue Jean Burguet, 33000, Bordeaux, France.
FAU - Mertens, Cecile
AU  - Mertens C
AD  - Department of Clinical Gerontology, University Hospital of Bordeaux, 33000, 
      Bordeaux, France.
FAU - Beylot-Barry, Marie
AU  - Beylot-Barry M
AD  - Hopital Saint Andre, service de Dermatologie, University Hospital of Bordeaux, 1 
      rue Jean Burguet, 33000, Bordeaux, France.
AD  - Univ. Bordeaux, INSERM U1053, Team 3 Oncogenesis of Cutaneous Lymphoma, 33076, 
      Bordeaux, France.
FAU - Pham-Ledard, Anne
AU  - Pham-Ledard A
AUID- ORCID: 0000-0003-2960-6084
AD  - Hopital Saint Andre, service de Dermatologie, University Hospital of Bordeaux, 1 
      rue Jean Burguet, 33000, Bordeaux, France. anne.pham-ledard@chu-bordeaux.fr.
AD  - Univ. Bordeaux, INSERM U1053, Team 3 Oncogenesis of Cutaneous Lymphoma, 33076, 
      Bordeaux, France. anne.pham-ledard@chu-bordeaux.fr.
LA  - eng
PT  - Journal Article
DEP - 20190119
PL  - Germany
TA  - Cancer Immunol Immunother
JT  - Cancer immunology, immunotherapy : CII
JID - 8605732
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Ipilimumab)
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Agents/*adverse effects/therapeutic use
MH  - Comorbidity
MH  - Female
MH  - Geriatric Assessment
MH  - *Hospitalization
MH  - Humans
MH  - *Immunosuppression Therapy
MH  - Ipilimumab/*adverse effects/therapeutic use
MH  - Male
MH  - Melanoma/*complications/diagnosis/drug therapy/genetics
MH  - Middle Aged
MH  - Survival Analysis
PMC - PMC11028202
OTO - NOTNLM
OT  - Adverse events
OT  - Checkpoint inhibitors
OT  - Elderly
OT  - Ipilimumab
OT  - Melanoma
OT  - Older adults
COIS- Consulting and advisory role for Bristol-Myers Squibb (Dutriaux, Beylot-Barry); 
      speaker honorarium (Pham-Ledard, Dutriaux, Beylot-Barry) travelling, expenses and 
      accommodation (Pham-Ledard, Dutriaux, Beylot-Barry, Prey). All other authors 
      declare that they have no conflict of interest.
EDAT- 2019/01/21 06:00
MHDA- 2019/04/17 06:00
PMCR- 2019/01/19
CRDT- 2019/01/21 06:00
PHST- 2018/05/01 00:00 [received]
PHST- 2019/01/06 00:00 [accepted]
PHST- 2019/01/21 06:00 [pubmed]
PHST- 2019/04/17 06:00 [medline]
PHST- 2019/01/21 06:00 [entrez]
PHST- 2019/01/19 00:00 [pmc-release]
AID - 10.1007/s00262-019-02298-9 [pii]
AID - 2298 [pii]
AID - 10.1007/s00262-019-02298-9 [doi]
PST - ppublish
SO  - Cancer Immunol Immunother. 2019 Apr;68(4):545-551. doi: 
      10.1007/s00262-019-02298-9. Epub 2019 Jan 19.