PMID- 37429982
OWN - NLM
STAT- MEDLINE
DCOM- 20230825
LR  - 20230829
IS  - 1179-1969 (Electronic)
IS  - 1170-229X (Linking)
VI  - 40
IP  - 9
DP  - 2023 Sep
TI  - Associated Factors to Efficacy and Tolerance of Immunotherapy in Older Patients 
      with Cancer Aged 70 Years and Over: Impact of Coprescriptions.
PG  - 837-846
LID - 10.1007/s40266-023-01048-y [doi]
AB  - BACKGROUND: Immunotherapy with immune checkpoint blockers (ICB) significantly 
      improves the prognosis for an increasing number of cancers. However, data on 
      geriatric populations taking ICB are rare. OBJECTIVE: This study aimed to 
      identify factors associated with the efficacy and tolerance of ICB in an older 
      population. PATIENTS AND METHODS: This retrospective monocentric study included 
      consecutive patients aged >/= 70 years with solid cancer who received ICB between 
      January 2018 and December 2019. Efficacy was assessed by progression-free 
      survival (PFS) and tolerance was defined as cessation of immunotherapy due to the 
      occurrence of any adverse event. RESULTS: One hundred and five patients (65.7% 
      men) were included, mainly at the metastatic stage (95.2%); 50.5% had lung 
      cancer. Most (80%) patients were treated with anti-PD1 (nivolumab, 
      pembrolizumab), 19.1% with anti-PD-L1 (atezolizumab, durvalumab, and avelumab) 
      and 0.9% with anti-CTLA4 ICB (ipilimumab). Median PFS was 3.7 months [95% 
      confidence interval (CI) (2.75-5.70)]. PFS was shorter in univariate analysis 
      when ICB was taken concomitantly with an antiplatelet agent (AP) [hazard ratio 
      (HR) = 1.93; 95% CI (1.22-3.04); p = 0.005]. Tolerance was lower in univariate 
      analysis for lung cancer [odds ratio (OR) = 3.03; 95% CI (1.07-8.56), p < 0.05] 
      and in patients taking proton pump inhibitors (PPI) [OR = 5.50; 95% CI 
      (1.96-15.42), p < 0.001]. There was a trend toward poorer tolerance among 
      patients living alone [OR = 2.26; 95% CI (0.76-6.72); p = 0.14]. CONCLUSIONS: In 
      older patients taking ICB for solid cancers, concomitant AP may influence 
      efficacy and concomitant PPI may influence tolerance. Further studies are needed 
      to confirm these results.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
FAU - Perret, Marie
AU  - Perret M
AD  - Geriatrics, Hospital of Champmaillot, Dijon-Bourgogne University Hospital, Dijon, 
      France.
FAU - Bertaut, Aurelie
AU  - Bertaut A
AUID- ORCID: 0000-0002-7934-9509
AD  - Unit of Methodology and Biostatistics, Centre Georges Francois Leclerc, Dijon, 
      France.
FAU - Niogret, Julie
AU  - Niogret J
AUID- ORCID: 0000-0002-3563-4658
AD  - Geriatric Oncology Coordination Unit in Burgundy, Dijon-Bourgogne University 
      Hospital, Dijon, France.
AD  - Medical Oncology Department, Centre George Francois Leclerc, Dijon, France.
FAU - Marilier, Sophie
AU  - Marilier S
AD  - Geriatrics, Hospital of Champmaillot, Dijon-Bourgogne University Hospital, Dijon, 
      France.
AD  - Geriatric Oncology Coordination Unit in Burgundy, Dijon-Bourgogne University 
      Hospital, Dijon, France.
FAU - Jouanny, Pierre
AU  - Jouanny P
AD  - Geriatrics, Hospital of Champmaillot, Dijon-Bourgogne University Hospital, Dijon, 
      France.
FAU - Manckoundia, Patrick
AU  - Manckoundia P
AUID- ORCID: 0000-0002-5518-9803
AD  - Geriatrics, Hospital of Champmaillot, Dijon-Bourgogne University Hospital, Dijon, 
      France.
AD  - UMR INSERM U1093, University of Burgundy, Dijon, France.
FAU - Bengrine-Lefevre, Leila
AU  - Bengrine-Lefevre L
AUID- ORCID: 0000-0002-0762-7303
AD  - Geriatric Oncology Coordination Unit in Burgundy, Dijon-Bourgogne University 
      Hospital, Dijon, France.
AD  - Medical Oncology Department, Centre George Francois Leclerc, Dijon, France.
FAU - Quipourt, Valerie
AU  - Quipourt V
AD  - Geriatrics, Hospital of Champmaillot, Dijon-Bourgogne University Hospital, Dijon, 
      France.
AD  - Geriatric Oncology Coordination Unit in Burgundy, Dijon-Bourgogne University 
      Hospital, Dijon, France.
FAU - Barben, Jeremy
AU  - Barben J
AUID- ORCID: 0000-0001-7140-8415
AD  - Geriatrics, Hospital of Champmaillot, Dijon-Bourgogne University Hospital, Dijon, 
      France. jeremy.barben@chu-dijon.fr.
AD  - Geriatric Oncology Coordination Unit in Burgundy, Dijon-Bourgogne University 
      Hospital, Dijon, France. jeremy.barben@chu-dijon.fr.
AD  - UMR INSERM U1231, University of Burgundy, Dijon, France. 
      jeremy.barben@chu-dijon.fr.
LA  - eng
PT  - Journal Article
DEP - 20230710
PL  - New Zealand
TA  - Drugs Aging
JT  - Drugs & aging
JID - 9102074
RN  - 0 (Ipilimumab)
RN  - 31YO63LBSN (Nivolumab)
RN  - 0 (Immune Checkpoint Inhibitors)
SB  - IM
MH  - Male
MH  - Humans
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Retrospective Studies
MH  - Ipilimumab
MH  - *Nivolumab
MH  - *Lung Neoplasms
MH  - Immune Checkpoint Inhibitors
MH  - Immunotherapy/adverse effects/methods
EDAT- 2023/07/11 01:07
MHDA- 2023/08/25 06:43
CRDT- 2023/07/10 23:26
PHST- 2023/06/19 00:00 [accepted]
PHST- 2023/08/25 06:43 [medline]
PHST- 2023/07/11 01:07 [pubmed]
PHST- 2023/07/10 23:26 [entrez]
AID - 10.1007/s40266-023-01048-y [pii]
AID - 10.1007/s40266-023-01048-y [doi]
PST - ppublish
SO  - Drugs Aging. 2023 Sep;40(9):837-846. doi: 10.1007/s40266-023-01048-y. Epub 2023 
      Jul 10.