PMID- 38199430
OWN - NLM
STAT- MEDLINE
DCOM- 20240206
LR  - 20240206
IS  - 1879-0461 (Electronic)
IS  - 1040-8428 (Linking)
VI  - 194
DP  - 2024 Feb
TI  - Geriatric predictors of response and adverse events in older patients with cancer 
      treated with immune checkpoint inhibitors: A systematic review.
PG  - 104259
LID - S1040-8428(24)00002-7 [pii]
LID - 10.1016/j.critrevonc.2024.104259 [doi]
AB  - BACKGROUND: Immunotherapy with checkpoint inhibitors (ICI) has improved cancer 
      treatment in recent years. Older and frail patients are frequently treated with 
      ICIs, but since they have been underrepresented in previous clinical trials, the 
      real impact of ICI in this patient group is not well defined. The aim of this 
      systematic review was to evaluate the evidence for associations between geriatric 
      impairments and treatment outcomes in older patients with advanced and metastatic 
      cancer treated with ICIs. METHODS: A systematic search was conducted in PubMed, 
      Cochrane Library, Embase, and Web of Science for relevant articles published 
      before June 2022. Studies investigating the association between impairments in at 
      least two geriatric domains and treatment outcome were considered eligible. Data 
      extraction and risk of bias assessment using the QUIPS tool was performed 
      independently by two investigators. RESULTS: A total of nine studies were 
      included. Median sample size of the studies was 92 patients (interquartile range 
      (IQR) 47-113), with a median of 26 frail patients (IQR 21-35). Five studies 
      investigated disease-related and survival outcomes, and two of them found a 
      statistically significant association between geriatric impairments and either 
      survival or disease progression. Eight studies investigated toxicity outcomes, 
      and two of them showed a statistically significant association between geriatric 
      impairments and immune-related adverse events (irAEs). Few studies suggested a 
      relation between geriatric impairments and worse clinical outcomes. CONCLUSIONS: 
      Only a few studies have investigated the association between geriatric 
      impairments and treatment outcomes and these studies were small. Older patients 
      with geriatric impairments seem to be more likely to experience irAEs, but larger 
      studies that include frail patients and use geriatric screening tools are 
      required to confirm this association. These studies will be essential to improve 
      the development of specific strategies to deal with frail patients.
CI  - Copyright (c) 2024. Published by Elsevier B.V.
FAU - Ozkan, Asli
AU  - Ozkan A
AD  - Department of Medical Oncology, Leiden University Medical Center, Leiden, the 
      Netherlands.
FAU - van den Bos, Frederiek
AU  - van den Bos F
AD  - Department of Gerontology and Geriatrics, Leiden University Medical Center, 
      Leiden, the Netherlands.
FAU - Mooijaart, Simon P
AU  - Mooijaart SP
AD  - Department of Gerontology and Geriatrics, Leiden University Medical Center, 
      Leiden, the Netherlands; Center for Medicine for Older People, Leiden University 
      Medical Center, Leiden, the Netherlands.
FAU - Slingerland, Marije
AU  - Slingerland M
AD  - Department of Medical Oncology, Leiden University Medical Center, Leiden, the 
      Netherlands.
FAU - Kapiteijn, Ellen
AU  - Kapiteijn E
AD  - Department of Medical Oncology, Leiden University Medical Center, Leiden, the 
      Netherlands.
FAU - de Miranda, Noel F C C
AU  - de Miranda NFCC
AD  - Department of Pathology, Leiden University Medical Center, Leiden, the 
      Netherlands.
FAU - Portielje, Johanneke E A
AU  - Portielje JEA
AD  - Department of Medical Oncology, Leiden University Medical Center, Leiden, the 
      Netherlands.
FAU - de Glas, Nienke A
AU  - de Glas NA
AD  - Department of Medical Oncology, Leiden University Medical Center, Leiden, the 
      Netherlands. Electronic address: n.a.de_glas@lumc.nl.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20240109
PL  - Netherlands
TA  - Crit Rev Oncol Hematol
JT  - Critical reviews in oncology/hematology
JID - 8916049
RN  - 0 (Immune Checkpoint Inhibitors)
SB  - IM
MH  - Humans
MH  - Aged
MH  - *Immune Checkpoint Inhibitors/adverse effects
MH  - *Neoplasms/drug therapy
OTO - NOTNLM
OT  - Frailty
OT  - Geriatric oncology
OT  - Geriatric screening
OT  - Geriatric syndromes
OT  - Immune checkpoint inhibitors
OT  - Immunosenescence
OT  - Older patients
OT  - Overall survival
OT  - Systematic review
OT  - Toxicity
COIS- Declaration of Competing Interest M. Slingerland is a paid advisory board member 
      for Bristol-Myers Squibb, AstraZeneca, and Lilly. E. Kapiteijn has 
      consultancy/advisory relationships with Bristol Myers Squibb, Novartis, Merck, 
      Pierre Fabre, Lilly and Bayer, these were paid to the institution. Furthermore, 
      she received research grants not related to this paper from Bristol Myers Squibb, 
      Delcath, Novartis and Pierre Fabre. No potential conflict of interest were 
      disclosed by the other authors. The funders had no role in the design of the 
      study; in the collection, analyses, or interpretation of data; in the writing of 
      the manuscript, or in the decision to publish the results.
EDAT- 2024/01/11 00:42
MHDA- 2024/02/06 06:43
CRDT- 2024/01/10 20:16
PHST- 2023/05/05 00:00 [received]
PHST- 2023/11/13 00:00 [revised]
PHST- 2024/01/04 00:00 [accepted]
PHST- 2024/02/06 06:43 [medline]
PHST- 2024/01/11 00:42 [pubmed]
PHST- 2024/01/10 20:16 [entrez]
AID - S1040-8428(24)00002-7 [pii]
AID - 10.1016/j.critrevonc.2024.104259 [doi]
PST - ppublish
SO  - Crit Rev Oncol Hematol. 2024 Feb;194:104259. doi: 
      10.1016/j.critrevonc.2024.104259. Epub 2024 Jan 9.