Safety of Immune Checkpoint Inhibitors in Elderly Patients: An Observational Study
Background: Immunotherapy has completely changed the treatment of solid tumors. Although immune checkpoint inhibitors (ICIs) seem to be an appealing alternative to chemotherapy, especially in elderly patients, due to a more tolerable toxicity profile, they can lead to a peculiar variety of immune-re...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/28/5/283 |
| _version_ | 1797514926188658688 |
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| author | Agnese Paderi Sara Fancelli Enrico Caliman Serena Pillozzi Elisabetta Gambale Marinella Micol Mela Laura Doni Francesca Mazzoni Lorenzo Antonuzzo |
| author_facet | Agnese Paderi Sara Fancelli Enrico Caliman Serena Pillozzi Elisabetta Gambale Marinella Micol Mela Laura Doni Francesca Mazzoni Lorenzo Antonuzzo |
| author_sort | Agnese Paderi |
| collection | DOAJ |
| description | Background: Immunotherapy has completely changed the treatment of solid tumors. Although immune checkpoint inhibitors (ICIs) seem to be an appealing alternative to chemotherapy, especially in elderly patients, due to a more tolerable toxicity profile, they can lead to a peculiar variety of immune-related adverse events (irAEs). However, data on tolerability and outcome of ICIs in the elderly are lacking due to poor accrual in clinical trials of these patients. Methods: We performed a retro-prospective analysis on patients treated with single agent anti-PD-L1/PD-1 at the Clinical Oncology Unit, Careggi University Hospital, from March 2016 to March 2020. Data on the treatment responses, type and severity of irAEs, as well as the corticosteroids (CCS) dosage used for irAEs and the discontinuation rate, were described per each patient, according to two different age-based cohorts of patients (< or ≥70 years). Results: We reported a lower incidence of all-grade toxicity in elderly compared to younger patients (64.9% vs. 44.9%, <i>p</i> = 0.018). The two age-cohorts showed a different profile of irAEs. Endocrine irAEs were significantly higher in younger patients (39.7% vs. 21.7%, <i>p</i> = 0.002), while dermatologic toxicities were more common in the older group (35.0% vs. 11.3%, <i>p</i> = 0.047). Use of CCS and treatment discontinuation rate do not differ significantly between the two age groups. Conclusion: Our findings suggest that treatment with ICIs in elderly populations is safe and feasible. Patients over 70 years are more prone to develop skin irAEs, while younger patients are more subject to experience endocrine toxicities. |
| first_indexed | 2024-03-10T06:38:28Z |
| format | Article |
| id | doaj.art-5376654c34084a43a3836b59703bcd3b |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T06:38:28Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-5376654c34084a43a3836b59703bcd3b2023-11-22T17:54:20ZengMDPI AGCurrent Oncology1198-00521718-77292021-08-012853259326710.3390/curroncol28050283Safety of Immune Checkpoint Inhibitors in Elderly Patients: An Observational StudyAgnese Paderi0Sara Fancelli1Enrico Caliman2Serena Pillozzi3Elisabetta Gambale4Marinella Micol Mela5Laura Doni6Francesca Mazzoni7Lorenzo Antonuzzo8Medical Oncology Unit, Careggi University Hospital, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, 50134 Florence, ItalyBackground: Immunotherapy has completely changed the treatment of solid tumors. Although immune checkpoint inhibitors (ICIs) seem to be an appealing alternative to chemotherapy, especially in elderly patients, due to a more tolerable toxicity profile, they can lead to a peculiar variety of immune-related adverse events (irAEs). However, data on tolerability and outcome of ICIs in the elderly are lacking due to poor accrual in clinical trials of these patients. Methods: We performed a retro-prospective analysis on patients treated with single agent anti-PD-L1/PD-1 at the Clinical Oncology Unit, Careggi University Hospital, from March 2016 to March 2020. Data on the treatment responses, type and severity of irAEs, as well as the corticosteroids (CCS) dosage used for irAEs and the discontinuation rate, were described per each patient, according to two different age-based cohorts of patients (< or ≥70 years). Results: We reported a lower incidence of all-grade toxicity in elderly compared to younger patients (64.9% vs. 44.9%, <i>p</i> = 0.018). The two age-cohorts showed a different profile of irAEs. Endocrine irAEs were significantly higher in younger patients (39.7% vs. 21.7%, <i>p</i> = 0.002), while dermatologic toxicities were more common in the older group (35.0% vs. 11.3%, <i>p</i> = 0.047). Use of CCS and treatment discontinuation rate do not differ significantly between the two age groups. Conclusion: Our findings suggest that treatment with ICIs in elderly populations is safe and feasible. Patients over 70 years are more prone to develop skin irAEs, while younger patients are more subject to experience endocrine toxicities.https://www.mdpi.com/1718-7729/28/5/283agingimmunosenescenceICIelderlyskin toxicityendocrinologic toxicity |
| spellingShingle | Agnese Paderi Sara Fancelli Enrico Caliman Serena Pillozzi Elisabetta Gambale Marinella Micol Mela Laura Doni Francesca Mazzoni Lorenzo Antonuzzo Safety of Immune Checkpoint Inhibitors in Elderly Patients: An Observational Study Current Oncology aging immunosenescence ICI elderly skin toxicity endocrinologic toxicity |
| title | Safety of Immune Checkpoint Inhibitors in Elderly Patients: An Observational Study |
| title_full | Safety of Immune Checkpoint Inhibitors in Elderly Patients: An Observational Study |
| title_fullStr | Safety of Immune Checkpoint Inhibitors in Elderly Patients: An Observational Study |
| title_full_unstemmed | Safety of Immune Checkpoint Inhibitors in Elderly Patients: An Observational Study |
| title_short | Safety of Immune Checkpoint Inhibitors in Elderly Patients: An Observational Study |
| title_sort | safety of immune checkpoint inhibitors in elderly patients an observational study |
| topic | aging immunosenescence ICI elderly skin toxicity endocrinologic toxicity |
| url | https://www.mdpi.com/1718-7729/28/5/283 |
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