Efficacy and safety of immune checkpoint inhibitor monotherapy in elderly patients with non‐small cell lung cancer

• Published in: Aging medicine Vol. 4; no. 1; pp. 42 - 46
• Main Authors: Chikaishi, Yasuhiro, Inoue, Masaaki, Kusanagi, Kasumi, Honda, Yohei, Yoshida, Junichi, Tanaka, Masao
• Format: Journal Article
• Language: English
• Published: Australia John Wiley & Sons, Inc 01.03.2021; John Wiley and Sons Inc; Wiley
• Subjects: Age; Apoptosis; Biopsy; Cancer therapies; Chemotherapy; Clinical outcomes; elderly patient; Histology; immune checkpoint inhibitor; Inflammatory bowel disease; Ligands; Lung cancer; Lung diseases; Myasthenia gravis; non‐small cell lung cancer; Palliative care; Patients; Pleural effusion; Short Communication; Thoracic surgery; Tomography; elderly patient; immune checkpoint inhibitor; non‐small cell lung cancer
• ISSN: 2475-0360; 2475-0360
• DOI: 10.1002/agm2.12147

The efficacy and safety of immune checkpoint inhibitor (ICI) monotherapy in elderly patients with non‐small cell lung cancer (NSCLC) remain unclear, especially in patients older than 80 years. We retrospectively reviewed the records of 10 patients older than 80 years with NSCLCs treated by ICIs. The median age was 85 years (range, 82‐93 years), and 7 patients were men. The median length of follow‐up was 13 months (range, 4.5‐23 months). Eight patients had adenocarcinoma (3 of whom had exon 19 deletions), and two had squamous cell carcinoma. Expression of programmed cell death ligand 1 (PD‐L1) was ≥ 50% in 3 patients, between 1% and 49% in 4 patients, < 1% in 1 patient, and undetected in 2 patients. Patients with undetected PD‐L1 underwent transbronchial lung biopsy. Performance status was graded zero, one, and two in two, seven, and one patients, respectively. First‐, second‐, and third‐line treatments were administered to three, three, and four patients, respectively. The 2‐year overall survival rate was 30.0% (median, 285 days). Time to treatment failure rate on the 2 years was 10.0% (median, 167 days). One patient achieved a partial response, and one achieved a complete response. ICI‐associated adverse events occurred in five patients. In summary, ICIs were effective in some patients older than 80 years; however, some experienced adverse effects. Elderly patients must be selected carefully for ICI treatment.