Comparison of efficacy of immune checkpoint inhibitors (ICIs) between younger and older patients: A systematic review and meta-analysis

•This meta-analysis compared the efficacy of ICIs between younger and older patients.•ICIs significantly improved OS in both younger (HR, 0.75) and older (HR, 0.73) groups.•An improvement in PFS was observed in younger (HR, 0.58) and older (HR, 0.77) patients.•In the PD-1 inhibitor subgroup, a signi...

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Vydáno v:Cancer treatment reviews Ročník 45; s. 30 - 37
Hlavní autoři: Nishijima, Tomohiro F., Muss, Hyman B., Shachar, Shlomit S., Moschos, Stergios J.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Netherlands Elsevier Ltd 01.04.2016
Témata:
Age
Age Factors
Aging - immunology
Antibodies, Monoclonal - classification
Antibodies, Monoclonal - immunology
Antibodies, Monoclonal - pharmacology
Antineoplastic Agents - classification
Antineoplastic Agents - immunology
Antineoplastic Agents - pharmacology
Disease-Free Survival
Hematology, Oncology and Palliative Medicine
Humans
Immune checkpoint inhibitor
Immunosenescence
Meta-analysis
Neoplasms - drug therapy
Neoplasms - immunology
Overall survival
Progression-free survival
Randomized Controlled Trials as Topic
Systematic review
Treatment Outcome
Immune checkpoint inhibitor
Immunosenescence
Systematic review
Overall survival
Progression-free survival
Age
Meta-analysis
ISSN:0305-7372, 1532-1967, 1532-1967
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Shrnutí:•This meta-analysis compared the efficacy of ICIs between younger and older patients.•ICIs significantly improved OS in both younger (HR, 0.75) and older (HR, 0.73) groups.•An improvement in PFS was observed in younger (HR, 0.58) and older (HR, 0.77) patients.•In the PD-1 inhibitor subgroup, a significant benefit was not seen in the patients aged ⩾75 years. Immune checkpoint inhibitors (ICIs) rely on the presence of ongoing immune response to exert their antitumor effect. Little is known whether an age-related decline in immune function negatively influences antitumor response and in so doing diminishes the efficacy of ICIs in elderly subjects. We performed a meta-analysis to compare the efficacy of ICIs between younger and older patients. PubMed and the ASCO databases were searched up to September 2015. We included randomized controlled trials (RCTs) of ICIs (ipilimumab, tremelimumab, nivolumab and pembrolizumab) reporting subgroup comparison of overall survival (OS) and/or progression-free survival (PFS) based on age cutoffs. The summary hazard ratio (HR) and 95% confidence interval (CI) were calculated. A total of 5265 patients from nine RCTs of ICI were included. When patients are dichotomized into younger and older groups with an age cut-off of 65–70years, ICIs improved OS in both younger (HR, 0.75; 95% CI, 0.68–0.82) and older (HR, 0.73; 95% CI, 0.62–0.87) groups. An improvement in PFS was observed in younger (HR, 0.58; 95% CI, 0.40–0.84) and older (HR, 0.77; 95% CI, 0.58–1.01) patients. Subgroup analyses according to ICI and tumor type showed a consistent survival benefit in both younger and older groups except for the subgroup of older patients treated in 4 trials of anti-programmed cell death protein-1 (PD-1) monoclonal antibody (HR, 0.86; 95% CI, 0.41–1.83). A benefit in OS with ICIs was significant in both younger and older patients with a cut-off age of 65–70years.
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ISSN:0305-7372
1532-1967
1532-1967
DOI:10.1016/j.ctrv.2016.02.006