1
|
Saleh K, Auperin A, Martin N, Borcoman E, Torossian N, Iacob M, Ferrand FR, Khalife N, Baste N, Guigay J, Le Tourneau C, Daste A, Saada-Bouzid E, Even C. Efficacy and safety of immune checkpoint inhibitors in elderly patients (≥70 years) with squamous cell carcinoma of the head and neck. Eur J Cancer 2021; 157:190-197. [PMID: 34536943 DOI: 10.1016/j.ejca.2021.08.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/14/2021] [Accepted: 08/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recent meta-analysis showed that immune checkpoint inhibitors (ICIs) have comparable activity between younger and older patients. However, little is known about efficacy and safety of ICI in elderly patients with relapsed/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). The aim of this study is to compare the efficacy of ICI for patients aged ≥70 y to that for younger patients, while taking into account potential confounding factors. METHODS A retrospective study was conducted at four hospitals in France. Patients treated with ICI for R/M SCCHN between September 2014 and December 2018 were eligible. Patients' charts were reviewed for clinical and radiological data as well as oncologic outcomes. RESULTS We included 226 patients, of whom 67 were aged ≥70 years. Objective response rate (ORR), median overall survival (OS) and median progression-free survival (PFS) were 23%, 9.7 months and 2.7 months, respectively, for elderly patients, compared to 13%, 8.7 months and 1.9 months for younger patients (respective p-values: 0.071, 0.87 and 0.21). After adjustment for performance status, site of progression, number of ICI drugs, time between initial diagnosis and ICI start and number of previous lines, age ≥70 years was significantly associated with a better PFS (hazard ratio [HR], 0.66; p = 0.021) but not OS (HR, 0.91; p = 0.59). Grade 3-5 adverse events (AEs) occurred in 15% of patients aged ≥70 years and in 8% of younger patients (p = 0.13). CONCLUSION Patients aged ≥70 years with R/M SCCHN may respond to ICI similarly as younger patients in terms of ORR, OS and PFS, while maintaining comparable rate of AEs.
Collapse
Affiliation(s)
- Khalil Saleh
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France.
| | - Anne Auperin
- Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Nicolas Martin
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Edith Borcoman
- Department of Medical Oncology, Institut Curie, Paris & Saint-Cloud, France
| | - Nouritza Torossian
- Department of Medical Oncology, Institut Curie, Paris & Saint-Cloud, France
| | - Mariana Iacob
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | | | - Nadine Khalife
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Neus Baste
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Joel Guigay
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation, Institut Curie, Paris & Saint-Cloud, France; INSERM U900 Research Unit, Saint-Cloud, France; Paris-Saclay University, Paris, France
| | - Amaury Daste
- Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital-CHU Bordeaux, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France; Université Côte d'Azur, Nice, France
| | - Caroline Even
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| |
Collapse
|