Show simple item record

dc.contributor.authorGomes, Fabio
dc.contributor.authorLorigan, Paul C
dc.contributor.authorWoolley, Sharon
dc.contributor.authorFoden, Philip
dc.contributor.authorBurns, Katy
dc.contributor.authorYorke, Janelle
dc.contributor.authorBlackhall, Fiona H
dc.date.accessioned2021-03-08T06:18:46Z
dc.date.available2021-03-08T06:18:46Z
dc.date.issued2021en
dc.identifier.citationGomes F, Lorigan P, Woolley S, Foden P, Burns K, Yorke J, et al. A prospective cohort study on the safety of checkpoint inhibitors in older cancer patients - the ELDERS study. ESMO Open. 2021;6(1):100042.en
dc.identifier.pmid33516147en
dc.identifier.doi10.1016/j.esmoop.2020.100042en
dc.identifier.urihttp://hdl.handle.net/10541/623781
dc.description.abstractObjective: Older cancer patients are underrepresented in the pivotal trials of checkpoint inhibitors (CPIs). This study aimed to investigate the impact of an ageing immune system on CPI-related toxicity and provide evidence for the role of geriatric assessments with CPI. Methods: The ELDERS study is a prospective observational study with two cohorts: older (70+ years of age) and younger (<70 years of age). Patients with advanced/metastatic non-small-cell lung cancer or melanoma starting single-agent CPI were eligible. The older cohort was assessed for frailty with Geriatric-8 (G8) screening, which when positive (<15 points) was followed by a holistic set of geriatric assessments. Primary endpoint was the incidence of grade 3-5 immune-related adverse events (irAEs). Results: One hundred and forty patients were enrolled with 43% being pretreated and pembrolizumab represented 92% of treatments on study. The older cohort had a significantly higher comorbidity burden (P < 0.001) and polypharmacy (P = 0.004). While 50% of older patients had a positive G8 screening, 60% on this frail subgroup had a performance status score of 0 or 1. There was no significant difference in the incidence of irAEs grade 3-5 between older and younger cohorts (18.6% versus 12.9%; odds ratio 1.55, confidence interval 95% 0.61-3.89; P = 0.353). Exposure to systemic steroids due to irAEs was numerically longer for older patients (22 versus 8 weeks; P = 0.208). A positive G8 screening predicted hospital admissions (P = 0.031) and risk of death (P = 0.01). Conclusions: The use of CPI in older patients was not associated with more high-grade toxicity. The G8 screening identified a subgroup with higher risk of AEs and its implementation should be considered in the context of CPI.en
dc.language.isoenen
dc.relation.urlhttps://dx.doi.org/10.1016/j.esmoop.2020.100042en
dc.titleA prospective cohort study on the safety of checkpoint inhibitors in older cancer patients - the ELDERS studyen
dc.typeArticleen
dc.contributor.departmentMedical Oncology Department, The Christie NHS Foundation Trust, Manchesteren
dc.identifier.journalESMO Openen
dc.description.noteen]
refterms.dateFOA2021-03-08T13:31:28Z


Files in this item

Thumbnail
Name:
33516147.pdf
Size:
363.6Kb
Format:
PDF
Description:
From UNPAYWALL

This item appears in the following Collection(s)

Show simple item record