Efficacy and safety of immune checkpoint inhibitors in young adults with metastatic melanoma
Authors
Wong, S. K.Blum, S. M.
Sun, X.
Da Silva, I. P.
Zubiri, L.
Ye, F.
Bai, K.
Zhang, K.
Ugurel, S.
Zimmer, L.
Livingstone, E.
Schadendorf, D.
Serra-Bellver, Patricio
Muñoz-Couselo, E.
Ortiz, C.
Lostes, J.
Huertas, R. M.
Arance, A.
Pickering, L.
Long, G. V.
Carlino, M. S.
Buchbinder, E. I.
Vázquez-Cortés, L.
Jara-Casas, D.
Márquez-Rodas, I.
González-Espinoza, I. R.
Balko, J. M.
Menzies, A. M.
Sullivan, R. J.
Johnson, D. B.
Affiliation
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USAIssue Date
2022
Metadata
Show full item recordAbstract
Background: The integration of immune checkpoint inhibitors (ICI) for the treatment of melanoma has resulted in remarkable and durable responses. Given the potential role of immunosenescence, age may contribute to differential ICI efficacy and toxicity. While older patients have been studied in detail, outcomes from ICI in young patients (≤40 years) are not well characterised. Methods: We performed a multi-institutional, retrospective study of patients with advanced melanoma treated with anti-PD-1 monotherapy or ICI combination (ipilimumab and anti-PD-1). Response rates, survival, and toxicities were examined based on age comparing those under 40 years of age with older patients (age 41-70 and ≥ 71 years). Results: A total of 676 patients were included: 190 patients (28%) aged ≤40 years, 313 (46%) between ages 41-70, and 173 patients (26%) aged ≥71. Patients ≤40 years had higher response rates (53% vs 38%, p = 0.035) and improved progression-free survival (median 13.7 vs 4.0 months, p = 0.032) with combination ICI compared to monotherapy. Progression-free survival was similar among groups while overall survival was inferior in patients >70 years, who had low response rates to combination therapy (28%). ICIs had a similar incidence of severe toxicities, though hepatotoxicity was particularly common in younger patients vs. patients >40 with monotherapy (9% vs. 2%, p = 0.007) or combination ICI (37% vs. 10%, p < 0.001). Conclusions: ICIs had comparable efficacy between younger and older patients, although outcomes were superior with combination ICI compared to monotherapy in patients aged ≤40 years. Toxicity incidence was similar across age groups, though organs affected were substantially different.Citation
Wong SK, Blum SM, Sun X, Da Silva IP, Zubiri L, Ye F, et al. Efficacy and safety of immune checkpoint inhibitors in young adults with metastatic melanoma. European journal of cancer (Oxford, England : 1990). 2022 Dec 27;181:188-97. PubMed PMID: 36680880. Epub 2023/01/22. eng.Journal
European Journal of CancerDOI
10.1016/j.ejca.2022.12.013PubMed ID
36680880Additional Links
https://dx.doi.org/10.1016/j.ejca.2022.12.013Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1016/j.ejca.2022.12.013
Scopus Count
Collections
Related articles
- Systematic review and meta-analysis efficacy and safety of immune checkpoint inhibitors in advanced melanoma patients with anti-PD-1 progression: a systematic review and meta-analysis.
- Authors: Alrabadi NN, Abushukair HM, Ababneh OE, Syaj SS, Al-Horani SS, Qarqash AA, Darabseh OA, Al-Sous MM, Al-Aomar SR, Ahmed YB, Haddad R, Al Qarqaz FA
- Issue date: 2021 Sep
- Association Between Sex and Immune Checkpoint Inhibitor Outcomes for Patients With Melanoma.
- Authors: Jang SR, Nikita N, Banks J, Keith SW, Johnson JM, Wilson M, Lu-Yao G
- Issue date: 2021 Dec 1
- Neuroimmunological adverse events associated with immune checkpoint inhibitor: a retrospective, pharmacovigilance study using FAERS database.
- Authors: Mikami T, Liaw B, Asada M, Niimura T, Zamami Y, Green-LaRoche D, Pai L, Levy M, Jeyapalan S
- Issue date: 2021 Mar
- Ipilimumab alone or ipilimumab plus anti-PD-1 therapy in patients with metastatic melanoma resistant to anti-PD-(L)1 monotherapy: a multicentre, retrospective, cohort study.
- Authors: Pires da Silva I, Ahmed T, Reijers ILM, Weppler AM, Betof Warner A, Patrinely JR, Serra-Bellver P, Allayous C, Mangana J, Nguyen K, Zimmer L, Trojaniello C, Stout D, Lyle M, Klein O, Gerard CL, Michielin O, Haydon A, Ascierto PA, Carlino MS, Lebbe C, Lorigan P, Johnson DB, Sandhu S, Lo SN, Blank CU, Menzies AM, Long GV
- Issue date: 2021 Jun
- Outcomes after resumption of immune checkpoint inhibitor therapy after high-grade immune-mediated hepatitis.
- Authors: Li M, Sack JS, Rahma OE, Hodi FS, Zucker SD, Grover S
- Issue date: 2020 Dec 1