Immunotherapy questioned for the elderly

Immunotherapy is less effective for elderly patients with non-small-cell lung cancer than with younger patients, a conference will hear today.

Information on this treatment for older patients has previously been lacking. So Dr Elena Corral de la Fuente and colleagues at the Hospital Universitario Ramon y Cajal in Spain, carried out a study.

They looked at information on 98 patients with advanced non-small-cell lung cancer treated with immunotherapy agents over a four year period. just over a quarter of these patients were aged 70 years or above.

This older group was seen to have significantly shorter overall survival than younger patients (median 5.5 months versus 13 months), and progression-free survival (1.8 vs 3.6 months), but similar toxicity from the drugs.

Details will be presented today (10 April) at the European Lung Cancer Congress held in Geneva, Switzerland.

The researchers state: "Our results suggest that elderly patients could have worse survival outcomes with immunotherapy than younger patients, without differences in terms of toxicity.

"Prospective randomised clinical trials and more real-world data are needed to answer remaining questions on the use of immunotherapy in elderly patients."

A further study presented at the Congress examined outcomes from three trials and found significantly improved overall survival in older patients with the condition when they were treated with the immunotherapy agent pembrolizumab rather than chemotherapy.

Lead author, Dr Kaname Nosaki of the Kyushu Cancer Center, Fukuoka, Japan, said: "Pembrolizumab monotherapy improved overall survival over chemotherapy, together with a more favourable safety profile. Our data support the use of pembrolizumab monotherapy in elderly patients with advanced PD-L1- expressing non-small-cell lung cancer."

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