TY - JOUR
T1 - Association of Age with Efficacy of Immunotherapy in Metastatic Melanoma
AU - Jain, Varsha
AU - Hwang, Wei Ting
AU - Venigalla, Sriram
AU - Nead, Kevin T.
AU - Lukens, John N.
AU - Mitchell, Tara C.
AU - Shabason, Jacob E.
N1 - Publisher Copyright:
© AlphaMed Press 2019
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Management of melanoma has been revolutionized by the use of immune checkpoint inhibitors. Immune system changes associated with aging may affect the efficacy of immune-based therapies. Using the National Cancer Database, we evaluated the impact of age on the receipt and efficacy of modern immunotherapies in patients with metastatic melanoma. We identified 11,944 patients from 2011–2015, of whom 25% received immunotherapy. Older (≥60 years), compared with younger, patients were less likely to receive immunotherapy (odds ratio, 0.69; 95% confidence interval [CI], 0.61–0.78; p <.001). Immunotherapy was associated with a survival benefit in both younger and older patients (<60 years: hazard ratio [HR], 0.64; 95% CI, 0.57–0.72; p <.001; ≥60 years: HR, 0.55; 95% CI, 0.50–0.60; p <.001). Importantly, there was a statistically significant interaction between age and survival with immunotherapy, where a greater benefit was observed for older patients (pinteraction = 0.013). Further work studying the age-related response to immunotherapy is warranted.
AB - Management of melanoma has been revolutionized by the use of immune checkpoint inhibitors. Immune system changes associated with aging may affect the efficacy of immune-based therapies. Using the National Cancer Database, we evaluated the impact of age on the receipt and efficacy of modern immunotherapies in patients with metastatic melanoma. We identified 11,944 patients from 2011–2015, of whom 25% received immunotherapy. Older (≥60 years), compared with younger, patients were less likely to receive immunotherapy (odds ratio, 0.69; 95% confidence interval [CI], 0.61–0.78; p <.001). Immunotherapy was associated with a survival benefit in both younger and older patients (<60 years: hazard ratio [HR], 0.64; 95% CI, 0.57–0.72; p <.001; ≥60 years: HR, 0.55; 95% CI, 0.50–0.60; p <.001). Importantly, there was a statistically significant interaction between age and survival with immunotherapy, where a greater benefit was observed for older patients (pinteraction = 0.013). Further work studying the age-related response to immunotherapy is warranted.
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U2 - 10.1634/theoncologist.2019-0377
DO - 10.1634/theoncologist.2019-0377
M3 - Article
C2 - 32043765
AN - SCOPUS:85074852336
SN - 1083-7159
VL - 25
SP - e381-e385
JO - Oncologist
JF - Oncologist
IS - 2
ER -