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• W2890890263 abstract "e21544 Background: Immune checkpoint inhibitors (ICIs) have a promising activity in variety of malignancies however little is known regarding their efficacy and toxicity profile in older adults (≥65 yo). Accordingly, we performed a meta-analysis of published trials using anti-PD-1 or PD-L1 to define the activity of these agents in this subset of patients. Methods: We conducted a search using PubMed and Web of Science databases for randomized controlled trials (RCTs) of PD-1 and PD-L1 inhibitors including nivolumab (N), pembrolizumab (P), and atezolizumab (A). We then identified the studies that reported a subgroup analysis of overall survival (OS) based on an age cutoff. Results: We identified a total of 17 RCTs that compared N, P and A to chemotherapy or targeted therapy. Out of those trials only 9 reported hazard ratio (HR) based on age and were included in this meta-analysis. These trials treated a total of 5033 patients including 2315 patient ≥65 yo (46%). The overall estimated, random-effects hazard ratio (HR) for death was 0.69 with 95% CI of 0.63 -0.74 (p < 0.0001) in the general population favoring ICIs. Based on the selected trials, there was evidence of a 31% reduction in the hazard of death with PD1/PDL1 inhibitors compared with chemo/targeted therapy. This OS benefit persisted when the analysis was done based on disease type (NSCLC or others) or the drug target (PD-1 or PD-L1). Analysis based on age cutoff of 65 yo showed that the efficacy of PD-1 and PD-L1 inhibitors did not vary for older or younger patients. The overall estimated random-effects HR was 0.64 with 95% CI of 0.54 -0.76 in patients ≥65 yo vs. 0.68 with 95% CI of 0.61-0.75 in patients < 65 yo. Data regarding toxicity based on age was available only for 3 trials. The rate of grade 3-4 toxicities was comparable between the 2 groups (45-50% in patients ≥ 65 compared to 37.1-50% in patients < 65). Conclusions: PD-1 and PD-L1 inhibitors efficacy using N, P or A is comparable in older and younger adults when using an age cutoff of 65 years. Future ICIs trials should report efficacy and toxicity based on age." @default.
• W2890890263 created "2018-09-27" @default.
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• W2890890263 date "2017-05-20" @default.
• W2890890263 modified "2023-09-27" @default.
• W2890890263 title "Efficacy of PD-1 and PD-L1 inhibitors in older adults: A meta-analysis." @default.
• W2890890263 doi "https://doi.org/10.1200/jco.2017.35.15_suppl.e21544" @default.
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