There is scarce prospective literature regarding the efficacy and safety of cancer immunotherapy in the elderly. Our study aimed to evaluate this in our local setting, given its increasing use and perceived safety when compared to platinum-based chemotherapy.
We retrospectively reviewed all elderly patients (age 75) treated with immunotherapy for non-small-cell lung cancer (NSCLC) at an Australian tertiary metropolitan hospital. Parameters evaluated included demographic data, treatment received, survival outcomes and side effects of treatment. Retrospective analysis using simple means was performed on the data from all eligible patients.
Our study included 13 participants, with a median age of 80 years. At treatment commencement, their median Eastern Cooperative Oncology Group (ECOG) performance status was 1, with stage 4 disease in 85%. Immunotherapy was predominantly a 2nd line treatment, with a median of 8 cycles received (range 1-68 cycles). 61.5% of patients responded to therapy. The median overall survival in the cohort was 33 weeks from the commencement of immunotherapy (range 1-168 weeks). Approximately one-third of patients experienced toxicity, the most severe of which was grade 3 toxicity occurring in 2 patients who experienced hypophysitis and lichenoid rash respectively.
In our cohort of patients, cancer immunotherapy for NSCLC was effective and well tolerated. Additional prospective evidence is needed in this area to guide patient selection for therapy.