Evidence map›Paper›PMID 32681403›Full record

SynthesisDrugs & aging2020

Immune Checkpoint Inhibitors for Patients Aged ≥ 75 Years with Advanced Cancer in First- and Second-Line Settings: A Meta-Analysis.

Thierry Landre, Gaetan Des Guetz, Kader Chouahnia, Virginie Fossey-Diaz, Stéphane Culine

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Drugs & aging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  19. Aging, cancer, and antitumor immunity.International journal of clinical oncology · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Thierry LandreGeriatric Oncology Coordination Unit, UCOG 93, APHP, HUPSSD, Université Sorbonne Paris Nord, Sevran, France. thierry.landre@aphp.fr.ORCID 0000-0003-0967-1276
Gaetan Des GuetzOncology Department, CH Delafontaine, Université de Limoges, St Denis, France.
Kader ChouahniaOncology Department, APHP, Avicenne, HUPSSD, Université Sorbonne Paris Nord, Bobigny, France.
Virginie Fossey-DiazGeriatric Department, UCOG Paris Nord, AP-HP, Bretonneau Hospital, 23 Rue Joseph de Maistre, 75018, Paris, France.
Stéphane CulineDepartment of Medical Oncology, UCOG Paris Nord, AP-HP, Saint-Louis Hospital, 1 Avenue Claude Vellefaux, 75010, Paris, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe impact of aging on the effectiveness of immune checkpoint inhibitors (ICIs) remains controversial, and little is known on the subject in adults aged ≥ 75 years.

objectiveThe objective of this comprehensive meta-analysis was to assess the efficacy of ICIs in patients aged ≥ 75 years.

methodsWe performed a meta-analysis of published randomized controlled trials concerning ICIs (as monotherapy or in combination) versus standard therapy in patients with advanced solid tumors between January 2010 and January 2020. We compared overall survival between older (aged ≥ 75 years) and younger (< 75 years) patients. Hazard ratios (HRs) and 95% confidence intervals (CIs) were collected and pooled. The secondary endpoint focused on the impact of the use of ICIs in first- and second-line settings.

resultsIn total, 15 phase III studies evaluating anti-programmed cell death 1 (anti-PD-1) (nivolumab or pembrolizumab), anti-programmed cell death ligand 1 (anti-PD-L1) (atezolizumab or avelumab), or anti-cytotoxic T lymphocyte antigen 4 (anti-CTLA-4) (ipilimumab) therapies were included. Enrolled patients had non-small-cell lung cancer, renal cell carcinoma, melanoma, head and neck squamous cell carcinoma, or gastric cancer. Eight studies assessed treatment in the first-line setting and seven in the second-line setting. The median age was 64 years, with 906 patients aged ≥ 75 years (552 in first line, 354 in second line) and 8741 were aged < 75 years (4992 in first line, 3749 in second line). In the first-line setting, HRs for death were 0.78 (95% CI 0.61-0.99) in patients aged ≥ 75 years versus 0.84 (95% CI 0.71-1.00) in those aged < 75 years. In the second-line setting, HRs for death were 1.02 (95% CI 0.77-1.36) in patients aged ≥ 75 years versus 0.68 (95% CI 0.61-0.75) in those aged < 75 years, with a statistically significant difference observed between subgroups (p = 0.009 for interaction).

conclusionsICIs appear to be effective in patients aged ≥ 75 years. However, the survival benefit is mainly observed in first-line treatment and remains unclear in the second-line setting.

Indexed as

AgedAntibodies, MonoclonalAntineoplastic Combined Chemotherapy ProtocolsB7-H1 AntigenCTLA-4 AntigenFemaleHumansImmune Checkpoint InhibitorsMaleNeoplasmsProgrammed Cell Death 1 ReceptorProportional Hazards ModelsRandomized Controlled Trials as TopicSurvival AnalysisTreatment OutcomeAntibodies, MonoclonalB7-H1 AntigenCD274 protein, humanCTLA-4 AntigenCTLA4 protein, humanImmune Checkpoint InhibitorsProgrammed Cell Death 1 Receptor

Identifiers

PMID32681403

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.