ArticleOncology letters2020
Safety and tolerability of PD-1/PD-L1 inhibitors in elderly and frail patients with advanced malignancies.
Article in Oncology letters, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Safety and Effectiveness of Immune Checkpoint Inhibitors in Older Patients with Cancer: A Systematic Review of 48 Real-World Studies.Drugs & aging · 2021Pooled it
- Review
- Association of sarcopenia with survival and treatment response in brain metastasis of non-small cell lung cancer.Scientific reports · 2026Article
- Management of brain metastases in older adults with non-small cell lung cancer.Frontiers in oncology · 2026Review
- Off-Label Use of First-Line Immunotherapy for Metastatic Renal Cell Carcinoma.Clinical genitourinary cancer · 2025Article
- Immune-related adverse events in older adults receiving immune checkpoint inhibitors: a comprehensive analysis of the Food and Drug Administration Adverse Event Reporting System.Age and ageing · 2025Article
- Frailty trajectories and their determinants in cancer patients undergoing immunotherapy: a prospective longitudinal study.Frontiers in oncology · 2025Article
- Toxicity of Cancer Immunotherapies in Older Patients: Does Age Make a Difference?Drugs & aging · 2024Review
- Safety of nivolumab monotherapy in five cancer types: pooled analysis of post-marketing surveillance in Japan.International journal of clinical oncology · 2024Article
- Safety of immune checkpoint inhibitors in patients aged over 80 years: a retrospective cohort study.Cancer immunology, immunotherapy : CII · 2024Article
- Predicting immune-related adverse events using a simplified frailty score in cancer patients treated with checkpoint inhibitors: A retrospective cohort study.Cancer medicine · 2023Article
- Association between PD-1 inhibitor-related adverse events and frailty assessed by frailty index in lung cancer patients.Cancer medicine · 2023Article
- Article
- Article
- The Association between Early Changes in Neutrophil-Lymphocyte Ratio and Survival in Patients Treated with Immunotherapy.Journal of clinical medicine · 2022Article
- Clinical activity of PD-1 inhibition in the treatment of locally advanced or metastatic basal cell carcinoma.Journal for immunotherapy of cancer · 2022Article
- Management of Metastatic Colorectal Carcinoma in Older Adults: Balancing Risks and Benefits of Novel Therapies.Drugs & aging · 2021Review
- Occurrence of hepatitis in an elderly woman during the treatment of pembrolizumab for right advanced renal pelvis, ureteral cancer, and bladder cancer.JGH open : an open access journal of gastroenterology and hepatology · 2021Article
- Chemotherapy and Targeted Agents in the Treatment of Elderly Patients with Metastatic Colorectal Cancer.Journal of clinical medicine · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The number of elderly patients with cancer has increased due to aging of the population. However, safety of programmed cell death-1 (PD-1) or programed cell death ligand 1 (PD-L1) inhibitors in elderly patients remains controversial, and limited information exists in frail patients. The present study retrospectively identified 197 patients treated with nivolumab, pembrolizumab or atezolizumab for unresectable advanced cancer between September 2014 and December 2018. Patients were divided into the elderly (age, ≥75 years) and non-elderly (age, <75 years) groups. The detailed immune-related adverse events (irAE) profile and development of critical complications were evaluated. To assess tolerability, the proportion of patients who continued PD-1/PD-L1 inhibitor for >6 months was analyzed. In the two groups, a three-element frailty score, including performance status, Charlson Comorbidity Index and neutrophil-lymphocyte ratio, was estimated, and patients were divided into the low-, intermediate- and high-frailty subgroups. Safety and tolerability were evaluated using the aforementioned items. A total of 58 patients (29.4%) were aged ≥75 years. No significant difference was found in the development of irAEs, hospitalization and treatment discontinuation due to irAEs between the two groups. However, the occurrence of unexpected critical complications was significantly higher in the elderly group (P=0.03). Among the elderly patients with high frailty, more critical complications and fatal irAE (hepatitis) were observed. In this population, 33.3% were able to continue treatment for >6 months without disease progression. The present analysis based on real world data showed similar safety and tolerability of PD-1/PD-L1 inhibitors in elderly patients with advanced malignancies. However, the impact of irAE in elderly patients, especially those with frailty, was occasionally greater compared with that in younger and fit patients.
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