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Cancer is a disease that affects the elderly and is estimated to account for 55 per cent of new confirmed cancer cases.
, older cancer patients are heterogeneic and the risk-benefit assessment of specific treatment strategies is difficult.
, older cancer patients are underrepresented in clinical trials of many important therapeutic drugs, such as checkpoint inhibitors (CPIs).
LDERS study aims to investigate the effects of the aging immune system on CPI-related toxicity and to provide evidence of the role of CPI in the assessment of old age.
LDERS study is a forward-looking observational study that includes two cohorts: the elderly (over 70 years old) and the young (under 70 years of age).
patients with advanced/metastasis non-small cell lung cancer or melanoma treated with single-drug CPI.
used Geriatric-8 (G8) to screen patients in the elderly queue, followed by a comprehensive assessment of the elderly when the screening was positive.
endpoints are the occurrence of level 3-5 immune-related adverse events (irAEs).
140 patients were admitted to the group, of whom 43% were pretreated and Pim monoantigen accounted for 92% of the study treatment.
the elderly queue had a higher combined burden (P.lt;0.001) and a multidrample co-use burden (P-0.004).
50 per cent positive for G8 screening in older patients, while 60 per cent of patients in this vulnerable subgroup had a performance status score of only 0-1.
difference in the occurrence of 3-5 irAEs in the old and young queues was not statistically significant (18.6% vs. 12.9%; advantage ratio was 1.55, 95% CI 0.61-3.89; P=0.353).
older patients were treated with systemic steroids for irAE (22 weeks vs 8 weeks; P=0.208).
the risk of hospitalization (P=0.031) and death (P=0.01) for patients who are positive for G8 screening.
in short, older cancer patients do not have any higher adverse reactions to CPI treatment than younger people.
G8 screening identified a sub-group with a higher AE risk, and G8 screening of patients should be considered in the context of CPI treatment.
