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Real-World Effectiveness of ICIs for Older Patients With Advanced Melanoma

December 04, 2020

Immune checkpoint inhibitors (ICIs) are effective in cutaneous metastatic melanoma patients aged 65 years and older (J Geriatr Oncol. 2020;S1879-4068[20]30450-1. doi:10.1016/j.jgo.2020.09.023).

ICIs are known to be successful in treating advanced melanoma, but their success in patients 65 years and older is less clear because of an age-related decline in immune function.

Authors aimed to evaluate the effectiveness of ICIs in this population through a retrospective cohort study of patients 65 years and older who were diagnosed with stage IV cutaneous melanoma between 2012 and 2015. SEER-Medicare data was used to evaluate survival by first systemic treatment type.

The median survival was the longest for patients treated with PD-1 inhibitors (34 months) compared with other therapies. The ICI survival benefit remained consistent after adjusting for age. Hazard ratios comparing ICIs to no systemic therapy were 0.35 (95% CI: 0.24–0.52) for PD-1 inhibitors and 0.48 (95% CI: 0.37–0.63) for CTLA-4 inhibitors.

“In a nationally representative cohort of patients with advanced melanoma, ICI therapy delivered in a real-world setting significantly improved survival in patients aged 65 years and older,” concluded the study authors.—Lisa Kuhns

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