Abstract
BackgroundImmune-related adverse events (irAEs) may complicate the immune checkpoint inhibition (ICI) therapy. The effect of age on these irAEs is not elucidated. The aim of the study was to compare the occurrence of irAEs in different age groups.MethodsPatients with lung cancer receiving anti-programmed death- (ligand)1 (PD-(L)1) were selected from the US Food and Drug Administration Adverse Event Reporting System (FAERS) database. Immune cell infiltration data set was obtained from TIMER 2.0 web server. The patients were stratified for age as follows: <65 year-old (young patients, YP), 65 to 75 year-old (middle aged patients, MP), ≥75 year-old (old patients, OP). The severity of irAEs was compared using logistic binary regression model. The distribution differences of immune cell infiltration were estimated using non-parametric tests.ResultsOf all the 17,006 patients treated by anti-PD-(L)1, 7,355 were <65 (YP), 6,706 were 65–75 (MP), and 2,945 were ≥75 (OP). In general, we analyzed a total of 16 irAEs in this article and found that pulmonary toxicity was more frequent in OP (OP vs. YP: OR = 1.45, 95% CI: 1.28–1.64) and MP (MP vs. YP: OR = 1.38, 95% CI: 1.24–1.52), but hepatitis was less frequent in OP (OP vs. YP: OR = 0.56, 95% CI: 0.32–0.97) and MP (MP vs. YP: OR = 0.57, 95%CI: 0.38–0.85). Further analysis demonstrated that older patients showed less B cell, CD8+ T cell and myeloid dendritic cell infiltration than younger patients.ConclusionsElderly patients exhibited higher incidences of pulmonary toxicity, while hepatitis was found at low incidence. Therefore, clinicians should carefully monitor comorbidities in elderly patients.
Highlights
Programmed cell death protein-1 (PD-1) and programmed cell death protein- ligand 1 (PD-L1) are the two most intensively studied immune regulatory checkpoint pathways in cancer [1], which relies on the presence of ongoing antitumor immune response after blocking this pathway [2]
We analyzed a total of 16 Immune-related adverse events (irAEs) in this article and found that pulmonary toxicity was more frequent in OP (OP vs. YP: odds ratios (ORs) = 1.45, 95% confidence intervals (CIs): 1.28–1.64) and MP (MP vs. YP: OR = 1.38, 95% CI: 1.24–1.52), but hepatitis was less frequent in OP (OP vs. YP: OR = 0.56, 95% CI: 0.32–0.97) and MP (MP vs. YP: OR = 0.57, 95%CI: 0.38–0.85)
Elderly patients exhibited higher incidences of pulmonary toxicity, while hepatitis was found at low incidence
Summary
Programmed cell death protein-1 (PD-1) and programmed cell death protein- ligand 1 (PD-L1) are the two most intensively studied immune regulatory checkpoint pathways in cancer [1], which relies on the presence of ongoing antitumor immune response after blocking this pathway [2]. Adverse Events Generated by Anti-PD-(L) Therapy these immune checkpoint proteins [3, 4]. Immune checkpoint inhibitors (ICIs) against PD-(L) have changed the treatment landscape of many different cancers so far. Potential host anti-tumor immune response is the basis for the clinical benefit of PD-(L) agents [7]. Immune-related adverse events (irAEs) may complicate the immune checkpoint inhibition (ICI) therapy. The aim of the study was to compare the occurrence of irAEs in different age groups
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
