P66.04 Real World Data: Immunotherapy in Lung Cancer Patients over 65 Years Old in Spain

Abstract

In the last decade, immunotherapy (IT) has become a key therapeutic tool in lung cancer treatment. The number of elderly patients with this pathology in Spain has been progressively increased in recent years, becoming a representative subgroup nowadays. Studies carried out with IT in these patients are a minority and controversial, generating a need in clinical practice. The aim of the study is to establish clinical and toxicity differences between patients older and younger than 65 years, treated with IT. Retrospective study that includes all epidemiological, clinical and pathological data of patients > 65 and <65 years diagnosed with lung cancer at Puerta de Hierro Hospital from January 2014 to March 2020, and who received treatment with IT, either in the first line or successive. A total of 155 patients were analyzed. Table 1 summarizes the main characteristics between both populations. The mean number of treatments received in both groups was similar (3.0 in <65 years vs 2.7 in> 65). When both groups were compared, no statistically significant differences in the percentage of patients who needed to interrupt IT due to toxicity were observed, being 15.9% of those <65 years and 17.9% of those> 65 years (p = 0.576) who required this interruption. There were also no differences in toxicity between grade 3 or 4 (10.2% vs 10.4%, p = 0.99) or in the number of admissions due to immune-related toxicity (IR) (9.0% vs 4.5%, p = 0.19). Neither group required immunosuppressive treatment for severe toxicity, but they did require steroids at high doses. There were no deaths secondary to IT toxicity, being the majority due to disease progression.Table 1Characteristics<65 years (88)>65 years (67)Gender Male Woman54.5% 45.6%74.6% 25.4%Median age5872ECOG 0-1 ≥293.2% 4.5%97.0% 3.0%Charlson index810StageI – 3.4% II – 6.8% III - 33.0% IV – 56.8%I – 3.0% II – 11.9% III – 23.9% IV – 61.2%Histology Adenocarcinoma Squamous cell carcinoma Small cell Others59.1% 27.3% 2.3% 11.4%56.7% 25.4% 4.5% 13.4%PDL-1 Positive Negative Unknown29.5% 9.1% 13.6%32.8% 16.4% 7.5%Disease situation at the toxicity moment Complete response Partial response Stable disease Progression8.2% 13.7% 20.5% 47.9%1.6% 27.9% 23.0% 32.8%Toxicity types Asthenia Anemia Pneumonitis Thyroid disorders Cutaneous Colitis Nephritis Hepatitis Others11.4% 1.1% 14.8% 10.2% 9.1% 6.8% 0% 3.4% 13.6%13.4% 0% 11.9% 11.9% 9.0% 4.5% 4.5% 1.5% 9.0%Toxicity grade 1 2 3 417.0% 6.8% 5.7% 3.4%14.9% 13.4% 8.9% 1.5% Open table in a new tab Patients > 65 years with lung cancer who received IT treatment in our center do not experience more serious adverse events, do not require more treatment interruptions or more admissions, compared to those <65 years. Consequently, IT should be a valid treatment option in this population and its management should be optimized, with the aim of offering the best possible quality of care to this subgroup of patients.