Treatment trends with immune checkpoint inhibitor (ICI) therapy in older adults with lung cancer.

Abstract

e24016 Background: ICI therapy has become the standard of care for the treatment of most types of advanced lung cancer with an average age at diagnosis of 70 years old (yo). The objectives of this study were to describe the demographics and practice patterns of real-world ICI usage in lung cancer patients > 70 yo. Methods: We conducted a retrospective, observational cohort study utilizing statistically deidentified data sourced from CancerLinQ Discovery® ( www.cancerlinq.org/solutions/researchers ): Lung Cancer (2014-2019), October, 2018 data set release, American Society of Clinical Oncology’s (ASCO’s) CancerLinQ LLC. Of the 1632 patients in this data release, only those patients who received a single agent ICI of nivolumab, pembrolizumab or atezolizumab and had a known birthdate were included in the analyses. Results: The majority of the 1632 patients in the data set were male (46.9%) and Caucasian (43.4%), although a substantial percentage of patient Gender and Race data was not known (14.5% and 43.1% respectively). The majority of the patients were treated in the southern part of the United States (52.6%) and the median ages for adenocarcinoma and squamous cell carcinoma histologies were 66 and 70, respectively, with interquartile ranges of 59-74 and 63-76. In the analyses, the major delineator was age at 70 yo, where age is based on when a patient received their first ICI dose. For patients < 70 yo, the mean (max) number of cycles in patients who received atezolizumab, nivolumab and pembrolizumab was 5.4 (24), 8.7 (62) and 7.7 (32), respectively and for patients > 70 yo was 4.6 (30), 8.1 (64) and 6.5 (23), respectively. The median overall survival for patients < 70 yo who received atezolizumab, nivolumab and pembrolizumab was 24, 12 and 24 months, respectively and for patients > 70 yo was 24, 12 and 18 months, respectively. Conclusions: The number of cycles and overall survival reported in this real-world dataset were similar between patients older and younger than 70 yo with lung cancer treated with ICI. Limitations included decreased power for multivariate analysis due to suppressed data elements which has been improved in more recent data releases.