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Data regarding characteristics, safety and survival outcomes of patients aged 80 or older treated with immune checkpoint inhibitors (ICI) in routine oncology practice are limited. We retrospectively collected data of patients aged 80 and older with advanced non-small cell lung cancer (NSCLC) or melanoma treated with anti-PD1, anti-PD-L1 or anti-CTLA-4 regardless of the treatment line, in 14 institutions, between January 2014 and June 2017. Progression-free survival (PFS) and overall survival (OS) were estimated with the Kaplan Meier method. Toxicity was assessed according to CTCAE 5.0. Multivariate analyses were performed with the Cox model. Eighty-two patients were included (36 with NSCLC, 45 with melanoma). Their median age was 82 years (range 80–93). Nivolumab and pembrolizumab were mainly used. In the NSCLC group, median PFS and OS were 2.3 months (95%CI 1.8–6.1) and 8.8 months (95%CI 5.5–18.1), respectively. In the melanoma group, median PFS and OS were 10.2 months (95%CI 4.5–20.0) and 24.5 months (95%CI 14.1–NR), respectively. The albumin level was found to be independently associated with a better OS in both groups. Grade 3–4 toxicities occurred in 15 patients (18.5%). One patient died from ICI-induced pulmonary toxicity. Our study findings suggest that treatment with ICI in elderly patients with NSCLC and melanoma has a risk-benefit ratio that supports its use. However, we report in this cohort that one in five patients has a grade 3–4 IRAEs leading to treatment discontinuation. Geriatric assessment prior to initiation of therapy and during therapy should be routine in patients aged 80 years and older.

Immune checkpoint inhibitors in patients aged 80 or older with advanced non-small cell lung cancer or melanoma: a real-life multicentre study