文章：

纳武利尤单抗与伊匹木单抗联合治疗八旬及九旬黑色素瘤患者

Combined Nivolumab and Ipilimumab in Octogenarian and Nonagenarian Melanoma Patients

原文发布日期：30 August 2023

DOI: 10.3390/cancers15174330

类型: Article

开放获取: 是

英文摘要：

Data regarding elderly melanoma patients treated with anti-PD-1 or anti-CTLA-4 antibodies are in favor of tolerability outcomes that are similar to those of younger counterparts. However, there are very few studies focusing on elderly patients receiving nivolumab combined with ipilimumab (NIVO + IPI). Here, we ask what are the current prescribing patterns of NIVO + IPI in the very elderly population and analyze the tolerance profile. This French multicenter retrospective study was conducted on 60 melanoma patients aged 80 years and older treated with NIVO + IPI between January 2011 and June 2022. The mean age at first NIVO + IPI administration was 83.7 years (range: 79.3–93.3 years). Fifty-five patients (92%) were in good general condition and lived at home. Two dosing regimens were used: NIVO 1 mg/kg + IPI 3 mg/kg Q3W (NIVO1 + IPI3) in 27 patients (45%) and NIVO 3 mg/kg + IPI 1 mg/kg Q3W (NIVO3 + IPI1) in 33 patients (55%). NIVO + IPI was a first-line treatment in 39 patients (65%). The global prevalence of immune-related adverse events was 63% (38/60), with 27% (16/60) being of grade 3 or higher. Grade ≥ 3 adverse events were less frequent in patients treated with NIVO3 + IPI1 compared with those treated with NIVO1 + IPI3 (12% versus 44%,p= 0.04). In conclusion, the prescribing patterns of NIVO + IPI in very elderly patients are heterogeneous in terms of the dosing regimen and line of treatment. The safety profile of NIVO + IPI is reassuring; whether or not the low-dose regimen NIVO3 + IPI1 should be preferred over NIVO1 + IPI3 in patients aged 80 years or older remains an open question.

摘要翻译： 

关于接受抗PD-1或抗CTLA-4抗体治疗的老年黑色素瘤患者的数据显示，其耐受性与年轻患者相似。然而，目前针对接受纳武利尤单抗联合伊匹木单抗（NIVO + IPI）治疗的老年患者的研究非常有限。本研究旨在探讨超高龄人群中NIVO + IPI的当前处方模式，并分析其耐受性特征。这项法国多中心回顾性研究纳入了2011年1月至2022年6月期间接受NIVO + IPI治疗的60例80岁及以上黑色素瘤患者。首次接受NIVO + IPI治疗的平均年龄为83.7岁（范围：79.3–93.3岁）。55例患者（92%）一般状况良好且居家生活。采用两种给药方案：27例患者（45%）接受NIVO 1 mg/kg + IPI 3 mg/kg Q3W（NIVO1 + IPI3），33例患者（55%）接受NIVO 3 mg/kg + IPI 1 mg/kg Q3W（NIVO3 + IPI1）。其中39例患者（65%）将NIVO + IPI作为一线治疗。免疫相关不良事件总体发生率为63%（38/60），其中27%（16/60）为3级或以上。与接受NIVO1 + IPI3治疗的患者相比，接受NIVO3 + IPI1治疗的患者发生≥3级不良事件的频率较低（12%对比44%，p=0.04）。总之，超高龄患者中NIVO + IPI的处方模式在给药方案和治疗线数方面存在异质性。NIVO + IPI的安全性特征令人放心；对于80岁及以上患者，低剂量方案NIVO3 + IPI1是否应优于NIVO1 + IPI3仍是一个有待探讨的问题。

原文链接：

Combined Nivolumab and Ipilimumab in Octogenarian and Nonagenarian Melanoma Patients