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The impact of immunosenescence on the efficacy of immune checkpoint inhibitors in melanoma patients: a meta-analysis

Authors Li P, Yang X, Feng Y, Wu L, Ma W, Ding G, Wei Y, Sun L

Received 12 February 2018

Accepted for publication 13 May 2018

Published 26 October 2018 Volume 2018:11 Pages 7521—7527

DOI https://doi.org/10.2147/OTT.S165368

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Jianmin Xu


Ping Li,1 Xuefang Yang,2 Yumiao Feng,1 Lijuan Wu,1 Wei Ma,1 Gaozhong Ding,1 Yun Wei,1 Lan Sun1

1Department of Dermatology, The Affiliated Suzhou Hospital of Nanjing Medical University, Jiangsu 215001, China; 2The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital Eastern, Jiangsu 215001, China

Background: Immunosenescence, the age-related decline of immunity, affects the immune responses of melanoma patients. Through immune responses, immune checkpoint inhibitors (ICIs) exert their antitumor robustness. In different ages of melanoma patients, especially the older patients, the effectiveness of ICIs remains unclear. It is still controversial whether ICIs should be used in treating older patients.
Materials and methods: The authors included clinical trials of ICIs in older and younger patients. The authors used hazard ratio (HR) and 95% CI of overall survival (OS).
Results: From four phase III randomized clinical trials 2,251 melanoma patients were included. We found that ICIs significantly prolonged the OS for melanoma patients in both younger (HR, 0.71; 95% CI, 0.60–0.82; P<0.001) and older groups (HR, 0.62; 95% CI, 0.41–0.83; P<0.001) compared with controls. Anti-programmed death-1 (PD-1) agents appeared to be more efficient in older melanoma patients (HR, 0.34; 95% CI, 0.14–0.53) versus younger patients (HR, 0.52; 95% CI, 0.26–0.78).
Conclusion: ICIs significantly prolonged the OS for melanoma patients in both younger and older groups than controls. Anti-PD-1 agents were more efficient in older melanoma patients versus younger patients. ICIs could be used for older melanoma patients.

Keywords: immunosenescence, aging, immune checkpoint inhibitor, PD-1, melanoma
 

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