Aim: Cancer rates in older people are increasing and this population poses difficulties for treatment due to underlying frailty. Immune checkpoint inhibitors are a cancer treatment that have revolutionized cancer therapy, though their tolerability in frail patients is still under investigation. This study assessed the frequency of immune-related adverse events among non-frail and frail patients with cancer over 60 years old. The secondary objective was to assess discontinuation and cycles completed between the two groups.
Method: This is a single-centre retrospective study where data for patients who received immunotherapy from December 2021 to July 2023 was extrapolated from patient electronic medical records. Data collected included baseline demographics, frailty status, immune-related adverse events, discontinuation, and cycles completed. This data was analysed using both logistic and general linear modelling.
Result: One hundred and twenty-two (122) patients met inclusion criteria with 102 completed records available for final analysis. The final statistical model demonstrated that the presence of frailty was associated with a decreased likelihood of side effects with an odds ratio of 0.41 (p = 0.024). Specifically, non-frail patients were found to experience grade 1 adverse events and skin-related events more frequently than the frail cohort. However, non-frail patients completed more cycles than non-frail patients with 9.5 cycles compared to 6 cycles (p = 0.037).
Conclusion: Subsequently, the authors concluded that immune checkpoint inhibitors are likely well tolerated even by frail elderly patients. Further larger centre trials are required to assess the association between frailty and tolerability of immune checkpoint inhibitors.