Safety profiles with immunotherapy similar among older, younger patients with breast cancer
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Key takeaways:
- Similar overall rates of immune related adverse events occurred among older and younger patients.
- Interruptions in immunotherapy due to toxicity occurred among a higher percentage of older patients.
Older patients undergoing immunotherapy for breast cancer experienced similar rates of immune-related adverse events as younger patients, according to a presenter at San Antonio Breast Cancer Symposium.
Patients aged 65 years or older experienced higher rates of nephritis, whereas those aged younger than 65 years experienced higher rates of transaminitis and higher-grade hypothyroidism.
“Immunotherapy is currently approved for both early- and advanced-stage triple-negative breast cancer. However, the toxicity of immunotherapy and immune related adverse events [among] patients 65 years and older with breast cancer are not described in detail in results from registration trials,” Neelima Vidula, MD, breast medical oncologist at Massachusetts General Hospital, told Healio. “A better understanding of immune related adverse events in adults aged 65 years and older could help inform clinical decision making in this patient population.”
Vidula and colleagues conducted a retrospective review 129 patients with breast cancer — 25 aged 65 years or older and 104 aged younger than 65 years — who received immunotherapy at an academic institution.
Similar rates of autoimmune comorbidities were present at baseline for both age groups. Patients aged younger than 65 years underwent longer median duration of immunotherapy treatment.
A higher percentage of older patients required interruptions in immunotherapy due to toxicity (16% vs. 7%).
Researchers observed similar overall rates of immune-related adverse events among older (72%) and younger patients (65%). They also observed similar immune-related adverse events per patient for both groups.
Older patients experienced a significantly higher rate of immune-related nephritis (12% vs. 1%) whereas the younger group experienced a significantly higher rate of transaminitis (33% vs. 12%).
Researchers observed similar rates of hypothyroidism between the two groups; however, younger patients experienced significantly higher rates of grade 2 or grade 3 hypothyroidism.
Results showed significantly more steroid use for management of immune-related adverse events among older patients. Complete resolution of immune-related adverse events occurred among 67% of older patients vs. 57% of younger patients.
Researchers acknowledged the rarity of late-onset immune-related adverse events that occurred more than 3 months after discontinuation of immunotherapy as well as deaths from immune-related adverse events in both cohorts.
“Further research is merited to validate these findings in a larger cohort, and we have a multicenter analysis underway,” Vidula said. “Research studies such as this one are important to help with clinical decision-making for older adults as we strive to balance efficacy of novel drugs with toxicity.”
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Vidula N, et al. Abstract PS14-01. Presented at: San Antonio Breast Cancer Symposium; Dec. 5-9, 2023; San Antonio.
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