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Age-Based Disparities in Metastatic Melanoma Patients Treated in the Immune Checkpoint Inhibitors (ICI) Versus Non-ICI Era: A Population-Based Study

Immune checkpoint inhibitors (ICIs) have revolutionized metastatic melanoma treatment, but our knowledge of ICI activity across age groups is insufficient. Patients in different age groups with advanced melanoma were selected based on the ICI approval time in this study. Patients with melanoma were...

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Autores principales: Safi, Mohammed, Al-Azab, Mahmoud, Jin, Chenxing, Trapani, Dario, Baldi, Salem, Adlat, Salah, Wang, Aman, Ahmad, Bashir, Al-madani, Hamza, Shan, Xiu, Liu, Jiwei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8650702/
https://www.ncbi.nlm.nih.gov/pubmed/34887846
http://dx.doi.org/10.3389/fimmu.2021.609728
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author Safi, Mohammed
Al-Azab, Mahmoud
Jin, Chenxing
Trapani, Dario
Baldi, Salem
Adlat, Salah
Wang, Aman
Ahmad, Bashir
Al-madani, Hamza
Shan, Xiu
Liu, Jiwei
author_facet Safi, Mohammed
Al-Azab, Mahmoud
Jin, Chenxing
Trapani, Dario
Baldi, Salem
Adlat, Salah
Wang, Aman
Ahmad, Bashir
Al-madani, Hamza
Shan, Xiu
Liu, Jiwei
author_sort Safi, Mohammed
collection PubMed
description Immune checkpoint inhibitors (ICIs) have revolutionized metastatic melanoma treatment, but our knowledge of ICI activity across age groups is insufficient. Patients in different age groups with advanced melanoma were selected based on the ICI approval time in this study. Patients with melanoma were identified in the Surveillance, Epidemiology, and End Result (SEER) database program 2004–2016. The results showed that 4,040 patients had advanced melanoma before the advent of ICI (referred to as the “non-ICI era”), whereas there were 6,188 cases after ICI approval (referred to as the “ICI era”). In all age groups, the cases were dominated by men. The differences between the first (20–59 years) and second (60–74 years) age groups in both eras were significant in terms of surgery performance and holding of insurance policies (p = 0.05). The first and second groups (20–59 and 60–70 years old, respectively) showed no difference in survival (median = 8 months) during the non-ICI era, but the difference was evident in the first, second, and third age groups in the ICI era, with the younger group (20–59 years) having significantly better survival (median = 18, 14, and 10 months, respectively, p = 0.0001). Multivariate analysis of the first group (the youngest) in the ICI era revealed that surgery was significantly associated with an increase in survival among patients compared with those who did not undergo surgery (p < 0.0001). Furthermore, having an insurance policy among all age groups in the ICI era was associated with favorable survival in the first (20–59 years) and second (60–74 years) age groups (p = 0.0001), while there were no survival differences in the older ICI group (>74 years). Although there were differences in survival between the ICI era and the non-ICI era, these results demonstrate that ICI positively affected the survival of younger patients with advanced melanoma (first age group) than it had beneficial effects on older patients. Moreover, having had cancer surgery and holding an insurance policy were positive predictors for patient survival. This study emphasizes that adequate clinical and preclinical studies are important to enhance ICI outcomes across age groups.
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spelling pubmed-86507022021-12-08 Age-Based Disparities in Metastatic Melanoma Patients Treated in the Immune Checkpoint Inhibitors (ICI) Versus Non-ICI Era: A Population-Based Study Safi, Mohammed Al-Azab, Mahmoud Jin, Chenxing Trapani, Dario Baldi, Salem Adlat, Salah Wang, Aman Ahmad, Bashir Al-madani, Hamza Shan, Xiu Liu, Jiwei Front Immunol Immunology Immune checkpoint inhibitors (ICIs) have revolutionized metastatic melanoma treatment, but our knowledge of ICI activity across age groups is insufficient. Patients in different age groups with advanced melanoma were selected based on the ICI approval time in this study. Patients with melanoma were identified in the Surveillance, Epidemiology, and End Result (SEER) database program 2004–2016. The results showed that 4,040 patients had advanced melanoma before the advent of ICI (referred to as the “non-ICI era”), whereas there were 6,188 cases after ICI approval (referred to as the “ICI era”). In all age groups, the cases were dominated by men. The differences between the first (20–59 years) and second (60–74 years) age groups in both eras were significant in terms of surgery performance and holding of insurance policies (p = 0.05). The first and second groups (20–59 and 60–70 years old, respectively) showed no difference in survival (median = 8 months) during the non-ICI era, but the difference was evident in the first, second, and third age groups in the ICI era, with the younger group (20–59 years) having significantly better survival (median = 18, 14, and 10 months, respectively, p = 0.0001). Multivariate analysis of the first group (the youngest) in the ICI era revealed that surgery was significantly associated with an increase in survival among patients compared with those who did not undergo surgery (p < 0.0001). Furthermore, having an insurance policy among all age groups in the ICI era was associated with favorable survival in the first (20–59 years) and second (60–74 years) age groups (p = 0.0001), while there were no survival differences in the older ICI group (>74 years). Although there were differences in survival between the ICI era and the non-ICI era, these results demonstrate that ICI positively affected the survival of younger patients with advanced melanoma (first age group) than it had beneficial effects on older patients. Moreover, having had cancer surgery and holding an insurance policy were positive predictors for patient survival. This study emphasizes that adequate clinical and preclinical studies are important to enhance ICI outcomes across age groups. Frontiers Media S.A. 2021-11-16 /pmc/articles/PMC8650702/ /pubmed/34887846 http://dx.doi.org/10.3389/fimmu.2021.609728 Text en Copyright © 2021 Safi, Al-Azab, Jin, Trapani, Baldi, Adlat, Wang, Ahmad, Al-madani, Shan and Liu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Safi, Mohammed
Al-Azab, Mahmoud
Jin, Chenxing
Trapani, Dario
Baldi, Salem
Adlat, Salah
Wang, Aman
Ahmad, Bashir
Al-madani, Hamza
Shan, Xiu
Liu, Jiwei
Age-Based Disparities in Metastatic Melanoma Patients Treated in the Immune Checkpoint Inhibitors (ICI) Versus Non-ICI Era: A Population-Based Study
title Age-Based Disparities in Metastatic Melanoma Patients Treated in the Immune Checkpoint Inhibitors (ICI) Versus Non-ICI Era: A Population-Based Study
title_full Age-Based Disparities in Metastatic Melanoma Patients Treated in the Immune Checkpoint Inhibitors (ICI) Versus Non-ICI Era: A Population-Based Study
title_fullStr Age-Based Disparities in Metastatic Melanoma Patients Treated in the Immune Checkpoint Inhibitors (ICI) Versus Non-ICI Era: A Population-Based Study
title_full_unstemmed Age-Based Disparities in Metastatic Melanoma Patients Treated in the Immune Checkpoint Inhibitors (ICI) Versus Non-ICI Era: A Population-Based Study
title_short Age-Based Disparities in Metastatic Melanoma Patients Treated in the Immune Checkpoint Inhibitors (ICI) Versus Non-ICI Era: A Population-Based Study
title_sort age-based disparities in metastatic melanoma patients treated in the immune checkpoint inhibitors (ici) versus non-ici era: a population-based study
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8650702/
https://www.ncbi.nlm.nih.gov/pubmed/34887846
http://dx.doi.org/10.3389/fimmu.2021.609728
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