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:	Mohammed Safi, Mahmoud Al-Azab, Chenxing Jin, Dario Trapani, Salem Baldi, Salah Adlat, Aman Wang, Bashir Ahmad, Hamza Al-madani, Xiu Shan, Jiwei Liu
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	age distribution melanoma SEER database epidemiology immune-checkpoint inhibitor (ICI) Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/e3bbedb1cd5b45c9be422cb26d540dfe
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spelling	oai:doaj.org-article:e3bbedb1cd5b45c9be422cb26d540dfe2021-11-30T14:27:54ZAge-Based Disparities in Metastatic Melanoma Patients Treated in the Immune Checkpoint Inhibitors (ICI) Versus Non-ICI Era: A Population-Based Study1664-322410.3389/fimmu.2021.609728https://doaj.org/article/e3bbedb1cd5b45c9be422cb26d540dfe2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fimmu.2021.609728/fullhttps://doaj.org/toc/1664-3224Immune 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.Mohammed SafiMahmoud Al-AzabChenxing JinDario TrapaniSalem BaldiSalah AdlatAman WangBashir AhmadHamza Al-madaniXiu ShanJiwei LiuFrontiers Media S.A.articleage distributionmelanomaSEER databaseepidemiologyimmune-checkpoint inhibitor (ICI)Immunologic diseases. AllergyRC581-607ENFrontiers in Immunology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	age distribution melanoma SEER database epidemiology immune-checkpoint inhibitor (ICI) Immunologic diseases. Allergy RC581-607
spellingShingle	age distribution melanoma SEER database epidemiology immune-checkpoint inhibitor (ICI) Immunologic diseases. Allergy RC581-607 Mohammed Safi Mahmoud Al-Azab Chenxing Jin Dario Trapani Salem Baldi Salah Adlat Aman Wang Bashir Ahmad Hamza Al-madani Xiu Shan Jiwei Liu Age-Based Disparities in Metastatic Melanoma Patients Treated in the Immune Checkpoint Inhibitors (ICI) Versus Non-ICI Era: A Population-Based Study
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.
format	article
author	Mohammed Safi Mahmoud Al-Azab Chenxing Jin Dario Trapani Salem Baldi Salah Adlat Aman Wang Bashir Ahmad Hamza Al-madani Xiu Shan Jiwei Liu
author_facet	Mohammed Safi Mahmoud Al-Azab Chenxing Jin Dario Trapani Salem Baldi Salah Adlat Aman Wang Bashir Ahmad Hamza Al-madani Xiu Shan Jiwei Liu
author_sort	Mohammed Safi
title	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_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_sort	age-based disparities in metastatic melanoma patients treated in the immune checkpoint inhibitors (ici) versus non-ici era: a population-based study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/e3bbedb1cd5b45c9be422cb26d540dfe
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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

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