Polypharmacy as a prognostic factor in older patients with advanced non-small-cell lung cancer treated with anti-PD-1/PD-L1 antibody-based immunotherapy

• Published in: Journal of cancer research and clinical oncology 2020-10, Vol.146 (10), p.2659-2668
• Main Authors: Hakozaki, Taiki, Hosomi, Yukio, Shimizu, Akihiro, Kitadai, Rui, Mirokuji, Kie, Okuma, Yusuke
• Format: Article
• Language: English
• Subjects: Cancer Research; Hematology; Immune checkpoint inhibitors; Immunotherapy; Internal Medicine; Lung cancer; Medicine; Medicine & Public Health; Multivariate analysis; Non-small cell lung carcinoma; Older people; Oncology; Original Article – Clinical Oncology; Patients; PD-1 protein; PD-L1 protein; Polypharmacy; Small cell lung carcinoma
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-020-03252-4

Purpose Polypharmacy is a common problem among older adults. However, its prevalence and impact on the clinical outcomes of anticancer treatment, such as survival and adverse events, in older patients with advanced cancer have not been well investigated. Methods We retrospectively reviewed data from Japanese patients treated with an immune checkpoint inhibitor (ICI) for advanced or recurrent non-small-cell lung cancer (NSCLC) between 2016 and 2019. Results Among 157 older (aged ≥ 65 years) patients, the prevalence of polypharmacy, defined as ≥ 5 medications, was 59.9% (94/157). The prevalence of potentially inappropriate medication use, according to the screening tool of older people’s prescription (STOPP) criteria version 2, was 38.2% (60/157). The median progression-free survival (PFS) in patients with and without polypharmacy was 3.7 and 5.5 months, respectively ( P  = 0.0017). The median overall survival (OS) in patients with and without polypharmacy was 9.5 and 28.1 months, respectively ( P