title: Responses to immune checkpoint inhibitors in nonagenarians.
abstract: The incidence of melanoma continues to rise with the most rapid increase seen in the elderly population. Historically, elderly patients with advanced melanoma have had dismal clinical outcomes, in part, due to distinct tumor biology, and often ineligibility for effective therapies during their development. In addition, due to relatively few geriatric patients being accrued to clinical trials of novel immunotherapeutics, there is a paucity of data regarding their safety and efficacy. Herein, we present the clinical course of three consecutive nonagenarians (≥90 y old) with metastatic melanoma, who were treated with single-agent or combination immune checkpoint inhibitors. Two patients experienced complete or partial responses with acceptable safety profiles, and one other tolerated therapy well although a significant response was not noted. These cases suggest that with close monitoring, even very elderly patients with advanced cancers and acceptable performance status may tolerate and benefit from immune checkpoint inhibitors.
authors.affiliation: Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center , Nashville, TN, USA.
authors.forename: Romany A N
authors.initials: RA
authors.lastname: Johnpulle
authors.affiliation: The University of Alabama at Birmingham , Birmingham, AL, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Conry
authors.affiliation: Robert H Lurie Comprehensive Cancer Center of Northwestern University , Chicago, IL, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Sosman
authors.affiliation: Roswell Park Cancer Institute , Buffalo, NY, USA.
authors.forename: Igor
authors.initials: I
authors.lastname: Puzanov
authors.affiliation: Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center , Nashville, TN, USA.
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Johnson
keywords: Advanced melanoma; elderly; immunotherapy; ipilimumab; nivolumab; pembrolizumab