Envafolimab monotherapy or combination therapy in elderly patients with advanced solid tumors.

Abstract

e14610 Background: Programmed death-1/programmed death-ligand 1(PD-1/PD-L1) inhibitors have become an important treatment in both monotherapy and combination therapy for advanced solid tumors. Envafolimab, a humanized single-domain anti-PD-L1 antibody, has been approved for defective mismatch repair (dMMR)/microsatellite instability high (MSI-H) tumors.With the aging of the population, the incidence rate of tumors in the elderly has gradually increased. Due to the high number of complications, poor tolerance, and lack of treatment standards in the elderly, sadly, the prognosis of the elderly population is poor. We conducted a retrospective study to evaluate the efficacy and safety of envafolimab with previously untreated and treated for advanced solid tumors (including lung cancer, malignant pleural mesothelioma, and digestive system tumors), especially in elderly people over 70 years old. Methods: Patients received weekly 150 mg subcutaneous envafolimab injectins, combined with chemotherapy or antiangiogenic therapy. The primary endpoint was objective response rate (ORR), and the second endpoints were disease control rate (DCR), progression-free survival (PFS), Overall survival(OS)and safety. Results: Seventeen patients were enrolled in this study. The ORR was 29% ,and the DCR was 94%,observed, among them, lung cancer DCR was 100%. Median PFS was 11 months (95% CI 2-16). Median OS was 18.3months (95% CI 10.6–not reached). In the multivariate Cox regression model, combined liver and brain metastases have poor prognosis.The average age was 78 years, stage IV 59% (10/17), with two or more underlying diseases 59% (10/17)，ECOG score 2-3 points 41% (7/17). The most common adverse event was immune-related endocrinopathies, mainly manifested as thyroid dysfunction (23.5%, 4/17). No grade 4 adverse events or treatment-related death occurred. Conclusions: Envafolimab is an efficient, safe and convenient treatment for advanced cancer patients aged 70 and above, especially for those multiple comorbidities and poor ECOG scores.