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TOPLINE:

Geriatric assessment in older patients with cancer receiving immune checkpoint inhibitors showed that frailty was not significantly associated with an increased risk for severe immune-related adverse events (irAEs), but frailty and the number of impaired geriatric domains were linked to higher risks for hospitalisation and mortality.

METHODOLOGY:

• This analysis included 110 patients (age, ≥ 65 years; 68% men) from two multicentre prospective observational studies (84 from the IMAGINE study and 26 from the TENT study) conducted between September 2018 and February 2024.
• Patients receiving anti-PD-1 monotherapy for solid tumours were considered those with frailty if they exhibited two or more geriatric domains (somatic, functional, mental, and social), which was validated using screening tools such as Geriatric 8 (G8) questionnaire scores and the Six-Item Cognitive Impairment Test within 2 weeks of treatment initiation.
• Researchers collected data on irAEs of grade 3 or higher, unplanned hospital admissions, and mortality status. The median follow-up duration was 12.4 months.
• Overall, 61 patients (55%) were classified as those with frailty, with 50% of the total cohort having impaired G8 scores (≤ 14), and 65% of patients without frailty vs 38% of those with frailty had normal G8 scores.

TAKEAWAY:

• Frailty was not significantly associated with irAEs of grade 3 or higher (odds ratio [OR], 1.52; P = .495), with similar rates observed between patients with and without frailty (18.0% vs 16.3%; P = .814).
• Patients with two impaired domains showed no significant association with irAEs of grade 3 or higher (OR, 1.75; P = .375); similar outcomes were observed for those with three or four impaired domains (OR, 0.80; P = .828).
• Patients with frailty demonstrated higher risks for hospitalisation (OR, 3.98; P = .024) and mortality (hazard ratio [HR], 5.23; P = .002).
• Patients with three or four impaired geriatric domains showed a significantly higher risk for hospitalisation (OR, 8.85; P = .005) and death (HR, 15.04; P < .001) than those with no or one impaired domain.

IN PRACTICE:

"[The study] findings highlight the need for further research to determine whether interventions guided by geriatric assessments can reduce hospital admissions and investigate critical patient outcomes, such as quality of life," the authors wrote.

SOURCE:

This study was led by Asli Özkan, Department of Medical Oncology, Leiden University Medical Center, Leiden, Netherlands. It was published online on October 04, 2025, in the International Journal of Cancer.

LIMITATIONS:

The relatively small sample size could be attributed to challenges in patient enrolment. This study included only data on irAEs of grade 3 or higher; patients with frailty may have experienced significant impacts from irAEs of grade 1-2. Additionally, comorbidities and tumour types sharing common etiological factors could have affected the observed associations in the study.

DISCLOSURES:

This study was supported by the Leiden University Fund project and Stichting Fonds Oncologie Holland and by a grant from the Leiden University Medical Center and ZonMw/Veni program. Five authors reported receiving travel costs, honoraria, or research grants or having consultancy or advisory relationships with various sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.