Decreased life-space mobility and depression may be risk factors for immune-related adverse events (irAEs) among older adults with advanced cancer who are receiving immune checkpoint inhibitor (ICI) therapy, according to research published in The Oncologist.

Researchers conducted a retrospective study at a comprehensive cancer center to learn more about potential risk factors for irAEs in older cancer patients taking ICIs.

The researchers analyzed chart data from patients age 70 and older with any stage cancer who had received at least 1 dose of an ICI between October 6, 2011, and April 5, 2018. The researchers identified 238 patients with a median age of 76 years.

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Most patients (90.3%) had stage III or stage IV disease. Melanoma was the most common type of cancer (36%), followed by non-small cell lung cancer (24%). Nivolumab (50%) was the most frequently used ICI, followed by pembrolizumab (19%) and ipilimumab (18%). One patient received concurrent chemotherapy.

The study’s primary outcome was the identification of patient characteristics — including demographics, mobility, comorbidities, and functional status — associated with irAEs.

The researchers found that most characteristics of special interest did not have a significant association with irAEs. This included fall risk, weight loss, hearing loss, and cognitive limitations.

However, decreased mobility and depression were associated with an increased risk of irAEs. In a multivariate analysis, depression was associated with an increased risk of any-grade irAEs (odds ratio [OR], 2.41; 95% CI, 1.24-4.71; P <.01), and impaired life-space mobility was associated with an increased risk of grade 3 or higher irAEs (OR, 4.4; 95% CI, 1.4-4.5; P =.01).

“Given the small scale of our cohort and the retrospective nature of this analysis, which is likely limited by underreporting in clinical documentation, this study is primarily hypothesis-generating,” the researchers wrote. “These results can inform future studies with larger, more diverse patient groups and more comprehensive methods of measuring geriatrics-focused characteristics to strengthen the generalizability of our findings.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Johns AC, Yang M, Wei L, et al. Risk factors for immune checkpoint inhibitor immunotherapy toxicity among older adults with cancer. Oncologist. Published online April 21, 2023. doi:10.1093/oncolo/oyad097

This article originally appeared on Oncology Nurse Advisor