Immune-related adverse events between elderly patients with gastrointestinal and lung cancers - A real-world study

Q: What was the main goal of this study?

To compare immune-related adverse events (irAEs) in elderly patients with gastrointestinal and lung cancers receiving immune checkpoint inhibitors and provide real-world safety data.

Q: How were patients selected and analyzed?

Elderly patients (≥70 years) with gastrointestinal tumors or lung cancer who received at least two ICI cycles in 2016–2022 were included. A 2:1 propensity score matching was used to balance baseline characteristics, and chi-squared tests were used for comparisons.

Q: Which cancer type had a higher overall incidence of any-grade irAEs?

Elderly patients with lung cancer had a higher incidence of any-grade irAEs than those with gastrointestinal tumors (61.0% vs. 47.9%; P=0.013). After matching, lung cancer still showed a higher trend (61.7% vs. 50.8%; P=0.056).

Sep 22, 2026

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Immune checkpoint inhibitors show durable efficacy, yet immune-related adverse events (irAEs) in elderly patients remain insufficiently defined, especially across different tumor types. This retrospective real-world study compared irAEs in elderly patients (≥70 years) with gastrointestinal tumors versus lung cancer receiving ICIs from 2016 to 2022. Using 2:1 propensity score matching, incidence comparisons used chi-squared testing. Lung cancer patients had higher overall any-grade irAEs, while GI tumors showed more skin toxicity and lung cancer more thyroid dysfunction.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

Original Article Immune-related adverse events between elderly patients with gastrointestinal and lung cancers: A real-world study Infong Chan1, Lingdong Kong2, Bo Jia2, Fengxiao Dong1, Yuling He2, Xumeng Ji2, Guomei Ren3, Lili Wang4, Zhihao Lu1, Lin Shen5, Yuyan Wang2 1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China; 2Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Thoracic Medical Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China; 3Department of Respiratory and Critical Illness, Taiyuan Central Hospital, Taiyuan, Shanxi 030009, China; 4Department of Medical Oncology, Yantai Harbour Hospital, Yantai, Shandong 264099, China; 5State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China. Abstract Background: Immune checkpoint inhibitors (ICIs) are known for their durable efficacy and favorable tolerance profiles. However, elderly patients are often underrepresented in clinical trials. The manifestation of immune-related adverse events (irAEs) in elderly patients with different tumor types remains unclear. This study aimed to compare irAEs in elderly patients with gastrointestinal and lung cancers receiving ICIs and to provide real-world safety data. Methods: This retrospective study included elderly patients (≥70 years) with gastrointestinal (GI) tumors or lung cancer who received ≥2 cycles of ICIs across multiple departments within a single academic medical center between January 2016 and February 2022. A 2:1 propensity score matching was used to balance baseline characteristics between the cohorts. The primary endpoint was the incidence of any-grade irAEs between GI tumors and lung cancer, whereas secondary analyses focused on organ-specific toxicities. Statistical comparisons were performed using the chi-squared test. Results: The overall incidence of any-grade irAEs was higher in elderly patients with lung cancer than in those with GI tumors (61.0% vs. 47.9%; P = 0.013). After matching for baseline characteristics, the lung cancer group still showed a trend toward a higher incidence of irAEs (61.7% vs. 50.8%; P = 0.056). Notably, patients with GI tumors had a higher incidence of skin toxicity (28.7% vs. 15.1%; P = 0.002), whereas patients with lung cancer had a higher incidence of thyroid dysfunction (28.1% vs. 11.9%, P <0.001) . Conclusions: Elderly patients with lung cancer were more likely to experience irAEs during immunotherapy than those with GI tumors. However, dermatological toxicities were more common in elderly patients with GI tumors, whereas thyroid dysfunction was more frequently observed in those with lung cancer. Keywords: Immune checkpoint inhibitors; Immune-related adverse events; Gastrointestinal tumor; Lung cancer; Real-world study; Elderly; Immune-related adverse events; Organ-specific toxicity Introduction With the increase in the geriatric population and the associated rise in the incidence of malignant tumors with age, elderly patients are expected to become a critical focus of clinical oncology in the future. In China specifically, lung and gastrointestinal (GI) tumors—primarily colorectal cancer, two malignancies central to this study—accounted for 681,124 and 333,821 new cases among older adults in 2024, respectively, with mortality rates among the highest worldwide. [1] Identifying appropriate treatment | Access this article online | | | --- | --- | | Quick Response Code: | Website:
[www.cmj.org](www.cmj.org) | | | DOI:
10.1097/CM9.0000000000004069 | options for this patient population is therefore imperative. [2] Fu

FAQs

What was the main goal of this study?

To compare immune-related adverse events (irAEs) in elderly patients with gastrointestinal and lung cancers receiving immune checkpoint inhibitors and provide real-world safety data.

How were patients selected and analyzed?

Elderly patients (≥70 years) with gastrointestinal tumors or lung cancer who received at least two ICI cycles in 2016–2022 were included. A 2:1 propensity score matching was used to balance baseline characteristics, and chi-squared tests were used for comparisons.

Which cancer type had a higher overall incidence of any-grade irAEs?

Elderly patients with lung cancer had a higher incidence of any-grade irAEs than those with gastrointestinal tumors (61.0% vs. 47.9%; P=0.013). After matching, lung cancer still showed a higher trend (61.7% vs. 50.8%; P=0.056).

How did organ-specific toxicities differ between groups?

GI tumors had a higher incidence of skin toxicity (28.7% vs. 15.1%; P=0.002), while lung cancer had a higher incidence of thyroid dysfunction (28.1% vs. 11.9%; P<0.001).

Sep 22, 2026

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