Efficacy and safety of immune checkpoint inhibitor immunotherapy in elderly cancer patients

Fox, B; Carmena, María de Toro; Álvarez, Rosa; Calles, Antonio; López, Carlos; Ramírez, Sara; Arranz, José Ángel; Martı́n, Miguel; Márquez-Rodas, Iván

doi:10.1007/s12094-019-02161-4

Cited by 17 publications

(11 citation statements)

References 18 publications

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“…This is analogous to doubts over the use of cancer screening in older adults [89,90], and represents one aspect of a controversy familiar to oncologists -namely, whether doing (or costing) more, in treatment terms, necessarily means doing better [91]. Demand will remain strong in all older patient groups for treatment modalities which are perceived, rightly or wrongly, to offer more hope of durable disease control with acceptable toxicity -e.g., molecularly-targeted drugs [92] and immune checkpoint inhibitors [93]. The spectrum of tumors in physiologically older patients tends to be more responsive to immunotherapies [94], even if only in a minority [95], whereas those in the physiologically younger group more often respond to hormonal or targeted drug therapies [96].…”

Section: How Fewer Remaining Life Years Are Translating Into More Patient Choicesmentioning

confidence: 99%

“…Demand will remain strong in all older patient groups for treatment modalities which are perceived, rightly or wrongly, to offer more hope of durable disease control with acceptable toxicity – e.g., molecularly-targeted drugs [ 92 ] and immune checkpoint inhibitors [ 93 ]. The spectrum of tumors in physiologically older patients tends to be more responsive to immunotherapies [ 94 ], even if only in a minority [ 95 ], whereas those in the physiologically younger group more often respond to hormonal or targeted drug therapies [ 96 ].…”

Section: How Fewer Remaining Life Years Are Translating Into More Pat...mentioning

confidence: 99%

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How aging of the global population is changing oncology

Gu¹,

Lin²,

Epstein³

2021

ecancer

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Population aging is causing a demographic redistribution with implications for the future of healthcare. How will this affect oncology? First, there will be an overall rise in cancer affecting older adults, even though age-specific cancer incidences continue to fall due to better prevention. Second, there will be a wider spectrum of health functionality in this expanding cohort of older adults, with differences between "physiologically older" and "physiologically younger" patients becoming more important for optimal treatment selection. Third, greater teamwork with supportive care, geriatric, mental health and rehabilitation experts will come to enrich oncologic decision-making by making it less formulaic than it is at present. Success in this transition to a more nuanced professional mindset will depend in part on the development of user-friendly computational tools that can integrate a complex mix of quantitative and qualitative inputs from evidence-based medicine, functional and cognitive assessments, and the personal priorities of older adults.

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Section: How Fewer Remaining Life Years Are Translating Into More Patient Choicesmentioning

confidence: 99%

Section: How Fewer Remaining Life Years Are Translating Into More Pat...mentioning

confidence: 99%

How aging of the global population is changing oncology

Gu¹,

Lin²,

Epstein³

2021

ecancer

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“…К сожалению, пожилая популяция недостаточно представлена в онкологических клинических исследованиях, поэтому опыт иммунотерапии опухолей в пожилой популяции, особенно в возрасте старше 75 лет, ограничен. Кроме того, в связи с тем, что старение влияет на функционирование иммунной системы, высказывается мнение о том, что эффективность иммунотерапии у пожилых людей может снижаться [5]. В то же время результаты ретроспективных исследований применения препаратов вне протокола указывают на то, что профиль эффективности и безопасности у молодых и пожилых сопоставим [6].…”

Section: Immunotherapy In Oncology введениеunclassified

“…Fox et al благоприятный ответ на лечение (улучшение или стабильное заболевание) регистрировался у 65% (13 из 20) пациентов в возрасте 75-94 лет, иоНЯ 3-4-й ст. наблюдались у 25% (5 из 20) пациентов [5]. Авторы описали различные виды токсичности.…”

Section: иммуноопосредованные нежелательные явления у пожилых пациентовunclassified

“…У четырех пациентов отмечалось повышение уровня печеночных ферментов 1-й степени, у одного пациентапреходящее повышение уровня ГГТ 3-й степени, однако ни в одном из описанных случаев не потребовалось прекращения иммунотерапии. Диарея 1-2-й степени развилась у пяти пациентов [5].…”

Section: иммуноопосредованные нежелательные явления у пожилых пациентовunclassified

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Immunotherapy in elderly patients

Лядова

Лядов

2021

Medicinskij sovet

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In the recent years the growing life expectancy of the population and increasing cancer burden in elderly patients substantiate the urgent need for the search of optimal cancer treatment strategies. This article provides an overview of the current literature on the efficacy and safety of checkpoint inhibitors in the elderly population. A literature search for published studies using Medline (PubMed) and Elibrary databases was performed. All studies containing data on treatment results including tumor response criteria, treatment response rate, tumor control rate, overall survival were included. Case studies, animal studies and studies containing duplicate results were excluded from the analysis. In elderly patients with cancer there is a substantial number of comorbid conditions and functional disorders, which may decrease the efficacy and modulate the tolerability of immune checkpoint inhibitors (ICI). Besides, different changes associated with immunologic ageing, including thymolysis, increase of the number of memory B-cells and a decrease of hematopoesis intensity are observed. Several studies performed a comparative analysis of efficacy and toxicity of ICIs in elderly and younger patients. In most cases similar results for efficacy and toxicity were demonstrated. To evaluate the toxicity and the influence of treatment on functional status and other important measures in geriatric population further studies of factors, influencing the tolerability and treatment response of newer ICI in elderly cancer patients are needed, including additional adverse events associated with treatment.

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