title: [Innovative therapies for metastatic melanoma in elderly patients].
abstract: The mortality rate for malignant melanoma is higher in elderly patients aged 75 years or more, with over 25% of melanomas being diagnosed in this population. This poorer prognosis might perhaps be improved by emerging targeted therapies and immunotherapy, although these agents must be prescribed with care in this rather fragile population. The purpose of our review of the literature concerning phase-2 and -3 published trials of these innovative molecules was to examine their optimal use in elderly patients presenting metastatic malignant melanoma. Most of the trials examined included elderly patients and some were analyzed by age sub-groups. In conclusion, elderly patients with ECOG 0/1 status can be given ipilimumab or vemurafenib as first-line therapy depending on tumoral BRaf mutation status. The benefit of combined targeted therapies does not seem to apply consistently in elderly patients and their use must be discussed. Further specific data must be collected in elderly patients concerning anti-PD1 molecules. For more fragile patients, risk scales or scores should enable more accurate use of innovative therapies in metastatic melanoma. Moreover, physicians must be aware of the common drug interactions with targeted therapies, since elderly patients are often taking several concomitant drugs.
authors.affiliation: Département de dermatologie, hôpital Saint-Eloi, CHU de Montpellier, université de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France. Electronic address: a-du_thanh@chu-montpellier.fr.
authors.forename: A
authors.initials: A
authors.lastname: Du-Thanh
authors.affiliation: Département de dermatologie, hôpital Saint-Eloi, CHU de Montpellier, université de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Lesage
authors.affiliation: Unité d'oncogériatrie, centre Antonin-Balmes, 39, avenue Charles-Flahaut, 34295 Montpellier, France.
authors.forename: E
authors.initials: E
authors.lastname: Ferreira
authors.affiliation: Département de dermatologie, hôpital Saint-Eloi, CHU de Montpellier, université de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France.
authors.forename: O
authors.initials: O
authors.lastname: Dereure
authors.affiliation: Département de dermatologie, hôpital Saint-Eloi, CHU de Montpellier, université de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France.
authors.forename: B
authors.initials: B
authors.lastname: Guillot
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D015897:Comorbidity; D004347:Drug Interactions; D005260:Female; D016330:Frail Elderly; D005602:France / Q000453:epidemiology; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects; D000074324:Ipilimumab; D020935:MAP Kinase Signaling System / Q000187:drug effects; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000009:adverse effects; D018579:Patient Selection; D019338:Polypharmacy; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D035703:Therapies, Investigational; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000074324:Ipilimumab; D047428:Protein Kinase Inhibitors
keywords: Clinical trials; Essais thérapeutiques; Immunotherapy; Immunothérapie; Melanoma; Mélanome; Oncogeriatrics; Oncogériatrie; Targeted therapies; Thérapies ciblées