Immune Checkpoint Inhibitors in Older Adults.
Cancer is primarily a disease of older adults. The treatment of advanced stage tumors usually involves the use of systemic agents that may be associated with significant risk of toxicity, especially in older patients. Immune checkpoint inhibitors are newcomers to the oncology world with improved efficacy and better safety profiles when compared to traditional cytotoxic drugs. This makes them an attractive treatment option. While there are no elderly specific trials, this review attempts to look at the current available data from a geriatric oncology perspective. We reviewed data from phase III studies that led to newly approved indications of checkpoint inhibitors in non-small cell lung cancer, melanoma, and renal cell cancer. Data were reviewed with respect to response, survival, and toxicity according to three groups: <65 years, 65-75 years, and >75 years. Current literature does not allow one to draw definitive conclusions regarding the role of immune checkpoint inhibitors in older adults. However, they may offer a potentially less toxic but equally efficacious treatment option for the senior adult oncology patient.
Department of Hematology-Oncology and Department of Geriatrics, Boston University Medical Center, 820 Harrison Ave, Boston, MA, 02118, USA. raelias@bu.edu.
Rawad
R
Elias
Division of Hematology-Oncology, Virginia Commonwealth University, 1200 East Broad Street, Richmond, VA, 23298, USA.
Joshua
J
Morales
Department of Hematology-Oncology and Department of Geriatrics, Boston University Medical Center, 820 Harrison Ave, Boston, MA, 02118, USA.
Yasser
Y
Rehman
Division of Hematology-Oncology, Rhode Island Hospital, 593 Eddy St, Providence, RI, 02903, USA.
Humera
H
Khurshid
D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006299:Health Services for the Aged; D006801:Humans; D007167:Immunotherapy / Q000379:methods* / Q000706:statistics & numerical data; D008495:Medical Oncology / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data
D000970:Antineoplastic Agents
Anti-CTLA-4; Anti-PD-1; Checkpoint inhibitors; Immunotherapy; Lung cancer; Melanoma; Older adults; Renal cancer