Aging, immune senescence, and immunotherapy: A comprehensive review
Rawad Elias1, Kevan Hartshorn2, Osama Rahma3
1Hartford HealthCare Cancer Institute, Hartford Hospital, Hartford, CT, USA.
Seminars in Oncology
|December 13, 2018
Summary
Immune checkpoint inhibitors (ICIs) are revolutionizing cancer care. This review examines how aging affects ICI efficacy and safety in older adults, synthesizing current clinical evidence for this growing patient group.
Area of Science:
- Oncology
- Immunology
- Geriatrics
Background:
- Immune checkpoint inhibitors (ICIs) have transformed cancer therapy.
- Older adults comprise the majority of cancer patients, yet specific data on ICI use in this demographic is limited.
- Immunosenescence, age-related immune system changes, may influence ICI effectiveness and safety.
Purpose of the Study:
- To review aging-associated immune alterations relevant to cancer and immunotherapy.
- To discuss the impact of chronic infections and frailty on immunotherapy in older adults.
- To summarize existing clinical data on ICI efficacy and toxicity in elderly cancer patients.
Main Methods:
- Literature review of aging, immunosenescence, and cancer immunotherapy.
- Analysis of clinical studies evaluating ICIs in older adult populations.
- Synthesis of evidence regarding ICI effectiveness and safety profiles.
Main Results:
- Aging impacts immune function, potentially altering responses to ICIs.
- Frailty and chronic infections are key factors in older adults undergoing immunotherapy.
- Current evidence suggests varying efficacy and toxicity of ICIs in the elderly, necessitating further research.
Conclusions:
- Understanding immunosenescence is crucial for optimizing ICI therapy in older adults.
- Personalized treatment strategies are needed to balance efficacy and safety in elderly cancer patients.
- Further clinical trials are essential to establish definitive guidelines for ICI use in this population.
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