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Checkpoint inhibitors in older patients with advanced non-small cell lung cancer

Maria Lucia Reale1, Gianpiero Diego Romano1, Loretta Paolelli1

  • 1Medical Oncology Unit, Vito Fazzi Hospital, Lecce, Italy.

Critical Reviews in Oncology/Hematology
|June 10, 2023
PubMed

Insights

Immune checkpoint inhibitors (ICIs) offer improved survival for lung cancer patients. This review focuses on optimizing immunotherapy for older adults, considering geriatric assessment and clinical trial inclusion.

Area of Science:

  • Oncology
  • Geriatrics
  • Immunotherapy

Background:

  • Immune checkpoint inhibitors (ICIs) have transformed lung cancer treatment, enhancing survival and response durability.
  • Older adults are often underrepresented in clinical trials, raising concerns about immunotherapy efficacy and safety in this demographic.
  • Personalized treatment is crucial to avoid over or under-treatment in elderly lung cancer patients.

Purpose of the Study:

  • To review the efficacy and safety of immunotherapy in older adults with advanced non-small cell lung cancer (NSCLC).
  • To highlight the importance of geriatric assessment and screening tools for this patient population.
  • To discuss future perspectives for optimizing immunotherapy in elderly NSCLC patients.

Main Methods:

  • Literature review focusing on immunotherapy in advanced NSCLC among older adults.
  • Discussion of comprehensive geriatric assessment (CGA) and its role in treatment decisions.
  • Analysis of treatment toxicity and management strategies specific to elderly patients.

Main Results:

  • Immunotherapy demonstrates significant benefits in advanced NSCLC, but careful consideration of patient-specific factors is needed for older adults.
  • Comprehensive geriatric assessment can identify frail individuals and guide treatment decisions, potentially improving outcomes.
  • Management of treatment-related toxicities requires tailored approaches in the elderly population.

Conclusions:

  • Integrating geriatric assessment into clinical practice is essential for safe and effective immunotherapy in older NSCLC patients.
  • Promoting the inclusion of older adults in specifically designed clinical trials is crucial for advancing research.
  • A personalized approach, considering both oncological and geriatric factors, is key to optimizing immunotherapy outcomes in elderly patients.
Keywords:
Elderly patientsGeriatric assessmentImmunotherapyNSCLC

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