Antibody drug conjugates in older patients: State of the art

Area of Science:

• Oncology
• Geriatric Medicine
• Pharmacology

Background:

• Over half of cancer cases affect individuals aged 65 and older.
• The geriatric population is underrepresented in clinical trials, limiting data on novel therapeutics.
• Evidence on the efficacy and safety of antibody drug conjugates (ADCs) in older patients is scarce.

Purpose of the Study:

• To review available data on the efficacy, safety, and pharmacokinetics of FDA-approved ADCs in the geriatric population.
• To explore clinical trial results specifically for older individuals and subgroup analyses within larger trials.
• To assess the suitability of current ADC treatments for elderly cancer patients.

Main Methods:

• Systematic review of published literature on ADCs for hematologic malignancies and solid tumors.
• Analysis of data from clinical trials focusing on geriatric populations.
• Inclusion of subgroup analyses from major trials involving older patients.
• Examination of pharmacokinetic data across different age groups.

Main Results:

• Available data indicate similar efficacy of ADCs in older adults compared to the general population.
• Older patients may experience a higher incidence of adverse events, potentially impacting quality of life.
• No significant pharmacokinetic differences were reported between age groups.

Conclusions:

• While efficacy appears comparable, careful monitoring for adverse events is crucial in older patients receiving ADCs.
• Current data do not support routine dose reductions or schedule modifications for geriatric patients.
• There is a critical need for clinical trials specifically designed for older patients, incorporating geriatric assessment tools, to ensure representative data and optimize treatment strategies.