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Related Concept Videos

Tumor Immunotherapy01:27

Tumor Immunotherapy

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Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
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Immunotherapy in Elderly Patients-Single-Center Experience.

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  • 1Medical Oncology Department, Centro Hospitalar Universitário de Santo António, 4099-001 Porto, Portugal.

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Immunotherapy (ICI) is effective and safe for elderly cancer patients, showing similar survival outcomes to younger adults. Age alone should not dictate treatment decisions, emphasizing personalized geriatric assessments for older adults with cancer.

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Area of Science:

  • Oncology
  • Geriatric Medicine
  • Immunotherapy

Background:

  • Aging is associated with increased cancer incidence and immunosenescence, potentially impacting immunotherapy efficacy.
  • Elderly patients are often underrepresented in clinical trials, creating an unmet need for safety and efficacy data.
  • Understanding age-related differences in cancer treatment response is crucial for personalized medicine.

Purpose of the Study:

  • To evaluate the effectiveness and safety of immune checkpoint inhibitors (ICI) in elderly patients with metastatic solid tumors compared to younger individuals.
  • To assess the impact of age on overall survival (OS), progression-free survival (PFS), and treatment response.
  • To investigate the association between age and immune-related adverse events (irAEs).

Main Methods:

  • Retrospective, single-center cohort study including 220 patients with metastatic solid tumors receiving ICI.
  • Patients were stratified into age groups (≥ 65 years vs. < 65 years).
  • Analysis included OS, PFS, treatment response, and irAEs across different cancer types (melanoma, NSCLC, renal, bladder).

Main Results:

  • No significant differences in OS or PFS were observed between elderly and younger patients across various cancer types (p = 0.388).
  • A significant difference in treatment response was noted in renal cancer patients (p = 0.041), with a potential negative impact of age.
  • Elderly patients showed a marginally higher incidence of irAEs, with oral corticosteroid therapy being marginally associated (p = 0.059); however, NSCLC elderly patients did not show statistically significant differences in irAEs (p = 0.86).

Conclusions:

  • ICI demonstrates maintained efficacy and safety in elderly patients with metastatic solid tumors, challenging age as a sole determinant for treatment.
  • A comprehensive geriatric assessment is recommended for personalized cancer treatment in the elderly, rather than relying solely on chronological age.
  • Further prospective studies are needed to elucidate immune responses in older adults and identify predictive biomarkers for cancer treatment.