Immune Checkpoint Inhibitors in the Treatment of Advanced Melanoma in Older Patients: An Overview of Published Data

Area of Science:

• Oncology
• Geriatric Medicine
• Immunotherapy

Background:

• Melanoma presents a significant health burden in older adults due to its high incidence and aggressive nature.
• Recent advancements in immunotherapy and targeted therapies have improved melanoma prognosis.
• Limited clinical trial data exists for geriatric patients, necessitating a review of real-world evidence.

Purpose of the Study:

• To review the efficacy and safety of immune checkpoint inhibitors in older melanoma patients (age 65-75 and >75 years).
• To discuss challenges in multidisciplinary decision-making for geriatric melanoma care.
• To evaluate immunotherapy outcomes in elderly populations compared to younger individuals.

Main Methods:

• Comprehensive narrative review of published data on immunotherapy for melanoma in geriatric patients.
• Analysis of treatments including anti-cytotoxic T lymphocyte-associated protein 4 (CTLA-4) inhibitors (ipilimumab), anti-programmed death-ligand 1 (PD-1) inhibitors (nivolumab, pembrolizumab), and anti-lymphocyte activation gene-3 (LAG-3) inhibitor (relatlimab).
• Examination of safety and tolerability data in patients aged 65 years and older.

Main Results:

• Available evidence suggests immunotherapy is equally beneficial for older melanoma patients.
• The incidence of adverse events in older patients receiving immunotherapy is comparable to younger populations.
• Despite potential underrepresentation in clinical trials, geriatric patients experience similar therapeutic advantages.

Conclusions:

• Immunotherapy demonstrates comparable efficacy and safety in older adults with melanoma.
• Multidisciplinary approaches are crucial for optimizing care in geriatric melanoma patients.
• Evidence supports the use of immune checkpoint inhibitors in the elderly, challenging previous assumptions about their tolerability and benefit.