Department of Hematology-Oncology and Department of Geriatrics, Boston University Medical Center, 820 Harrison Ave, Boston, MA, 02118, USA.
Division of Hematology-Oncology, Virginia Commonwealth University, 1200 East Broad Street, Richmond, VA, 23298, USA.
Curr Oncol Rep. 2016 Aug;18(8):47. doi: 10.1007/s11912-016-0534-9.
Cancer is primarily a disease of older adults. The treatment of advanced stage tumors usually involves the use of systemic agents that may be associated with significant risk of toxicity, especially in older patients. Immune checkpoint inhibitors are newcomers to the oncology world with improved efficacy and better safety profiles when compared to traditional cytotoxic drugs. This makes them an attractive treatment option. While there are no elderly specific trials, this review attempts to look at the current available data from a geriatric oncology perspective. We reviewed data from phase III studies that led to newly approved indications of checkpoint inhibitors in non-small cell lung cancer, melanoma, and renal cell cancer. Data were reviewed with respect to response, survival, and toxicity according to three groups: <65 years, 65-75 years, and >75 years. Current literature does not allow one to draw definitive conclusions regarding the role of immune checkpoint inhibitors in older adults. However, they may offer a potentially less toxic but equally efficacious treatment option for the senior adult oncology patient.
癌症主要是老年人的疾病。晚期肿瘤的治疗通常涉及使用全身性药物，这些药物可能会带来显著的毒性风险，尤其是在老年患者中。与传统的细胞毒性药物相比，免疫检查点抑制剂是肿瘤学领域的新成员，具有更好的疗效和更好的安全性。这使得它们成为一种有吸引力的治疗选择。虽然没有专门针对老年人的试验，但本综述试图从老年肿瘤学的角度来看待当前可用的数据。我们回顾了导致免疫检查点抑制剂在非小细胞肺癌、黑色素瘤和肾细胞癌中获得新批准适应症的 III 期研究的数据。根据<65 岁、65-75 岁和>75 岁三组，根据反应、生存和毒性对数据进行了回顾。目前的文献还不能确定免疫检查点抑制剂在老年人中的作用。然而，它们可能为老年肿瘤患者提供一种潜在毒性较小但同样有效的治疗选择。
