Marrone Kristen A, Forde Patrick M
From the Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD.
Cancer J. 2017 Jul/Aug;23(4):219-222. doi: 10.1097/PPO.0000000000000268.
Advancing age remains one of the most significant risk factors for cancer development. Changes in the immune system occur with aging, and likely play a role in the increased incidence of malignancy in older patients. With the advent of immune checkpoint inhibitors, and their use in a variety of malignancies, there has been an explosion of clinical trials evaluating their use. Unfortunately, these trials have not shown consistent results in elderly patients, nor have age-specific outcomes been consistently reported. Further evaluation of the efficacy and toxicity of these agents in the elderly is needed, as they are now in frequent clinical use. By investigating how age-related changes in the immune system occur and intersect with use of immune checkpoint inhibitors, their use can be optimized in a clear and safe manner. Further study of age-related changes in the immune system can also lead to effective combination immunotherapeutic approaches, maximizing the efficacy of immune checkpoint inhibitors across tumor types and across the age spectrum of cancer patients.
年龄增长仍然是癌症发生的最重要风险因素之一。免疫系统会随着年龄增长而发生变化，这可能在老年患者恶性肿瘤发病率增加中发挥作用。随着免疫检查点抑制剂的出现及其在多种恶性肿瘤中的应用，评估其使用的临床试验激增。不幸的是，这些试验在老年患者中并未显示出一致的结果，也没有始终如一地报告特定年龄的结果。由于这些药物目前在临床中频繁使用，因此需要进一步评估它们在老年人中的疗效和毒性。通过研究免疫系统中与年龄相关的变化如何发生以及与免疫检查点抑制剂的使用相互影响，可以以清晰且安全的方式优化其使用。对免疫系统中与年龄相关变化的进一步研究还可以带来有效的联合免疫治疗方法，在各种肿瘤类型以及癌症患者的整个年龄范围内最大化免疫检查点抑制剂的疗效。
