免疫检查点抑制剂在老年癌症患者中的疗效和不良反应。
Efficacy and Adverse Events of Immunotherapy with Checkpoint Inhibitors in Older Patients with Cancer.
机构信息
Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
Department of Medical Oncology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
出版信息
Drugs Aging. 2019 Oct;36(10):927-938. doi: 10.1007/s40266-019-00697-2.
The number of older patients with cancer is increasing as a result of the ageing of Western societies. Immune checkpoint inhibitors have improved cancer treatment and are associated with lower rates of treatment-related toxicity compared with chemotherapy in the general population. Nonetheless, immune checkpoint inhibitors have potentially serious immune-related adverse events, which might have a greater impact on older and more vulnerable patients and potentially influence treatment efficacy and quality of life. Previous clinical trials have shown no major increase in immune-related adverse events; however, older patients are underrepresented and relatively healthy in these trials. Observational studies suggest that older and more vulnerable patients may be at a higher risk of immune-related adverse events and early treatment discontinuation. Geriatric assessment could help identify older patients who will benefit from immune checkpoint inhibitors.
由于西方社会的老龄化，癌症老年患者的数量正在增加。免疫检查点抑制剂改善了癌症治疗效果，与普通人群中的化疗相比，其与治疗相关的毒性发生率更低。然而，免疫检查点抑制剂具有潜在的严重免疫相关不良反应，这可能对年龄较大和更脆弱的患者产生更大的影响，并可能影响治疗效果和生活质量。以前的临床试验并未显示免疫相关不良事件有明显增加；然而，在这些试验中，年龄较大的患者代表性不足，且相对健康。观察性研究表明，年龄较大和更脆弱的患者可能面临更高的免疫相关不良事件和早期治疗中断风险。老年评估可以帮助确定将从免疫检查点抑制剂中受益的老年患者。
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