Berben Lieze, Floris Giuseppe, Wildiers Hans, Hatse Sigrid
Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, 3000 Leuven, Belgium.
Department of Pathology, University Hospitals Leuven, 3000 Leuven, Belgium.
Cancers (Basel). 2021 Mar 19;13(6):1400. doi: 10.3390/cancers13061400.
Age is one of the main risk factors of cancer; several biological changes linked with the aging process can explain this. As our population is progressively aging, the proportion of older patients with cancer is increasing significantly. Due to the heterogeneity of general health and functional status amongst older persons, treatment of cancer is a major challenge in this vulnerable population. Older patients often experience more side effects of anticancer treatments. Over-treatment should be avoided to ensure an optimal quality of life. On the other hand, under-treatment due to fear of toxicity is a frequent problem and can lead to an increased risk of relapse and worse survival. There is a delicate balance between benefits of therapy and risk of toxicity. Robust biomarkers that reflect the body's biological age may aid in outlining optimal individual treatment regimens for older patients with cancer. In particular, the impact of age on systemic immunity and the tumor immune infiltrate should be considered, given the expanding role of immunotherapy in cancer treatment. In this review, we summarize current knowledge concerning the mechanistic connections between aging and cancer, as well as aging biomarkers that could be helpful in the field of geriatric oncology.
年龄是癌症的主要风险因素之一；与衰老过程相关的若干生物学变化可以解释这一点。随着我们的人口逐渐老龄化，老年癌症患者的比例正在显著增加。由于老年人总体健康状况和功能状态的异质性，癌症治疗对这一脆弱人群来说是一项重大挑战。老年患者往往会经历更多抗癌治疗的副作用。应避免过度治疗以确保最佳生活质量。另一方面，由于担心毒性而导致的治疗不足是一个常见问题，可能会导致复发风险增加和生存情况恶化。治疗益处与毒性风险之间存在微妙的平衡。反映身体生物学年龄的强大生物标志物可能有助于为老年癌症患者制定最佳的个体化治疗方案。特别是，鉴于免疫疗法在癌症治疗中的作用不断扩大，应考虑年龄对全身免疫和肿瘤免疫浸润的影响。在这篇综述中，我们总结了关于衰老与癌症之间机制联系的现有知识，以及可能有助于老年肿瘤学领域的衰老生物标志物。
