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老年患者放疗与免疫疗法的多模式治疗:理论依据、不断发展的数据及当前建议

Multimodality Treatment with Radiotherapy and Immunotherapy in Older Adults: Rationale, Evolving Data, and Current Recommendations.

作者信息

Germino Elizabeth A, Govindarajan Ameish, Sedrak Mina S, Li Daneng, Amini Arya

机构信息

Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA.

Department of Medical Oncology & Therapeutics Research, City of Hope Medical Center, Duarte, CA.

出版信息

Semin Radiat Oncol. 2022 Apr;32(2):142-154. doi: 10.1016/j.semradonc.2021.11.001.

Abstract

The combination of immunotherapy and radiotherapy/chemoradiation has demonstrated promising results in some disease sites for cancer patients. However, translation to real-world practice is complicated by limited representation in clinical trials of older adults with comorbidities who comprise a significant percentage of patients treated in the clinic. The purpose of this review is to outline the current evidence for multimodality treatment in the older adult population including extrapolation from single modality therapies and the rationale for combinatorial treatment. Although few in number, ongoing trials specifically targeting older cancer patients are highlighted. Looking toward the future, current gaps in the field are identified with recommendations to consider both in the preclinical setting and when designing clinical trials in order to better inform the use of multimodality therapy in the clinic as this data evolves.

摘要

免疫疗法与放疗/放化疗相结合已在癌症患者的某些疾病部位显示出有前景的结果。然而,向实际临床应用的转化因临床试验中合并症老年患者的代表性有限而变得复杂,这些老年患者在临床治疗的患者中占相当大的比例。本综述的目的是概述老年人群多模式治疗的现有证据,包括从单一模式疗法推断以及联合治疗的原理。尽管数量不多,但重点介绍了专门针对老年癌症患者的正在进行的试验。展望未来,确定了该领域当前的差距,并提出了在临床前环境以及设计临床试验时都应考虑的建议,以便随着这些数据的发展,更好地指导多模式疗法在临床中的应用。

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