Odette Cancer Centre, Sunnybrook Health Sciences Centre.
Department of Medicine, Division of Medical Oncology and Hematology, University of Toronto, Toronto, Ontario, Canada.
Curr Opin Support Palliat Care. 2023 Mar 1;17(1):37-46. doi: 10.1097/SPC.0000000000000637. Epub 2023 Jan 20.
PURPOSE OF THE REVIEW: The aim of this review is to describe the clinical use and tolerability of immune checkpoint inhibitors in older adults with solid tumors, where there is an abundance of evidence with recent updates including subgroups of older patients. RECENT FINDINGS: Studies with updated analyses and subgroups of older patients show that in general older patients benefit as well as younger patients and tolerate immunotherapy very well. However, in some instances of combination therapies which may expose patients to more toxicity, the benefits are reduced, and careful selection of older patients, including adjunctive assessments such as geriatric assessment, can help to identify the appropriate treatment for an individual patient. SUMMARY: Older adults remain underrepresented in clinical trials, including those involving immunotherapy. Therefore, efforts must be made to include more older patients in trials and to assess real-world evidence to inform decision-making.
本次综述的目的在于描述在老年实体瘤患者中应用免疫检查点抑制剂的临床使用情况和耐受性,其中包含了大量的最新证据,包括老年患者亚组的证据。
最近的发现:更新分析和老年患者亚组的研究表明,一般来说,老年患者和年轻患者一样能够从免疫治疗中获益,且能够很好地耐受免疫治疗。然而,在某些联合治疗的情况下,这些治疗可能会增加患者的毒性,从而降低了获益,仔细选择老年患者,包括辅助评估,如老年评估,可以帮助确定每个患者的合适治疗方案。
总结:老年患者在临床试验中代表性不足,包括免疫治疗临床试验。因此,必须努力让更多的老年患者参与临床试验,并评估真实世界的证据,以为决策提供信息。
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