Mailly-Giacchetti Léah, Lopez-Trabada Daniel, Feldman Judith, André Thierry, Cohen Romain
Department of Medical Oncology, Saint-Antoine Hospital, AP-HP, Paris, France.
Department of Geriatry, Saint-Antoine Hospital, AP-HP, Paris, France.
Bull Cancer. 2023 Nov;110(11):1204-1214. doi: 10.1016/j.bulcan.2023.06.012. Epub 2023 Sep 9.
Immune checkpoint inhibitors (ICI) are the standard of care for many solid tumors with specific physiopathology mechanisms and adverse events. While the percentage of elderly patients increase from years to years, these patients are underrepresented in clinical trials. Immunosenescence and inflammaging, two main components of the aging of our immune system, and their consequences on the safety and the efficacy are today major focus of clinical research. However, there are still no risk assessment score specific to ICI in elderly patients. In this review we showed the global reassuring data on safety from several retrospective and subgroup analysis, in elderly patients. In summary, impairment of the general state is an independent factor of occurrence of adverse events treatment related whatever the age. Here, we highlight the necessity to use of geriatric evaluation screening test in clinic, the need of specific risk score ICI use in the erdely population and mostly the inclusion of elderly patients in clinical trial to generate specific data.
免疫检查点抑制剂(ICI)是许多具有特定生理病理机制和不良事件的实体瘤的治疗标准。尽管老年患者的比例逐年增加,但这些患者在临床试验中的代表性不足。免疫衰老和炎症衰老作为我们免疫系统衰老的两个主要组成部分,及其对安全性和疗效的影响,是当今临床研究的主要焦点。然而,目前仍没有针对老年患者ICI的风险评估评分。在本综述中,我们展示了来自多项回顾性和亚组分析的关于老年患者安全性的总体可靠数据。总之,无论年龄如何,一般状况的损害都是与治疗相关不良事件发生的独立因素。在此,我们强调在临床中使用老年评估筛查测试的必要性,在老年人群中使用特定风险评分ICI的必要性,以及最重要的是将老年患者纳入临床试验以生成特定数据的必要性。