Department of Neurosurgery, Duke University School of Medicine, 047 Baker House, Trent Drive, Durham, NC, 27710, USA.
Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
Curr Oncol Rep. 2024 May;26(5):562-572. doi: 10.1007/s11912-024-01528-3. Epub 2024 Apr 8.
This manuscript will update prior reviews of immune checkpoint inhibitors (ICIs) in light of basic science, translational, and clinical discoveries in the field of cancer immunology and aging.
ICIs have led to significant advancements in the treatment of cancer. Landmark trials of ICIs have cited the efficacy and toxicity experienced by older patients, but most trials are not specifically designed to address outcomes in older patients. Underlying mechanisms of aging, like cellular senescence, affect the immune system and may ultimately alter the host's response to ICIs. Validated tools are currently used to identify older adults who may be at greater risk of developing complications from their cancer treatment. We review changes in the aging immune system that may alter responses to ICIs, report outcomes and toxicities in older adults from recent ICI clinical trials, and discuss clinical tools specific to older patients with cancer.
本综述旨在根据癌症免疫学和衰老领域的基础科学、转化和临床发现,更新关于免疫检查点抑制剂(ICI)的先前综述。
ICI 已推动癌症治疗取得重大进展。ICI 的标志性试验引用了老年患者的疗效和毒性,但大多数试验并非专门针对老年患者的结局设计。衰老的潜在机制,如细胞衰老,会影响免疫系统,并可能最终改变宿主对 ICI 的反应。目前正在使用经过验证的工具来识别可能因癌症治疗而出现并发症风险更高的老年人。我们综述了可能改变对 ICI 反应的衰老免疫系统的变化,报告了最近 ICI 临床试验中老年人的结局和毒性,并讨论了针对癌症老年患者的特定临床工具。