Impact of immunological aging on T cell-mediated therapies in older adults with multiple myeloma and lymphoma

The treatment landscape for lymphoma and multiple myeloma, which disproportionally affect older adults, has been transformed by the advent of T cell-mediated immunotherapies, including immune checkpoint inhibition, T cell-engaging bispecific antibodies, and chimeric antigen receptor (CAR) T cell the...

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Main Authors: Tamas Fulop, Abdullah M Khan, Valentín Ortiz-Maldonado, Marcus Vetter, Rainer Wirth, Fabian Ullrich, Paul J Bröckelmann, Amin T Turki, Elena-Diana Chiru, Bastian von Tresckow, Raul Cordoba, Nina Rosa Neuendorff
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:Journal for ImmunoTherapy of Cancer
Online Access:https://jitc.bmj.com/content/12/12/e009462.full
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author Tamas Fulop
Abdullah M Khan
Valentín Ortiz-Maldonado
Marcus Vetter
Rainer Wirth
Fabian Ullrich
Paul J Bröckelmann
Amin T Turki
Elena-Diana Chiru
Bastian von Tresckow
Raul Cordoba
Nina Rosa Neuendorff
author_facet Tamas Fulop
Abdullah M Khan
Valentín Ortiz-Maldonado
Marcus Vetter
Rainer Wirth
Fabian Ullrich
Paul J Bröckelmann
Amin T Turki
Elena-Diana Chiru
Bastian von Tresckow
Raul Cordoba
Nina Rosa Neuendorff
author_sort Tamas Fulop
collection DOAJ
description The treatment landscape for lymphoma and multiple myeloma, which disproportionally affect older adults, has been transformed by the advent of T cell-mediated immunotherapies, including immune checkpoint inhibition, T cell-engaging bispecific antibodies, and chimeric antigen receptor (CAR) T cell therapy, during the last decade. These treatment modalities re-enable the patient’s own immune system to combat malignant cells and offer the potential for sustained remissions and cure for various diseases.Age profoundly affects the physiological function of the immune system. The process of biological aging is largely driven by inflammatory signaling, which is reciprocally fueled by aging-related alterations of physiology and metabolism. In the T cell compartment, aging contributes to T cell senescence and exhaustion, increased abundance of terminally differentiated cells, a corresponding attrition in naïve T cell numbers, and a decrease in the breadth of the receptor repertoire. Furthermore, inflammatory signaling drives aging-related pathologies and contributes to frailty in older individuals. Thus, there is growing evidence of biological aging modulating the efficacy and toxicity of T cell-mediated immunotherapies.Here, we review the available evidence from biological and clinical studies focusing on the relationship between T cell-mediated treatment of hematologic malignancies and age. We discuss biological features potentially impacting clinical outcomes in various scenarios, and potential strategies to improve the safety and efficacy of immune checkpoint inhibitors, T cell-engaging bispecific antibodies, and CAR-T cell therapy in older patients.
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spelling doaj-art-8afaf79800064ff3a516fd0cd74465162025-08-20T02:38:18ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262024-12-01121210.1136/jitc-2024-009462Impact of immunological aging on T cell-mediated therapies in older adults with multiple myeloma and lymphomaTamas Fulop0Abdullah M Khan1Valentín Ortiz-Maldonado2Marcus Vetter3Rainer Wirth4Fabian Ullrich5Paul J Bröckelmann6Amin T Turki7Elena-Diana Chiru8Bastian von Tresckow9Raul Cordoba10Nina Rosa Neuendorff1111 Department of Medicine, Division of Geriatrics, Research Center on Aging, Université de Sherbrooke, Sherbrooke, Quebec, Canada6 Division of Hematology, The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA10 Department of Hematology, Oncoimmunotherapy Unit, Hospital Clínic de Barcelona, Barcelona, Spain7 Cancer Center Baselland, University of Basel Faculty of Medicine, Basel, Liestal, Switzerland8 Department of Geriatrics, Ruhr University Bochum, University Hospital Marien Hospital Herne, Herne, Germany1 Department of Hematology and Stem Cell Transplantation, West German Cancer Center and German Cancer Consortium (DKTK partner site Essen), University Duisburg-Essen, University Hospital Essen, Essen, Nordrhein-Westfalen, Germany2 Faculty of Medicine and University Hospital of Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany4 Department of Hematology and Oncology, University Hospital Marien Hospital Herne, Herne, Nordrhein-Westfalen, Germany7 Cancer Center Baselland, University of Basel Faculty of Medicine, Basel, Liestal, Switzerland1 Department of Hematology and Stem Cell Transplantation, West German Cancer Center and German Cancer Consortium (DKTK partner site Essen), University Duisburg-Essen, University Hospital Essen, Essen, Nordrhein-Westfalen, Germany9 Department of Hematology, Lymphoma Unit, Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain8 Department of Geriatrics, Ruhr University Bochum, University Hospital Marien Hospital Herne, Herne, GermanyThe treatment landscape for lymphoma and multiple myeloma, which disproportionally affect older adults, has been transformed by the advent of T cell-mediated immunotherapies, including immune checkpoint inhibition, T cell-engaging bispecific antibodies, and chimeric antigen receptor (CAR) T cell therapy, during the last decade. These treatment modalities re-enable the patient’s own immune system to combat malignant cells and offer the potential for sustained remissions and cure for various diseases.Age profoundly affects the physiological function of the immune system. The process of biological aging is largely driven by inflammatory signaling, which is reciprocally fueled by aging-related alterations of physiology and metabolism. In the T cell compartment, aging contributes to T cell senescence and exhaustion, increased abundance of terminally differentiated cells, a corresponding attrition in naïve T cell numbers, and a decrease in the breadth of the receptor repertoire. Furthermore, inflammatory signaling drives aging-related pathologies and contributes to frailty in older individuals. Thus, there is growing evidence of biological aging modulating the efficacy and toxicity of T cell-mediated immunotherapies.Here, we review the available evidence from biological and clinical studies focusing on the relationship between T cell-mediated treatment of hematologic malignancies and age. We discuss biological features potentially impacting clinical outcomes in various scenarios, and potential strategies to improve the safety and efficacy of immune checkpoint inhibitors, T cell-engaging bispecific antibodies, and CAR-T cell therapy in older patients.https://jitc.bmj.com/content/12/12/e009462.full
spellingShingle Tamas Fulop
Abdullah M Khan
Valentín Ortiz-Maldonado
Marcus Vetter
Rainer Wirth
Fabian Ullrich
Paul J Bröckelmann
Amin T Turki
Elena-Diana Chiru
Bastian von Tresckow
Raul Cordoba
Nina Rosa Neuendorff
Impact of immunological aging on T cell-mediated therapies in older adults with multiple myeloma and lymphoma
Journal for ImmunoTherapy of Cancer
title Impact of immunological aging on T cell-mediated therapies in older adults with multiple myeloma and lymphoma
title_full Impact of immunological aging on T cell-mediated therapies in older adults with multiple myeloma and lymphoma
title_fullStr Impact of immunological aging on T cell-mediated therapies in older adults with multiple myeloma and lymphoma
title_full_unstemmed Impact of immunological aging on T cell-mediated therapies in older adults with multiple myeloma and lymphoma
title_short Impact of immunological aging on T cell-mediated therapies in older adults with multiple myeloma and lymphoma
title_sort impact of immunological aging on t cell mediated therapies in older adults with multiple myeloma and lymphoma
url https://jitc.bmj.com/content/12/12/e009462.full
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