Immune Checkpoint Inhibitors in Frail Older Patients: A Review of Current Evidence

Age-related physiological changes, such as impaired organ function (i.e., renal, cardiac), frailty, reduced bone marrow reserves and altered pharmacokinetics, complicate treatment decisions and compromise survival in older patients with cancer. Immune checkpoint inhibitors (ICIs) have transformed th...

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Main Authors: Marcus Vetter, Vérène Dougoud-Chauvin, Laure Poudens Gaudout, Anita Margulies, Jan Gärtner, Till Wallrabenstein, Nina Rosa Neuendorff, Claudia Bollinger, Michael Gagesch, Mathias Schlögl
Format: Article
Language:English
Published: THE HEALTHBOOK COMPANY LTD. 2024-12-01
Series:healthbook TIMES. Oncology Hematology
Online Access:https://doi.org/10.36000/HBT.OH.2024.22.165
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Summary:Age-related physiological changes, such as impaired organ function (i.e., renal, cardiac), frailty, reduced bone marrow reserves and altered pharmacokinetics, complicate treatment decisions and compromise survival in older patients with cancer. Immune checkpoint inhibitors (ICIs) have transformed the landscape of cancer treatment, offering significant survival benefits across various malignancies, including older populations. However, aging can influence the effectiveness of ICIs and increase patient susceptibility to immune-related toxicities, resulting in poorer outcomes. The impact of age and frailty on the effectiveness and safety of ICI therapy remains poorly understood. This review examines recent data on the use of ICIs in older, frail patients with cancer. Existing evidence highlights the need for personalized approaches when using ICIs and calls for further research on treatment adaptations that could maximize benefits while minimizing risks in this vulnerable population. PEER REVIEWED ARTICLE **Peer reviewers:** Dr Ursula Hasler-Strub, Cantonal Hospital Graubünden, Chur, Switzerland Dr Andreas Hochstrasser, Hospital Simmental-Thun-Saanenland (STS), Thun, Switzerland Received on November 11, 2024; accepted after peer review on December 28, 2024; published online on December 30, 2024.
ISSN:2673-2092
2673-2106