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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author Marcus Vetter
Vérène Dougoud-Chauvin
Laure Poudens Gaudout
Anita Margulies
Jan Gärtner
Till Wallrabenstein
Nina Rosa Neuendorff
Claudia Bollinger
Michael Gagesch
Mathias Schlögl
author_facet Marcus Vetter
Vérène Dougoud-Chauvin
Laure Poudens Gaudout
Anita Margulies
Jan Gärtner
Till Wallrabenstein
Nina Rosa Neuendorff
Claudia Bollinger
Michael Gagesch
Mathias Schlögl
author_sort Marcus Vetter
collection DOAJ
description 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.
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publishDate 2024-12-01
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spelling doaj-art-b47b7811cfd6496b8fc5dd88309da40e2025-08-20T02:33:38ZengTHE HEALTHBOOK COMPANY LTD.healthbook TIMES. Oncology Hematology2673-20922673-21062024-12-0122410.36000/HBT.OH.2024.22.165Immune Checkpoint Inhibitors in Frail Older Patients: A Review of Current EvidenceMarcus VetterVérène Dougoud-ChauvinLaure Poudens GaudoutAnita MarguliesJan GärtnerTill WallrabensteinNina Rosa NeuendorffClaudia BollingerMichael GageschMathias SchlöglAge-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.https://doi.org/10.36000/HBT.OH.2024.22.165
spellingShingle Marcus Vetter
Vérène Dougoud-Chauvin
Laure Poudens Gaudout
Anita Margulies
Jan Gärtner
Till Wallrabenstein
Nina Rosa Neuendorff
Claudia Bollinger
Michael Gagesch
Mathias Schlögl
Immune Checkpoint Inhibitors in Frail Older Patients: A Review of Current Evidence
healthbook TIMES. Oncology Hematology
title Immune Checkpoint Inhibitors in Frail Older Patients: A Review of Current Evidence
title_full Immune Checkpoint Inhibitors in Frail Older Patients: A Review of Current Evidence
title_fullStr Immune Checkpoint Inhibitors in Frail Older Patients: A Review of Current Evidence
title_full_unstemmed Immune Checkpoint Inhibitors in Frail Older Patients: A Review of Current Evidence
title_short Immune Checkpoint Inhibitors in Frail Older Patients: A Review of Current Evidence
title_sort immune checkpoint inhibitors in frail older patients a review of current evidence
url https://doi.org/10.36000/HBT.OH.2024.22.165
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