Impact of Patient Age on Clinical Efficacy and Toxicity of Checkpoint Inhibitor Therapy

The addition of immune checkpoint inhibitors (ICIs) to the therapeutic armamentarium for solid malignancies has resulted in unprecedented improvements in patient outcomes in many cancers. The landscape of ICIs continues to evolve with novel approaches such as dual immune checkpoint blockade and comb...

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Autores principales:	Selina K. Wong, Caroline A. Nebhan, Douglas B. Johnson
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	age geriatric PD-1 Nivolumab Pembrolizumab ipilimumab Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/07c9e054d32446cb97d320077b60b483
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spelling	oai:doaj.org-article:07c9e054d32446cb97d320077b60b4832021-11-16T06:20:56ZImpact of Patient Age on Clinical Efficacy and Toxicity of Checkpoint Inhibitor Therapy1664-322410.3389/fimmu.2021.786046https://doaj.org/article/07c9e054d32446cb97d320077b60b4832021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fimmu.2021.786046/fullhttps://doaj.org/toc/1664-3224The addition of immune checkpoint inhibitors (ICIs) to the therapeutic armamentarium for solid malignancies has resulted in unprecedented improvements in patient outcomes in many cancers. The landscape of ICIs continues to evolve with novel approaches such as dual immune checkpoint blockade and combination therapies with other anticancer agents including cytotoxic chemotherapies and/or antiangiogenics. However, there is significant heterogeneity seen in antitumor responses, with certain patients deriving durable benefit, others experiencing initial benefit followed by acquired resistance necessitating change in therapy, and still others who are primarily refractory to ICIs. While generally better tolerated than traditional cytotoxic chemotherapy, ICIs are associated with unique toxicities, termed immune-related adverse events (irAEs), which can be severe or even lethal. As a disease of aging, older individuals make up a large proportion of patients diagnosed with cancer, yet this population is often underrepresented in clinical trials. Because ICIs indirectly target malignant cells through T cell activation, it has been hypothesized that age-related changes to the immune system may impact the efficacy and toxicity of these drugs. In this review, we discuss differences in the clinical efficacy and toxicity of ICIs in patients at the extremes of age.Selina K. WongCaroline A. NebhanDouglas B. JohnsonFrontiers Media S.A.articleagegeriatricPD-1NivolumabPembrolizumabipilimumabImmunologic diseases. AllergyRC581-607ENFrontiers in Immunology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	age geriatric PD-1 Nivolumab Pembrolizumab ipilimumab Immunologic diseases. Allergy RC581-607
spellingShingle	age geriatric PD-1 Nivolumab Pembrolizumab ipilimumab Immunologic diseases. Allergy RC581-607 Selina K. Wong Caroline A. Nebhan Douglas B. Johnson Impact of Patient Age on Clinical Efficacy and Toxicity of Checkpoint Inhibitor Therapy
description	The addition of immune checkpoint inhibitors (ICIs) to the therapeutic armamentarium for solid malignancies has resulted in unprecedented improvements in patient outcomes in many cancers. The landscape of ICIs continues to evolve with novel approaches such as dual immune checkpoint blockade and combination therapies with other anticancer agents including cytotoxic chemotherapies and/or antiangiogenics. However, there is significant heterogeneity seen in antitumor responses, with certain patients deriving durable benefit, others experiencing initial benefit followed by acquired resistance necessitating change in therapy, and still others who are primarily refractory to ICIs. While generally better tolerated than traditional cytotoxic chemotherapy, ICIs are associated with unique toxicities, termed immune-related adverse events (irAEs), which can be severe or even lethal. As a disease of aging, older individuals make up a large proportion of patients diagnosed with cancer, yet this population is often underrepresented in clinical trials. Because ICIs indirectly target malignant cells through T cell activation, it has been hypothesized that age-related changes to the immune system may impact the efficacy and toxicity of these drugs. In this review, we discuss differences in the clinical efficacy and toxicity of ICIs in patients at the extremes of age.
format	article
author	Selina K. Wong Caroline A. Nebhan Douglas B. Johnson
author_facet	Selina K. Wong Caroline A. Nebhan Douglas B. Johnson
author_sort	Selina K. Wong
title	Impact of Patient Age on Clinical Efficacy and Toxicity of Checkpoint Inhibitor Therapy
title_short	Impact of Patient Age on Clinical Efficacy and Toxicity of Checkpoint Inhibitor Therapy
title_full	Impact of Patient Age on Clinical Efficacy and Toxicity of Checkpoint Inhibitor Therapy
title_fullStr	Impact of Patient Age on Clinical Efficacy and Toxicity of Checkpoint Inhibitor Therapy
title_full_unstemmed	Impact of Patient Age on Clinical Efficacy and Toxicity of Checkpoint Inhibitor Therapy
title_sort	impact of patient age on clinical efficacy and toxicity of checkpoint inhibitor therapy
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/07c9e054d32446cb97d320077b60b483
work_keys_str_mv	AT selinakwong impactofpatientageonclinicalefficacyandtoxicityofcheckpointinhibitortherapy AT carolineanebhan impactofpatientageonclinicalefficacyandtoxicityofcheckpointinhibitortherapy AT douglasbjohnson impactofpatientageonclinicalefficacyandtoxicityofcheckpointinhibitortherapy
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Impact of Patient Age on Clinical Efficacy and Toxicity of Checkpoint Inhibitor Therapy

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