[Efficacy and toxicity of immune checkpoint inhibitors in elderly patients - 5th edition of the congress of pharmacology of anticancer drugs]

Bull Cancer. 2018 Dec;105(12):1202-1208. doi: 10.1016/j.bulcan.2018.10.004. Epub 2018 Nov 22.
[Article in French]

Abstract

Physiological aging causes qualitative or quantitative immune system decline, also called immunosenescence. Older people with cancer are often ineligible for chemotherapy. The new immunotherapies (with PD1, PDL1 and CTLA4 checkpoint inhibitors) have proven their effectiveness in many tumor types regardless of age and are often better tolerated than chemotherapy. In the older population, the subgroup data from the different pivotal studies show fairly reassuring efficacy and safety data, despite the frequent lack of power given the small population included. There remains, however, some doubt that age may be a risk factor for hyperprogression. Studies focusing on older subjects and dedicated meta-analysis seem necessary to obtain more accurate data.

Keywords: Adverse event; Efficacité; Efficacy; Elderly people; Immune checkpoint inhibitors; Inhibiteurs de points de contrôle immuns; Personnes âgées; Tolérance.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antineoplastic Agents, Immunological / adverse effects
  • Antineoplastic Agents, Immunological / therapeutic use*
  • B7-H1 Antigen / antagonists & inhibitors
  • CTLA-4 Antigen / antagonists & inhibitors
  • Humans
  • Immunosenescence*
  • Immunotherapy* / adverse effects
  • Neoplasms / therapy*
  • Nivolumab / therapeutic use
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents, Immunological
  • B7-H1 Antigen
  • CD274 protein, human
  • CTLA-4 Antigen
  • CTLA4 protein, human
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor
  • Nivolumab
  • atezolizumab
  • pembrolizumab