دورية أكاديمية
Immunotherapy use in older adults with cancer with frailty: A young SIOG review paper.
| العنوان: | Immunotherapy use in older adults with cancer with frailty: A young SIOG review paper. |
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| المؤلفون: | Guven DC; Medical Oncology Clinic, Health Sciences University, Elazig City Hospital, Elazig, Turkey. Electronic address: denizcguven@hotmail.com., Martinez-Cannon BA; Hematology-Oncology Department, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico., Testa GD; Division of Geriatric and Intensive Care Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139 Florence, Italy., Martins JC; Oncologista Clinica, Prevent Senior, São Paulo, Brazil., Velasco RN Jr; Clinical Trial and Research Division, Philippine Heart Center, Quezon City, Philippines., Kalsi T; Department of Ageing and Health, Guys and St Thomas' NHS Foundation Trust, London, UK., Gomes F; Medical Oncology Department, The Christie NHS Foundation Trust, Manchester, UK. |
| المصدر: | Journal of geriatric oncology [J Geriatr Oncol] 2024 May; Vol. 15 (4), pp. 101742. Date of Electronic Publication: 2024 Mar 11. |
| نوع المنشور: | Journal Article; Review; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101534770 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-4076 (Electronic) Linking ISSN: 18794068 NLM ISO Abbreviation: J Geriatr Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Amsterdam : Elsevier |
| مواضيع طبية MeSH: | Neoplasms*/drug therapy , Frailty* , Immune Checkpoint Inhibitors*/therapeutic use , Immune Checkpoint Inhibitors*/adverse effects , Geriatric Assessment*, Humans ; Aged ; Frail Elderly ; Immunotherapy/adverse effects ; Immunotherapy/methods ; Aged, 80 and over |
| مستخلص: | Immune checkpoint inhibitors (ICIs) became a treatment option in most tumor types and improved survival in patients with cancer in the last decade. Older patients with cancer are underrepresented in the pivotal clinical trials with ICIs. Older patients with cancer often have significant comorbidities and geriatric syndromes like frailty, which can complicate cancer care and treatment decisions. Frailty is among the most prevalent geriatric syndromes in patients with cancer and could lead to inferior survival and a higher risk of complications in patients treated with chemotherapy. However, the effect of frailty on the efficacy and safety of ICIs is understudied. This review focuses on the available evidence regarding the association between frailty and ICI efficacy and safety. Although the survival benefits of ICIs have generally been shown to be independent of age, the available real-world data has generally suggested higher rates of immune-related adverse events (irAEs) and treatment discontinuation in older patients. While international organizations recommend conducting a comprehensive geriatric assessment CGA to assess and address frailty before the start of anti-cancer therapies, an Eastern Cooperative Oncology Group (ECOG) performance status of 2 or higher is frequently used in clinical practice as synonymous with frailty, albeit with significant limitations. The available data has generally demonstrated diminished ICI efficacy in patients with an ECOG 2 or higher compared to patients with better performance status, while the incidence of high-grade irAEs were similar. Whilst evidence regarding outcomes with ICI in older patients and in those with sub-optimal performance status is growing, there is very limited data specifically evaluating the role of frailty with ICIs. These studies found a shortened overall survival, yet no evidence of a lower response rate to ICIs. These patients experienced more AEs, but they did not necessarily have a higher incidence of irAEs. Competing Interests: Conflict of Interest The authors declare no potential conflicts of interest. (Copyright © 2024 Elsevier Ltd. All rights reserved.) |
| فهرسة مساهمة: | Keywords: ECOG; Frailty; Immune checkpoint inhibitor; Immunotherapy; Toxicity |
| المشرفين على المادة: | 0 (Immune Checkpoint Inhibitors) |
| تواريخ الأحداث: | Date Created: 20240312 Date Completed: 20240511 Latest Revision: 20240516 |
| رمز التحديث: | 20240517 |
| DOI: | 10.1016/j.jgo.2024.101742 |
| PMID: | 38472009 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1879-4076 |
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| DOI: | 10.1016/j.jgo.2024.101742 |