Immunotherapy in Elderly Patients: A Review

Abstract

Immunotherapy is a recently developed treatment against most forms of cancer. Although since the early 1990s, many advances have been made with the finding of new drugs, as chemotherapy and molecular targeted therapies, the latest drugs approved for cancer treatment are mostly immunotherapy. These, including drugs directed against immune checkpoint PD-1, PD-L1 and CTLA-4, have become a consolidated treatment strategy regarding various kinds of tumours, with an effective response, and good tolerability towards patients. Older patients, aged over 65 years, constitute a large portion of neoplastic population, and are increasingly represented in medical oncology clinics. Unfortunately, however, these patients are underrepresented in randomized clinical trials, and we also know that with aging the microenvironment and immune cells undergo marked changes that are defined with the term of immunosenescence. In this review we will consider the various studies on immunotherapy in elder patients, evaluating the subgroup analyses to better clarify the efficacy and safety that immunotherapy shows in this frail population in which the treatment strategy must be carefully selected. Key words: Immunotherapy, aging, cancers, anti PD-L1, safety