■免疫疗法彻底改变了癌症治疗;然而,对老年人的功效和毒性知之甚少,一个队列占癌症病例总数的一半以上。在这次审查中,我们的目标是深入了解目前关于免疫疗法在老年人群中的临床效用和副作用的知识库,并找出文献中的关键空白,其中进一步研究至关重要.
■我们对现有文献进行了快速的批判性审查,重点研究报告年龄≥65岁的癌症患者使用免疫治疗的情况。该综述评估了包括不同类型癌症的研究,有多种研究类型(尽管主要是回顾性的),有不同的研究持续时间,并报告了不同的兴趣结果。由于这种异质性,荟萃分析和研究之间的直接比较是不可行的。
■总的来说,审查结果表明,当使用免疫治疗药物治疗时,某些恶性肿瘤在年轻和老年群体中显示出相当的存活率,免疫疗法相关副作用的发生率因年龄组而异,一般来说,缺乏对老年患者或包括老年患者的免疫治疗临床结局的决定因素的研究。
■增强的临床益处以及与免疫疗法相关的更好的耐受性使其成为常规化疗药物的有吸引力的替代品,尤其是老年患者。目前,评估免疫疗法临床结果的研究数量有限,尤其是老年人。总的来说,我们的研究结果反映了需要进一步的前瞻性研究,重点是代表现实生活人群的老年患者,为了更准确地理解临床效用,毒性概况,免疫检查点抑制剂在老年癌症患者中的成本效益。
UNASSIGNED: Immunotherapies have revolutionized cancer treatment; however, relatively little is known about their efficacy and toxicity in the elderly, a cohort accounting for more than half of total cancer cases. In this
review, we aim to provide insight into the current knowledge base regarding the clinical utility and side effects of immunotherapies in the geriatric population as well as identify key gaps in the literature where further research is essential.
UNASSIGNED: We conducted a rapid critical
review of available literature, focusing on studies reporting on use of immunotherapy in cancer patients aged ≥65 years. The
review assessed studies that included different types of cancer, were of multiple study types (although predominantly retrospective), had different study duration, and reported different outcomes of interest. Owing to this heterogeneity, meta-analysis and a direct comparison between studies were not feasible.
UNASSIGNED: Overall, the
review findings indicate that certain malignancies have shown comparable survival rates in younger and older age groups when managed with immunotherapeutic drugs, the incidence of immunotherapy-related side effects varies only slightly by age groups, and in general there is a lack of studies on the determinants of the clinical outcomes of immunotherapy in or including geriatric patients.
UNASSIGNED: Enhanced clinical benefits along with better tolerability associated with immunotherapies make it an attractive alternative to conventional chemotherapeutic drugs, especially in elderly patients. There is currently a limited number of studies assessing the clinical outcomes of immunotherapies, particularly in the elderly. Overall, our findings reflect a need for further prospective studies focussing on geriatric patients representative of the real-life population, in order to derive a more precise understanding of the clinical utility, toxicity profile, and cost-effectiveness of immune checkpoint inhibitors in older patients with cancer.