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 immunotherapies, including drugs directed against immune checkpoint Programmed cell death protein 1 (PD-1), Programmed cell death protein 1 ligand (PD-L) 1, and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), have become a consolidated treatment strategy regarding various kinds of tumors, with an effective response, and good tolerability towards patients. Patients over 65 years old constitute a large portion of the neoplastic population, and are increasingly represented in medical oncology clinics. Unfortunately, however, these patients are underrepresented in randomized clinical trials. We also know that with aging, the microenvironment and immune cells undergo marked changes that are defined by the term immunosenescence. In this review, we will consider the various studies on im-munotherapy in elderly patients, while 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.