Immune Checkpoint Blockade for Advanced NSCLC: A New Landscape for Elderly Patients

• Published in: International journal of molecular sciences Vol. 20; no. 9; p. 2258
• Main Authors: Perrotta, Fabio, Rocco, Danilo, Vitiello, Fabiana, De Palma, Raffaele, Guerra, Germano, De Luca, Antonio, Navani, Neal, Bianco, Andrea
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 07.05.2019; MDPI
• Subjects: Age; Aging; Antigens; Cancer therapies; Chemotherapy; Clinical trials; Cytotoxicity; FDA approval; Immune checkpoint inhibitors; Immune system; Immunotherapy; Ligands; Lung cancer; Lymphocytes; Medical prognosis; Medical research; Mutation; Older people; Population; Precision medicine; Proteins; Review; Senescence; T cell receptors; Tumors; precision oncology; Elderly patient; Immune checkpoint inhibitors; NSCLC; PD-1/PD-L1; biological big data
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms20092258

The therapeutic scenario for elderly patients with advanced NSCLC has been limited to radiotherapy and chemotherapy. Recently, a novel therapeutic approach based on targeting the immune-checkpoints has showed noteworthy results in advanced NSCLC. PD1/PD-L1 pathway is co-opted by tumor cells through the expression of PD-L1 on the tumor cell surface and on cells within the microenvironment, leading to suppression of anti-tumor cytolytic T-cell activity by the tumor. The success of immune-checkpoints inhibitors in clinical trials led to rapid approval by the FDA and EMA. Currently, data regarding efficacy and safety of ICIs in older subjects is limited by the poor number of elderly recruited in clinical trials. Careful assessment and management of comorbidities is essential to achieve better outcomes and limit the immune related adverse events in elderly NSCLC patients.