Varied responses to immunotherapy among elderly lung cancer patients reveal the need for more age-inclusive research and clinical trials.
The proportion of the U.S. population that is over 65 years of age has risen. Almost 50 million people are in this age range, a result of medical advancements which improve survival. However, cancer incidence has increased in this same age-group. More specifically, the 75 to 84-year-old age group has the highest percentage of cancer deaths. This increased incidence of cancer in the elderly may be associated with changes that occur in the immune system with advancing age.
Immunotherapy is a promising cancer treatment approach, and the use of checkpoint inhibitors has shown more successes to date. Despite this, most data available regarding the use of immunotherapy as a cancer treatment is from younger patients, and clinical trials including sufficient numbers of elderly patients is quite limited. Furthermore, elderly patients who are included in clinical trials tend to have good overall health status.
Researchers at the National Hospital Organization Kyushu Cancer Center in Fukuoka, Japan analyzed data from three clinical trials comparing pembrolizumab monotherapy with conventional chemotherapy in patients with non-small cell lung cancer (NSCLC). The pooled data included 264 patients with an age range of 75-90 years and over 2,000 patients under 75 years of age. The results showed that treatment with pembrolizumab was associated with longer overall survival in both age groups when compared to chemotherapy treatment.
A retrospective study with patients who also had NSCLC was conducted by researchers at the Hospital Universitario Ramon y Cajal in Madrid. The results of this study were different in that patients who were 70 years of age or older had significantly shorter overall survival than patients under 70 years old. Immunosenescence may affect how elderly patients can respond to immunotherapy, and more clinical studies including higher numbers of elderly patients are necessary to study how this population of patients can benefit from cancer immunotherapy.
Reference: Studies show varying efficacy of immunotherapy in elderly patients with lung cancer. (2019). Healio.com. Retrieved 17 June 2019, from https://www.healio.com/hematology-oncology/lung-cancer/news/online/%7Bbfea952e-3b02-4ef6-86b1-a3eb54a7f495%7D/studies-show-varying-efficacy-of-immunotherapy-in-elderly-patients-with-lung-cancer