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Semin Oncol. 2018 Aug;45(4):187-200. doi: 10.1053/j.seminoncol.2018.08.006. Epub 2018 Oct 24.

Aging, immune senescence, and immunotherapy: A comprehensive review.

Author information

1
Hartford HealthCare Cancer Institute, Hartford Hospital, Hartford, CT, USA. Electronic address: rawad.elias@hhchealth.org.
2
Section of Hematology Oncology, Boston University School of Medicine, Boston, MA, USA.
3
Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
4
Department of Medicine, Boston Medical Center, Boston University School of Medicine, MA, USA.
5
Department of Microbiology, Boston University School of Medicine, Boston, MA, USA; Flow Cytometry Core Facility, Boston University School of Medicine, Boston, MA, USA.

Abstract

The advent of immune checkpoint inhibitors (ICIs) has changed the landscape of cancer treatment. Older adults represent the majority of cancer patients; however, direct data evaluating ICIs in this patient population is lacking. Aging is associated with changes in the immune system known as "immunosenescence" that could impact the efficacy and safety profile of ICIs. In this paper, we review aging-associated changes in the immune system as they may relate to cancer and immunotherapy, with mention of the effect of chronic viral infections and frailty. Furthermore, we summarize the current clinical evidence of ICI effectiveness and toxicity among older adults with cancer.

KEYWORDS:

Checkpoint inhibitors; Frailty; Immune senescence; Immunotherapy; Older adults

[Indexed for MEDLINE]

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