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首页> 外文期刊>Journal of geriatric oncology >The development of immunotherapy in older adults: New treatments, new toxicities?
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The development of immunotherapy in older adults: New treatments, new toxicities?

机译：老年人免疫疗法的发展：新疗法，新毒性？

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Monoclonal antibodies targeting immune checkpoint molecules CTLA-4, PD-1 or PD-L1 are emerging as promising anticancer therapeutics in multiple cancer subtypes resulting in remarkable and long-lasting clinical responses. These immune checkpoint blockers (ICBs) have already obtained approval for the treatment of patients with metastatic melanoma, advanced/refractory non-small cell lung cancer and renal cell cancer. ICBs enhance immune responses against cancer cells but can also lead to inflammatory side effects called immune-related adverse events (irAEs). Such toxicities are distinct from those associated with traditional chemotherapeutic agents or molecularly targeted therapies. Although severe irAEs remain rare (similar to 10% of cases under monotherapy), they can become life-threatening if not anticipated and managed appropriately. As malignancies are frequently diagnosed in older patients, ICB treatment of elderly presents a unique challenge. However, the knowledge about efficacy and toxicity of these molecules in this specific population is limited, as most of the studies have involved a low number of older patients. In this review, we will discuss about the different ICB efficacy data available for older patients. We will then highlight the specific spectrum of immunotherapy toxicities and talk about their management in the context of older adults. (C) 2016 Elsevier Ltd. All rights reserved.
机译：靶向免疫检查点分子CTLA-4，PD-1或PD-L1的单克隆抗体正在成为多种癌症亚型中有希望的抗癌治疗剂，从而产生了显着而持久的临床反应。这些免疫检查点阻滞剂（ICB）已获得批准用于治疗转移性黑色素瘤，晚期/难治性非小细胞肺癌和肾细胞癌。 ICB增强了针对癌细胞的免疫反应，但也可能导致称为免疫相关不良事件（irAEs）的炎症性副作用。这样的毒性不同于与传统化学治疗剂或分子靶向疗法有关的毒性。尽管严重的irAE仍然很少见（约占单药治疗病例的10％），但如果没有适当的预期和适当的治疗，它们可能会危及生命。由于在老年患者中经常诊断出恶性肿瘤，因此ICB对老年患者的治疗提出了独特的挑战。但是，由于大多数研究涉及的老年患者数量很少，因此在这些特定人群中对这些分子的功效和毒性的了解有限。在这篇综述中，我们将讨论可用于老年患者的不同ICB疗效数据。然后，我们将重点介绍免疫疗法毒性的具体范围，并讨论在老年人中的治疗方法。 （C）2016 Elsevier Ltd.保留所有权利。

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