Immune Checkpoint Blockade for Advanced NSCLC: A New Landscape for Elderly Patients.
Fabio PerrottaDanilo RoccoFabiana VitielloRaffaele De PalmaGermano GuerraAntonio De LucaNeal NavaniAndrea BiancoPublished in: International journal of molecular sciences (2019)
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.
Keyphrases
- small cell lung cancer
- clinical trial
- community dwelling
- middle aged
- advanced non small cell lung cancer
- cell surface
- end stage renal disease
- brain metastases
- induced apoptosis
- stem cells
- locally advanced
- newly diagnosed
- ejection fraction
- early stage
- poor prognosis
- chronic kidney disease
- physical activity
- cell cycle arrest
- prognostic factors
- epidermal growth factor receptor
- cancer therapy
- electronic health record
- cell death
- radiation induced
- type diabetes
- signaling pathway
- endoplasmic reticulum stress
- phase ii
- open label
- binding protein
- cell proliferation
- oxidative stress
- deep learning
- long non coding rna
- drug induced
- loop mediated isothermal amplification
- tyrosine kinase
- artificial intelligence