协和医学杂志

2020, v.11(04) 459-464

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老年肿瘤免疫检查点抑制剂临床治疗进展
Clinical Progress of Immune Checkpoint Inhibitors in the Elderly

唐辉;周建凤;白春梅;
TANG Hui;ZHOU Jian-feng;BAI Chun-mei;Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &Peking Union Medical College;

摘要(Abstract):

免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)是当今肿瘤治疗领域的革命性突破,改变了多种肿瘤治疗模式。老年人占肿瘤现患人数及死亡人数的绝大部分,老年肿瘤患者存在免疫衰老、自身免疫性疾病及感染性疾病发生率高、肿瘤突变负荷与年轻患者存在差异等均可能影响ICIs疗效。在大部分ICIs临床试验中,老年肿瘤患者在受试人群中未能占据应有比例,亚组分析及荟萃分析结果提示年龄对疗效及免疫相关不良反应的发生影响较小。临床医生可参考相关试验数据,在体能状态较好的老年肿瘤患者中使用ICIs,以积累更多的真实世界数据。
The use of immune checkpoint inhibitors(ICIs) is a revolutionary breakthrough in cancer treatment, which has changed the treatment modality for many types of tumors. The elderly account for the majority of cancer cases and deaths. There are some factors that may affect the treatment of ICIs in aging patients, such as immunosenescence, high incidence of autoimmune diseases and infectious diseases, and difference of tumor mutational burden from young patients. In most clinical trials of ICIs, aging patients did not account for the due proportion of the participants. Results of subgroup analysis and meta-analysis showed that age had little effect on the efficacy of ICIs and immune-related adverse events. Clinicians can refer to the relevant trial data and administer ICIs in elderly cancer patients with good physical condition to accumulate more real-world data.

关键词(KeyWords): 免疫衰老;肿瘤;免疫检查点抑制剂;老年人
immunosenescence;tumor;immune checkpoint inhibitors;the elderly

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基金项目(Foundation): 中国医学科学院医学与健康科技创新工程(2016-12M-1-001)

作者(Author): 唐辉;周建凤;白春梅;
TANG Hui;ZHOU Jian-feng;BAI Chun-mei;Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &Peking Union Medical College;

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