By Sara Bondell - October 26, 2021
Cancer incidence rates increase as people age. According to the Centers for Disease Control and Prevention, more than two-thirds of all new cancers are diagnosed in patients older than 60. Because our immune systems weaken as we age, does this mean immunotherapy treatments are not as effective in older patients as they are in younger ones?
A new study from the Johns Hopkins Kimmel Cancer Center Convergence Institute says no. The findings provide support for expanding the use of immunotherapy treatment in the senior adult patient population.
“Older patients can derive similar benefits from immunotherapy compared to younger patients,” said Dr. Christine Sam, a medical oncologist in the Senior Adult Oncology Program at Moffitt Cancer Center. “It is not a magic bullet and doesn’t work in every cancer, but in many cases, patients can have very good response to these drugs with minimal toxicity.”
Sam says one of the most common types of immunotherapy prescribed to older patients are checkpoint inhibitors. Data on older patients enrolled on some of the landmark checkpoint inhibitor studies in various cancers such as non-small cell lung cancer, kidney cancer and bladder cancer show that older patients have comparable outcomes to younger patients.
Researchers involved in Johns Hopkins study found while although aging is associated with factors that could decrease immune response, biomarkers for immunotherapies could still be used as a basis to select immunotherapy treatment in older patients. However, a variety of other factors may be involved when determining if immunotherapy is appropriate, including overall health and any other medical conditions.
“Chronological age itself is not how we decide whether or not someone is a candidate for cancer directed treatment,” said Sam. “Numerous studies have shown that functional age, which looks at the whole person and how a person functions in daily life—including physiological, psychological and social aspects of daily life—is a far better determinant for how a patient will do with cancer treatment.”
Moffitt’s Senior Adult Oncology Clinic utilizes geriatric screening questions and tests to help more accurately assess the fitness of older patients and select treatment accordingly.
“It is important that patients are informed and have a thorough evaluation, ideally with geriatric screening, when being considered for various cancer therapies,” said Sam. “Many studies show that geriatric assessments can impact an oncologist’s decision making when it comes to treatment choice, and the use of geriatric assessment results in lower treatment toxicity.”