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International journal of molecular sciences
Feb 27, 2025;26 (5):

Immunotherapy for Elderly Patients with Advanced Non-Small Cell Lung Cancer: Challenges and Perspectives.

Anass Baladi, Hassan Abdelilah Tafenzi, Othmane Zouiten, Leila Afani, Ismail Essaadi, Mohammed El Fadli, Rhizlane Belbaraka
Author Information
  1. Anass Baladi: Department of Medical Oncology, Mohammed VI University Hospital, Marrakech 40000, Morocco. ORCID
  2. Hassan Abdelilah Tafenzi: Department of Medical Oncology, Mohammed VI University Hospital, Marrakech 40000, Morocco.
  3. Othmane Zouiten: Department of Medical Oncology, Mohammed VI University Hospital, Marrakech 40000, Morocco.
  4. Leila Afani: Department of Medical Oncology, Mohammed VI University Hospital, Marrakech 40000, Morocco.
  5. Ismail Essaadi: Laboratory of Biosciences and Health, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Morocco. ORCID
  6. Mohammed El Fadli: Department of Medical Oncology, Mohammed VI University Hospital, Marrakech 40000, Morocco. ORCID
  7. Rhizlane Belbaraka: Department of Medical Oncology, Mohammed VI University Hospital, Marrakech 40000, Morocco.
PMID: 40076743 DOI: 10.3390/ijms26052120

Abstract

Lung cancer, a leading cause of cancer-related mortality, disproportionately affects the elderly, who face unique challenges due to comorbidities and reduced organ function. Immune checkpoint inhibitors (ICIs) offer a more tolerable alternative to chemotherapy, but their efficacy and safety in elderly non-small cell lung cancer (NSCLC) patients remain underexplored due to limited representation in clinical trials. A narrative literature review was conducted using PubMed, Embase, and the Cochrane Library to evaluate studies on elderly NSCLC patients (≥65 years) treated with ICIs. Key outcomes assessed included overall survival, progression-free survival, response rates, treatment-related adverse events, and the influence of immunosenescence on treatment efficacy. The review highlighted evidence supporting the efficacy and safety of ICIs in elderly NSCLC patients, particularly those with good performance status. Age-related immunosenescence may affect outcomes, emphasizing the need for individualized treatment. Limited data suggest ICIs alone may be preferable to chemo-immunotherapy for patients over 75 years. However, the exclusion of elderly patients from clinical trials and methodological limitations reduces the generalizability of these findings. ICIs hold promise for advanced NSCLC in older adults, but tailored approaches and greater elderly inclusion in trials are needed to optimize outcomes.

Keywords

elderly patients immune checkpoint inhibitors immunosenescence lung cancer non-small cell lung cancer

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MeSH Term

Humans
Carcinoma, Non-Small-Cell Lung
Lung Neoplasms
Aged
Immunotherapy
Immune Checkpoint Inhibitors
Aged, 80 and over
Treatment Outcome

Chemicals

Immune Checkpoint Inhibitors
Journal Article Review
Article has an altmetric score of 1

Word Cloud

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