Checkpoint inhibitors in older patients with advanced non-small cell lung cancer

• Published in: Critical reviews in oncology/hematology 2023-08, Vol.188, p.104056-104056, Article 104056
• Main Authors: Reale, Maria Lucia, Romano, Gianpiero Diego, Paolelli, Loretta, Leo, Silvana
• Format: Article
• Language: English
• Subjects: Elderly patients; Geriatric assessment; Immunotherapy; NSCLC
• ISSN: 1040-8428; 1879-0461
• DOI: 10.1016/j.critrevonc.2023.104056

Immune checkpoint inhibitors (ICIs) have revolutionized lung cancer management improving overall survival and providing durable responses with a favorable toxicity profile. New questions have emerged regarding the efficacy and safety of immunotherapy among older adults, typically underrepresented in clinical trials. Several factors have to be taken into account in order to reduce the realistic risk of over or under-treatment of this growing subgroup of patients. In this perspective, geriatric assessment and screening tools should be implemented in clinical practice; moreover older patients’ inclusion into adapted-designed clinical trials should be promoted. In this review, we discuss immunotherapy activity in advanced non-small cell lung cancer (NSCLC) older patients, the role of the comprehensive geriatric assessment, treatment toxicity and its management with a focus on future perspectives in this rapidly evolving scenario. [Display omitted] •Immunotherapy has revolutionized management in lung cancer patients of all ages.•Older adults with advanced NSCLC are underrepresented in clinical trials.•Attempts to evaluate immunotherapy among frail older adults are ongoing.•Toxicity management should consider comorbidities in a multidisciplinary approach.