Immunotherapy is effective against a variety of cancers, with sometimes spectacular results. But I worry about how effective it is in people over age 65, who make up half of cancer patients.
We know that immunotherapy is tolerated by older individuals. But how well they respond to it and the side effects it causes them may be different from those observed in most clinical studies for two reasons. One is that clinical trials tend to include younger participants. The other is because of an aging process known as immunosenescence. It causes the immune system to change and become less effective over time.
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But we don’t know as much as we should about immunotherapy for older individuals as they are poorly represented in clinical trials. In 2013, individuals between the ages of 65 and 69 years made up 17 percent of clinical trial participants, those between the ages of 75 and 79 years made up 8 percent, and those who were 80 years and older made up only 4 percent.
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To help everyone — physicians, researchers, and patients — better understand how the immune system changes with age and how those changes could influence the success of immunotherapy, future studies must include a more representative elderly population, including those with multiple health issues.
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