Safety and efficacy of combined radiotherapy, immunotherapy and targeted agents in elderly patients: A literature review
Abstract
Purpose Aim of the present review is to assess present data about the use of the association of Radiotherapy (RT) and targeted therapy/immunotherapy (TT/IT) in elderly people.Design PubMed database was searched for English literature published up to December 2017 using the keywords "radiotherapy" combined with "bevacizumab", "cetuximab", "trastuzumab", "erlotinib", "gefitinib", "sorafenib", "sunitinib", "vismodegib", "sonidegib", "ipilimumab", "pembrolizumab", "nivolumab". Studies performing RT and TT/IT in people aged >65-years were evaluated focusing on safety, toxicity and efficacy. Studies eligible for inclusion were: case reports, retrospective/prospective studies in which RT and new drugs were used concomitantly or sequentially, focusing on elderly sub-group.Results The systematic search identified 626 records. After exclusion of duplicates, full-text review, cross-referencing and paper that did not respect the inclusion criteria, 81 studies were included in this review. In elderly patients the combination of RT with cetuximab or bevacizumab seems feasible but with higher reported side effects. Patients' age should not limit the association of trastuzumab and RT in HER2 positive breast cancer. The concurrent administration of TKIs and RT appears to be feasible and effective. Regarding the Immune Check Point inhibitors and RT, tolerance seems similar among older and younger people but definitive data are lacking. Instead, the association of RT and vismodegib/sonidegib remains investigational.Conclusion TT/IT in association of RT seems to be safe, but in elderly patients data concerning safety and toxicity are limited. Specific clinical trials on this population are encouraged.
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The effect of ICB antibody therapy on elderly patients has not been fully elucidated.
“therefore, the effect of ICB antibody therapy on elderly patients has not been fully elucidated [162].”
From Immunosenescence: a key player in cancer development (2020) · cites this paper as [162]
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Immunosenescence: a key player in cancer development
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- Authors
- Belgioia, L., Desideri, I., Errico, A., Franzese, C., Daidone, A., Marino, L., Fiore, M., Borghetti, P., Greto, D., & Fiorentino, A.
- Affiliations
- Ospedale Policlinico San Martino (IT)
- University of Florence (IT)
- Fondazione Humanitas per la Ricerca (IT)
- Università Campus Bio-Medico (IT)
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Ospedale Generale Regionale Francesco Miulli (IT)
- Corresponding author
- Fiorentino, Alba
- ORCID
- Venue
- Critical Reviews in Oncology/Hematology
- Publisher
- Elsevier BV
- Published
- 2019-01
- Volume
- 133
- Pages
- 163-170
- ISSN
- 1040-8428 (ISSN-L)
- OpenAlex
- W2902317782
- Cited by
- 35
- References
- 80
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 3 · 2023: 3 · 2022: 6 · 2021: 5 · 2020: 8 · 2019: 4
- FWCI
- 0.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Critical Reviews in Oncology/Hematology (publishedVersion)
- PubMed (publishedVersion)
- Florence Research (University of Florence) (submittedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
- Keywords
- radiotherapy, immunotherapy, targeted therapy, elderly patients, combination therapy, bevacizumab, cetuximab, trastuzumab, HER2-positive breast cancer, tyrosine kinase inhibitors, immune checkpoint inhibitors, vismodegib, sonidegib, treatment toxicity, treatment efficacy
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Aging, Antineoplastic Combined Chemotherapy Protocols, Combined Modality Therapy, Humans, Immunotherapy, Neoplasms, Treatment Outcome, Chemotherapy, Adjuvant, Radiotherapy, Adjuvant, Molecular Targeted Therapy, Chemoradiotherapy
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