Singhi Eric K, Mott Frank, Worst Michelle, Leung Cheuk Hong, Lee J Jack, Carter Brett, Presley Carolyn J, Heymach John V, Altan Mehmet
Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Medscape Oncology, New York, NY 10014, USA.
Oncol Lett. 2023 May 3;25(6):262. doi: 10.3892/ol.2023.13848. eCollection 2023 Jun.
Immunotherapy is an effective and generally well-tolerated treatment strategy for older adult patients (aged ≥70 years) with advanced non-small cell lung cancer (NSCLC). Unfortunately, most patients who receive immunotherapy eventually exhibit disease progression during treatment. The present study reports on a subset of older adult patients with advanced NSCLC who could effectively continue immunotherapy beyond radiographic disease progression due to perceived clinical benefit. Local consolidative radiotherapy may be used in select older adult patients to prolong the duration of immunotherapy they receive, with a particular consideration of their preexisting co-morbidities, performance status and tolerance of potential toxicities associated with combined modality therapy. However, prospective research is needed to determine which patients benefit most from the addition of local consolidative radiotherapy, including whether type of disease progression (i.e., sites of progression, pattern of progression) and/or extent of consolidation offered (i.e., complete or incomplete) impact clinical outcomes. Further research is also warranted to determine which patients would most benefit from the continuation of immunotherapy beyond documented radiographic disease progression.
免疫疗法是治疗老年(≥70岁)晚期非小细胞肺癌(NSCLC)患者的一种有效且总体耐受性良好的治疗策略。不幸的是,大多数接受免疫疗法的患者最终在治疗期间会出现疾病进展。本研究报告了一部分晚期NSCLC老年患者,由于察觉到临床获益,他们在影像学检查显示疾病进展后仍能有效继续接受免疫疗法。对于部分老年患者,可采用局部巩固放疗来延长其接受免疫疗法的时间,尤其要考虑他们已有的合并症、体能状态以及对联合治疗潜在毒性的耐受性。然而,需要开展前瞻性研究以确定哪些患者从添加局部巩固放疗中获益最大,包括疾病进展类型(即进展部位、进展模式)和/或提供的巩固范围(即完全或不完全)是否会影响临床结局。还需要进一步研究来确定哪些患者在影像学检查记录显示疾病进展后继续接受免疫疗法获益最大。