Department of Surgery, Division of Supportive Care in Cancer, University of Rochester Medical Center, Rochester, NY, USA; James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
J Geriatr Oncol. 2024 Jan;15(1):101655. doi: 10.1016/j.jgo.2023.101655. Epub 2023 Nov 6.
The number of adults aged ≥ 65 years with cancer is rapidly increasing. Older adults with cancer are susceptible to treatment-related acute and chronic adverse events, resulting in loss of independence, reduction in physical function, and decreased quality of life. Nevertheless, evidence-based interventions to prevent or treat acute and chronic adverse events in older adults with cancer are limited. Several promising blood-based biomarkers related to inflammation and epigenetic modifications are available to identify older adults with cancer who are at increased risk of accelerated aging and physical, functional, and cognitive impairments caused by the cancer and its treatment. Inflammatory changes and epigenetic modifications can be reversible and targeted by lifestyle changes and interventions. Here we discuss ways in which changes in inflammatory and epigenetic pathways influence the aging process and how these pathways can be targeted by interventions aimed at reducing inflammation and aging-associated biological markers. As the number of older adults with cancer entering survivorship continues to increase, it is becoming progressively more important to understand ways in which the benefit from treatment can be enhanced while reducing the effects of accelerated aging.
随着≥65 岁癌症患者人数的迅速增加,老年癌症患者易发生与治疗相关的急性和慢性不良事件,导致其丧失独立性、身体功能下降和生活质量降低。然而,预防或治疗老年癌症患者急性和慢性不良事件的循证干预措施有限。目前已有几种有前途的与炎症和表观遗传修饰相关的基于血液的生物标志物,可用于识别癌症及其治疗导致加速衰老以及身体、功能和认知障碍风险增加的老年癌症患者。炎症变化和表观遗传修饰是可以逆转的,并且可以通过生活方式改变和干预措施来靶向治疗。在这里,我们讨论了炎症和表观遗传途径的变化如何影响衰老过程,以及这些途径如何通过旨在减少炎症和与衰老相关的生物标志物的干预措施来靶向治疗。随着进入生存阶段的老年癌症患者人数继续增加,了解如何在增强治疗获益的同时减少加速衰老的影响变得越来越重要。