Melanoma has important burden in older populations due to high incidence and aggressive biology. The emergence of immunotherapy with immune checkpoint inhibitors and targeted therapy (BRAF/MEK inhibitors) significantly improved melanoma prognosis. Currently, the body of knowledge on the efficacy and tolerability of these treatments in geriatric patients is primarily based on the results outside of clinical trials since the majority of clinical studies do not include older patients. We present a comprehensive narrative review of published data regarding efficacy and safety of therapeutic modalities using immune checkpoint inhibitors in patients age 65–75 years and >75 years: the anti-cytotoxic T lymphocyte-associated protein 4 (CTLA-4) inhibitor (ipilimumab), the anti-programmed death-ligand 1 (PD-1) inhibitors (nivolumab and pembrolizumab), and the lymphocyte activation gene-3 (LAG-3) inhibitor (relatlimab). We carefully address difficulties in multi-disciplinary clinical decision-making in care of older melanoma patients. Although many older patients may not be offered immunotherapy, the available evidence indicates that immunotherapy is equally beneficial in the older patients and does not have higher incidence of adverse events in this group of patients compared to younger population.
黑色素瘤在老年人群中具有重要的疾病负担，这主要源于其高发病率及侵袭性生物学特性。随着免疫检查点抑制剂免疫疗法及靶向治疗（BRAF/MEK抑制剂）的出现，黑色素瘤的预后得到显著改善。目前，关于这些治疗在老年患者中疗效与耐受性的认知主要基于临床试验外的结果，因为大多数临床研究未纳入老年患者。本文针对65-75岁及75岁以上患者群体，系统综述了已发表的关于免疫检查点抑制剂治疗模式疗效与安全性的数据，包括抗细胞毒性T淋巴细胞相关蛋白4（CTLA-4）抑制剂（伊匹木单抗）、抗程序性死亡配体1（PD-1）抑制剂（纳武利尤单抗和帕博利珠单抗）以及淋巴细胞激活基因-3（LAG-3）抑制剂（瑞拉利单抗）。我们深入探讨了老年黑色素瘤患者多学科临床决策中面临的困难。尽管许多老年患者可能未接受免疫治疗，现有证据表明免疫治疗对老年患者同样有益，且与年轻人群相比，该患者群体的不良事件发生率并未更高。
肿瘤(癌症)患者之家