Immunotherapy for older patients with melanoma: From darkness to light?

Donatella Iacono, Maria Grazia Vitale, Debora Basile, Giacomo Pelizzari, Marika Cinausero, Elena Poletto, Gaetano Pascoletti, Alessandro Marco Minisini

Research output: Contribution to journalReview articlepeer-review

Abstract

Approximately 40% of malignant melanomas are diagnosed in patients older than 65 years. Elderly patients with melanoma present clinicopathological features related to a more aggressive biology, and they are often diagnosed with advanced stage of disease. Interestingly, in older patients the immune system can be altered with changes both in the innate system and in the adaptive immune system with the acquisition of a pro-inflammatory and immune suppressive phenotype. Immunotherapy with immune checkpoint inhibitors has reshaped the treatment strategies and prognosis of patients with melanoma, and particularly, older age should not be considered a contraindication for immunotherapy. However, data regarding efficacy and safety of immunotherapy in elderly population are still limited because frail older patients are generally excluded from clinical trials. Recently, real-world data have shed light on similar efficacy and safety of immunotherapy in older population compared with younger counterpart. The aim of the present review was to summarize the available knowledge on the underlying immune system in older patients with a diagnosis of melanoma and the immunotherapeutic approaches in this population.

Original languageEnglish
JournalPigment Cell and Melanoma Research
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • geriatric assessment
  • immune checkpoints inhibitors
  • immune-related toxicity
  • immunotherapy
  • melanoma
  • older patients

ASJC Scopus subject areas

  • Oncology
  • Biochemistry, Genetics and Molecular Biology(all)
  • Dermatology

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