Safety and efficacy of combined radiotherapy, immunotherapy and targeted agents in elderly patients

A literature review

AIRO Giovani Italian Association of Radiation Oncology-Young Members Working Group

Research output: Contribution to journalReview article

2 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)163-170
Number of pages8
JournalCritical Reviews in Oncology/Hematology
Volume133
DOIs
Publication statusPublished - Jan 1 2019

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Immunotherapy
Radiotherapy
Safety
HhAntag691
Literature
PubMed
Therapeutics
Retrospective Studies
Clinical Trials
Databases
Prospective Studies
Breast Neoplasms
Pharmaceutical Preparations

Keywords

  • Elderly patients
  • Immunotherapy
  • Radiotherapy
  • Target therapy

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Safety and efficacy of combined radiotherapy, immunotherapy and targeted agents in elderly patients : A literature review. / AIRO Giovani Italian Association of Radiation Oncology-Young Members Working Group.

In: Critical Reviews in Oncology/Hematology, Vol. 133, 01.01.2019, p. 163-170.

Research output: Contribution to journalReview article

AIRO Giovani Italian Association of Radiation Oncology-Young Members Working Group. / Safety and efficacy of combined radiotherapy, immunotherapy and targeted agents in elderly patients : A literature review. In: Critical Reviews in Oncology/Hematology. 2019 ; Vol. 133. pp. 163-170.
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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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author = "{AIRO Giovani Italian Association of Radiation Oncology-Young Members Working Group} and Liliana Belgioia and Isacco Desideri and Angelo Errico and Ciro Franzese and Antonino Daidone and Lorenza Marino and Michele Fiore and Paolo Borghetti and Daniela Greto and Alba Fiorentino",
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AU - Desideri, Isacco

AU - Errico, Angelo

AU - Franzese, Ciro

AU - Daidone, Antonino

AU - Marino, Lorenza

AU - Fiore, Michele

AU - Borghetti, Paolo

AU - Greto, Daniela

AU - Fiorentino, Alba

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N2 - 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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KW - Target therapy

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