老年癌症患者免疫治疗的现状及未来发展  

Current status and future development of immunotherapy in elderly cancer patients

作　　者：张天 于江泳 许晶 马洁 Zhang Tian;Yu Jiangyong;Xu Jing;Ma Jie(Center of Biotherapy,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院生物治疗中心国家老年医学中心中国医学科学院老年医学研究院,北京100730

出　　处：《中华老年医学杂志》2025年第3期256-261,共6页Chinese Journal of Geriatrics

基　　金：中央高水平医院临床科研业务费(BJ-2022-118,BJ-2022-101,BJ-2023-069);国家自然科学基金专项项目(82141107);中国医学科学院医学与健康科技创新工程(2021-I2M-1-050)。

摘　　要：随着人口老龄化加剧,老年癌症患者免疫治疗的有效性和安全性问题日益受到关注。本文论述了老年癌症患者免疫治疗的现状,重点探讨了其免疫状态特点、治疗反应及不良事件发生情况。老年癌症患者的免疫功能下降和合并症增加可能影响免疫治疗效果,并增加不良反应风险。然而,当前在老年癌症患者免疫治疗的临床实践中面临着诸多挑战:缺乏临床管理指南、标准化评估量表、特异性免疫功能标志物以及共病对免疫治疗影响相关评价指标与证据支持,且临床试验中老年患者的代表性严重不足。因此,本文建议:建立多学科协作医疗团队,制定个体化免疫治疗方案,并加强老年医学评估。此外,还需开发更适用于老年癌症患者的评估工具和筛选免疫功能标志物,以提高免疫治疗疗效预测和风险评估的准确性。As the global population ages,concerns regarding the efficacy and safety of immunotherapy in elderly cancer patients have gained increasing attention.This review examines the current landscape of immunotherapy in geriatric oncology,with a particular emphasis on the characteristics of immune status,therapeutic responses,and adverse events.The age-related decline in immune function,coupled with increased comorbidities,may influence the efficacy of immunotherapy and elevate the risk of adverse reactions.However,current clinical practice faces several challenges,including a lack of clinical management guidelines,standardized assessment tools,and specific immune biomarkers for elderly cancer patients,as well as the underrepresentation of the elderly population in clinical trials.Therefore,we propose the implementation of multidisciplinary care teams,the development of personalized treatment strategies,and enhanced geriatric assessments.Additionally,it is essential to create age-specific assessment tools and identify immune biomarkers to improve the accuracy of immunotherapy efficacy predictions and risk assessments.

关 键 词：肿瘤 免疫治疗 免疫衰老 免疫检查点抑制剂 不良反应 

分 类 号：R73[医药卫生—肿瘤]