Aging, cancer, and antitumor immunity

Aging leads to numerous changes that affect many components of the immune system, called immunosenescence. Indeed, elderly individuals exhibit dysregulated immune responses against pathogens, poor responses to vaccination, and increased susceptibility to many diseases including cancer, autoimmune disorders, and other chronic inflammatory diseases. Despite progressed understanding of immunosenescence, its detailed mechanisms are still not fully understood. With advances in medicine, the population of older cancer patients is expected to rapidly increase in the coming years. Cancer immunotherapies, including immune checkpoint inhibitors (ICIs), have been shown to be effective for multiple cancer types, whereas to date, few specific data for elderly individuals have been published. Some systemic reviews have demonstrated that ICIs exhibit similar efficacy in older cancer patients, but they seem to be less effective in very old patients. In addition, toxicities might be more frequently observed in such patients. Here, we provide a summary to better understand immunosenescence and an overview of its relationship with cancer and antitumor immunity, including the efficacy and toxicity of ICIs.

Automated summary

Aging leads to changes in the immune system, causing dysregulated responses and increased susceptibility to diseases in elderly individuals. Despite some understanding, detailed mechanisms of immunosenescence remain unclear. ICIs have shown efficacy in older cancer patients, but may be less effective in very old patients with more frequent toxicities.