Global Health Asia-Pacific October 2021 | Page 32

Older patients with non-small cell lung cancer can benefit from latest treatments

Study shows elderly can benefit from immune checkpoint inhibitors , a new cancer immunotherapy

The inhibitors work by preventing the immune system from turning off before cancer is completely eliminated .

Because elderly patients with NSCLC are likely to be excluded from clinical trials due to their lower functional capacity or comorbidities , survival benefits from immune checkpoint inhibitors remain unclear .

Immune checkpoints are a normal part of the immune system . Their role is to prevent an immune response from being so strong that it destroys healthy cells in the body .

Immune checkpoints engage when proteins on the surface of immune cells called T cells recognise and bind to partner proteins on other cells , such as some tumour cells . These proteins are called immune checkpoint proteins . When the checkpoint and partner proteins bind together , they send an “ off ” signal to the T cells . This can prevent the immune system from destroying the cancer .

Immunotherapy drugs called immune checkpoint inhibitors ( ICIs ) work by blocking checkpoint proteins from binding with their partner proteins . This prevents the “ off ” signal from being sent , allowing the T cells to kill cancer cells .

In patients with NSCLC , ICIs have become one of the standard pharmacological therapies , but elderly patients may be denied these in clinical trials .

In the latest study , scientists at the Kyushu Cancer Centre in Japan analysed over 86,000 patients with stage 4 NSCLC . They found that “ chronological age does not appear to impact on survival benefit of ICIs in stage 4 NSCLC ”. These findings should be validated in future prospective studies .

The findings are important because the need for immune checkpoint inhibitor therapy is increasing , and as the population ages , many patients receiving such drugs will be older adults .

Intellectual disabilities linked to increased risk of cancer

Nordic study ’ s findings indicate a need for extended surveillance and early intervention

eople with intellectual disabilities are at an increased risk of any cancer , but particularly a number of specific cancer types , according to a Nordic study .

Due to this link , the researchers have suggested that people with intellectual disabilities ( IDs ) undergo extended surveillance and early intervention for cancer . The results were presented by Dr Qianwei Liu of the Karolinska Institutet in Stockholm at the European Society for Medical Oncology Congress 2021 .

Dr Liu explained that there was a large gap in knowledge about the risks of cancer in people with IDs . Together with colleagues , he conducted a populationbased cohort study of more than 3.5 million children of whom 27,956 had clinically confirmed cases of ID .

To examine the association between ID and cancer , the team assessed the severity and type of intellectual disability and also looked at the mental health of siblings .

The researchers found a statistically significant increased risk for any cancer as well as for specific cancer types , in particular cancer of the oesophagus , stomach , small intestine , colon , pancreas , uterus , kidney , central nervous system , and other unspecified sites .

ID is subdivided into syndromic ID , in which intellectual deficits associated with other medical and behavioural signs and symptoms are present , and non-syndromic ID , in which intellectual deficits appear without other abnormalities . According to the study , excess cancer risk was not modified by severity of ID or sex but was higher in those with syndromic ID .

30 OCTOBER 2021 GlobalHealthAsiaPacific . com