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A recent study from researchers at the Johns Hopkins Kimmel Cancer Center, the Bloomberg Kimmel Institute for Cancer Immunotherapy, and the Johns Hopkins Convergence Institute reveals that older adults with cancer respond similarly to immune checkpoint inhibitors as their younger counterparts. This research, partially funded by the National Institutes of Health, including the National Cancer Institute’s Specialized Programs of Research Excellence, provides important insights into cancer treatment for the aging population.
Most diagnoses of solid tumors occur in individuals aged 65 and older, a demographic that historically experiences poorer outcomes from cancer treatments compared to younger patients. The underlying causes of these disparities remain complex. It is believed that age-related immune system declines may weaken the body’s ability to combat cancer cells. While newer therapies that enhance immune responses show promise, concerns persist that these age-related changes might reduce their effectiveness.
Published on April 21 in Nature Communications, the study strengthens the argument that immune checkpoint inhibitors can be effective across all age groups, regardless of the immune system’s alterations that come with aging. It also highlights significant differences in immune responses to these treatments between older and younger patients, which may eventually lead to more personalized treatment approaches to increase efficacy.
“Older patients do just as well, sometimes better than younger patients with immunotherapy treatments,” stated senior author Dr. Daniel Zabransky, an assistant professor of oncology at Johns Hopkins University. He emphasized that the findings reveal critical pathways that influence immune responses to immunotherapy across different age brackets, potentially paving the way for improved therapies tailored to individual patient needs.
The research involved analyzing immune cells and their cytokine production in the blood of approximately 100 patients receiving immune checkpoint inhibitors for cancer treatment, with about half of the participants being aged 65+ years. While both older and younger groups experienced similar benefits from the therapy, distinct differences in their immune profiles were observed.
For instance, T cells, which play a crucial role in eliminating damaged or harmful cells, displayed variations based on age. In older patients, T cells appeared to be less prepared to respond to cancer-related threats, leading Zabransky to suggest that these “inexperienced” cells might require additional therapies, such as immune checkpoint inhibitors, to enhance their effectiveness against cancer.
Looking ahead, Zabransky and his team plan to investigate immune cell behavior within tumors and how these variations affect responses to immunotherapy across age demographics. Their goal is to harness this knowledge to either develop new treatment options more suited to older populations or to create effective combinations of existing therapies that could enhance patient care. A key focus remains on optimizing treatment results in older adults while minimizing potential side effects that often accompany aggressive therapies.
“Currently, we administer immune checkpoint inhibitors to patients without significant consideration of how age might impact the immune system’s ability to target cancer cells,” Zabransky pointed out. “By gaining a deeper understanding of the age-related changes that occur throughout life, we aspire to refine our therapeutic strategies and personalize treatments to better accommodate these crucial patient-specific factors.”
The collaborative study involved contributions from numerous researchers at Johns Hopkins, including Chester Kao, Soren Charmsaz, Hua-Ling Tsai, and many others. Additionally, experts from Genentech Inc. and F. Hoffman-La Roche Ltd. participated in the research.
Funding for the study came from a variety of sources, including the Johns Hopkins Bloomberg Kimmel Institute for Cancer Immunotherapy, Swim Across America, imCORE-Genentech, and several grants from the National Cancer Institute and private foundations.
Several authors disclosed financial relationships with various pharmaceutical companies, reflecting the complex landscape of cancer research funding and industry collaboration. This transparency underlines the importance of managing such affiliations to ensure the integrity of research outcomes, with Johns Hopkins University adhering to its conflict-of-interest policies.
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