Article and Video CATEGORIES

Cancer Journey

Search By

Are Immune Checkpoint Inhibitors Sufficiently Tolerable to Recommend Them for Older or More Frail Patients?
Author
GRACE Videos and Articles

WCLC_2015_Immune_Checkpoint_Inhibitor_Tolerability_Older_Frail_Patients

 

Drs. Ben Solomon, Leora Horn, & Jack West consider whether immunotherapy might prove to be more problematic when given to a broader population of older and frail patients with advanced lung cancer.

[powerpress]

Download Transcript

[ratingwidget post_id=0]

Please feel free to offer comments and raise questions in our Discussion Forums.

 

Transcript

Dr. West:  What about issues of the tolerability of these immune checkpoint inhibitors? What are your impressions of — are they really trivial toxicity, compared with conventional chemotherapy, are there issues with patients who would really not be great candidates for chemotherapy being treated with immune therapies, potentially with challenging consequences if they have any toxicities… Have you seen that, or are you hearing about that in patients being admitted with complications who you think might not have been great candidates?

Dr. Horn:  So, it doesn’t seem that the elder patients, or the poor performance status patients, are having worse toxicities. In fact, I do — in my experience, it’s easier than chemotherapy. You know, people leave and sometimes they come back, “are you sure you gave me something a few weeks ago?” If patients don’t have toxicities, these drugs are far superior to chemotherapy. They don’t leave people feeling tired or down for four to five days after treatment, but in those patients that develop pneumonitis or colitis, are the two really big toxicities that seem to have a big impact on quality of life, you know, if people’s thyroids stop working, it’s easily fixed, but those can really have in impact on how people do. The nice thing is, it’s less frequent than neuropathy from chemotherapy or febrile neutropenia, or some of the other things that we see as a result of chemotherapy.

Dr. West:  Your thoughts?

Dr. Solomon:  Yeah, I completely agree, and certainly the PD-1 and PD-L1 inhibitors are really well tolerated. They do have some different toxicities which Leora mentioned, that patients need to be aware of, in particular, pneumonitis, and I think those are important symptoms to bring to the attention of doctors, and they need to be investigated, and patients put on steroids if there is evidence of that — but certainly, compared with some of the other immunotherapies, such as ipilimumab, those toxicities are much less frequent, and the drugs, even in older, frailer patients, are tolerated really well.

Dr. West:  It’s important just to underscore that early identification of a toxicity and addressing that, whether by stopping the drug or initiating steroids, in some patients, is critical. So, I think the biggest challenge would be if patients don’t mention it, and doctors are oversubscribed and are not attending to it. But, hopefully, as everyone gets more experienced with them, we’ll know what to be looking for and asking about.

Dr. Solomon:  Exactly.

Next Previous link

Previous PostNext Post

Related Content

Article
Recent Live Events with the Global Resource for Advancing Cancer Education ~ View the Full OnDemand Lung Cancer OncTalk from February 2024  
Image
Blood Cancer OncTalk 2023
Video
In this first batch of the Q&A Session of Blood Cancer OncTalk, Drs. Aaron Goodman, Sridevi Rajeeve, Tycel Phillips, Alakrita Taneja, and Marco Ruiz come together to answer questions from the attendees at our Blood Cancer OncTalk 2023 live event.  To watch the complete playlist click here.
Image
Blood Cancer OncTalk 2023
Video
This is the third batch of videos from the Blood Cancer OncTalk playlist. In these videos, Dr. Alankrita Taneja defines Smoldering Multiple Myeloma (SMM) and discusses how it differs from Multiple Myeloma (MM), risk factors and treatments.   To watch the complete playlist click here.

Forum Discussions

Hi Oaktowngrrl,  Welcome to Grace.  I'm so sorry you're going through this.

 

 Finding a reputable dedicated thoracic surgeon for lung surgery might be difficult, as it is a complex and...

Hello Hello,  Just want to let you know I see your post and will respond more appropriately in the morning. 

Recent Comments

JOIN THE CONVERSATION
Hi Oaktowngrrl,  Welcome to…
By JanineT GRACE … on
I can understand why you're…
By paulryan on
I'm so sorry to hear it.
By Andrian on
Hey,

 I'm sure you're…
By JanineT GRACE … on