Adoptive Immunotherapy in Elderly Cancer Patients

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About this Research Topic

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Background

In the last three decades, treatment strategies for cancers have dramatically changed leading to an exceptional improvement in patient care and survival. During this time, immunotherapy has shifted from cytokine-based approaches to cancer vaccines, immune checkpoint inhibitors, adoptive immunotherapies, and pharmacological modulation of the tumor microenvironment.

The proportion of the United States (US), the European Union, and East Asia populations over 65 years old are increasing significantly, and the group over 85 years old is the most rapidly growing segment, especially in the US. With the increasing number of aged populations, a significant amount of elderly cancer patients need more personalized care for their treatment. It is crucial to choose the most appropriate treatment option for particularly patients with preexisting conditions, including diabetes, hypertension, mental health, physical disability, frailty, cognitive impairment, undernutrition, or prior history of cancer therapies (surgery, radiation therapy, chemotherapy, or transplant).

Selecting the appropriate patient population before the adoptive immunotherapy as well as an early intervention during the therapy may mitigate the risk of toxicities.
Adoptive immunotherapy may be a very efficacious treatment for aged patients, considering age factor does not affect its efficacy in this cohort but there is room for improvement of toxicity risks.

Age factor should not be the only criteria to rule out effective cancer treatments that have the potential to advance the quality of life or improve overall survival. Proper selection of patients should be considered because it is the key to administering effective and safe adoptive immunotherapy. The current Research Topic focuses on how various adoptive immunotherapeutic approaches in elderly cancer patients affect their survival, response rate, quality of life, and the challenges they may experience.

All scientists and researchers interested in this Research Topic are invited to submit their work in the form of Original Research, Review, Mini-Review, and Perspective articles offering new insights into the adoptive immunotherapy perspective for elderly cancer patients. We welcome manuscripts focusing on, but not limited to, the following sub-topics:

• Compare aged (≥65 years old) and younger (<65 years old) in terms of the following aspects:
- Transduction efficacy, fold expansion during manufacturing CAR or TCR-T cells, anti-tumor activity, T cell phenotypes, exhaustion, senescence, etc.
- Complications during the apheresis.
- Overall outcomes of CAR-T cell therapy.
• Is Allo-CAR-T therapy better in aged patients?
• Ideal combination therapy or maintenance therapy to advance the efficacy of the treatment.
• CD28 or 41-BB costimulated CAR, which one is better in aged patients?
• Is CAR-T cell therapy cost-effective in aged patients?
• CAR-NK cell therapy in aged patients.
• Epigenetic regulation in aged patients.

Please note, manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by robust and relevant validation (clinical cohort or biological validation in vitro or in vivo) are out of scope for this topic.

Topic Editor Dr. Reona Sakemura has the patent: Humanigen and the travel fund Morphosys. He also has an NIH grant (K99 grant - K99CA273304-01); The other Topic Editors declare no competing interests with regard to the Research Topic subject

Keywords: Adoptive Immunotherapy, Elderly Cancer Patients, TCR-T cells, CAR-T, Allo-CAR-T, CAR-NK, aged patients

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