Immunotherapy for Lung Cancer in Adults Aged 65 and Older
- Immunotherapy treatments help older adults with resectable non-small cell lung cancer by shrinking tumors and delaying recurrence, though evidence remains mixed on whether these therapies extend overall lifespan,...
- Data from 11 clinical studies involving 3,152 patients aged 65 and older show that combining immunotherapy with chemotherapy, or using immunotherapy alone before or after surgery, reduces the...
- Understanding how tumors evade older immune systems has driven recent laboratory discoveries.
Immunotherapy treatments help older adults with resectable non-small cell lung cancer by shrinking tumors and delaying recurrence, though evidence remains mixed on whether these therapies extend overall lifespan, according to a systematic medical review published up to July 3, 2025. Non-small cell lung cancer represents roughly 85% of all lung cancer diagnoses, primarily affecting older adults with an average age of 71 at the time of diagnosis.
Treatment Efficacy in Older Adults
Data from 11 clinical studies involving 3,152 patients aged 65 and older show that combining immunotherapy with chemotherapy, or using immunotherapy alone before or after surgery, reduces the amount of cancer found during procedures. The studies compared these interventions against placebos or standard care regimens. While researchers noted that the treatments effectively delay the cancer from coming back, they found that immunotherapy probably makes little or no difference to overall survival rates in this age demographic. Evaluating these treatments in older populations requires accounting for immunosenescence, a natural aging process that reduces the immune system’s capacity to fight cancer. Because the elderly population is diverse, clinical guidelines emphasize that age alone should not dictate treatment choices. However, evidence remains limited regarding potential harms, as only one study included in the review provided data on unwanted side effects, and no study formally assessed patient well-being.
Cellular Mechanisms and New Research Directions
Understanding how tumors evade older immune systems has driven recent laboratory discoveries. Researchers at UT Southwestern Medical Center identified a mechanism where a hormone known as SCG2 binds directly to an inhibitory receptor called LILRB4 on myeloid cells. This interaction triggers a signaling cascade that converts tumor-fighting immune cells into tumor-supporting cells, according to a study published on July 24, 2025, in Nature Immunology. “Myeloid cells are among the first group of immune cells recruited to tumors, but very quickly these tumor-fighting cells turn into tumor-supporting cells. Our study suggests that receptors on these myeloid cells get stimulated by this hormone and end up suppressing the immune system,” said Cheng Cheng “Alec” Zhang, Professor of Physiology at UT Southwestern and co-leader of the study. Current immune checkpoint inhibitors benefit only about 20% to 30% of patients, underscoring the need to understand how cancers escape detection. In laboratory experiments with mice, treating animals with an antibody that blocks LILRB4 significantly slowed cancer growth. Researchers suggest that disrupting this specific hormone-receptor interaction could eventually yield new immunotherapy options, while delivering extra SCG2 might help treat autoimmune or inflammatory disorders driven by myeloid cells.