Expert Opinion on Pharmacotherapy最新文献_第2页

Incretins for obesity: closer to a nicotine patch than a silver bullet. 治疗肥胖的肠促胰岛素：更像是尼古丁贴片，而不是灵丹妙药。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-09-01 Epub Date: 2025-09-10 DOI: 10.1080/14656566.2025.2557458

Isabella Dippel, Megan Adelman, Kevin M Olson, Alexis Holt, Jahmae Collins, Andrea Reddest, Nicholas W Carris

{"title":"Incretins for obesity: closer to a nicotine patch than a silver bullet.","authors":"Isabella Dippel, Megan Adelman, Kevin M Olson, Alexis Holt, Jahmae Collins, Andrea Reddest, Nicholas W Carris","doi":"10.1080/14656566.2025.2557458","DOIUrl":"10.1080/14656566.2025.2557458","url":null,"abstract":"Introduction: Obesity is a pandemic and a key driver of type 2 diabetes mellitus, heart disease, and healthcare spending. Incretin drug therapy prescribing for obesity has dramatically increased in recent years, necessitating researchers and clinicians to rapidly update their understanding of and approach to obesity management.Areas covered: We assembled a multi-disciplinary team of experts to identify and complete a narrative review of the relevant literature regarding behavioral interventions, nutrition, physical activity, incretin drug therapy for weight loss, and the management of incretin drug adverse effects.Expert opinion: Incretin drug therapy can produce significant weight loss in properly selected individuals. However, many do not continue therapy indefinitely. To maximize the benefits of incretin therapy, individuals should receive behavioral support to increase their physical activity, the healthfulness of their diet, protein intake, awareness of food triggers, and ultimately their probability of short-term weight loss and long-term weight maintenance regardless of the long-term use of incretin therapy.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1359-1371"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Navigating regulatory challenges in pediatric epilepsy pharmacotherapy: pathways to safe and effective treatments. 应对儿童癫痫药物治疗中的监管挑战：安全有效的治疗途径。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-09-01 Epub Date: 2025-09-25 DOI: 10.1080/14656566.2025.2563279

Gianmichele Villano, Gianluca D'Onofrio, Antonella Riva, Andrea Santangelo, Klaus Rose, Pasquale Striano

{"title":"Navigating regulatory challenges in pediatric epilepsy pharmacotherapy: pathways to safe and effective treatments.","authors":"Gianmichele Villano, Gianluca D'Onofrio, Antonella Riva, Andrea Santangelo, Klaus Rose, Pasquale Striano","doi":"10.1080/14656566.2025.2563279","DOIUrl":"10.1080/14656566.2025.2563279","url":null,"abstract":"Introduction: Drug development for epilepsy, the most frequent chronic neurologic childhood condition, faces fundamental challenges. One of these is the concept of children as 'therapeutic orphans' and the resulting pediatric requirements of the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Developing new antiseizure medications (ASMs) is expensive. Public coffers and reimbursement institutions are increasingly struggling with fundings. Commercial drug developers are progressively skeptical about the risks of developing new ASMs, which makes a critical review of pediatric requirements even more important.Areas covered: This narrative review traces the roots of pediatric drug development in epilepsy and analyses the current FDA and EMA regulatory frameworks and incentives that shape ASMs approval for children. PubMed, EMBASE, Scopus and Google Scholar were searched for publications using combinations of terms related to 'pediatric epilepsy,' 'antiseizure medications,' 'regulatory frameworks' and 'pediatric drug development.' Official FDA, EMA websites and documents were also screened.Expert opinion: A more focused and science-driven approach, less influenced by nonscientific factors and emerging conflicts of interest, could help accelerate the development of innovative treatments for epilepsy. Optimizing incentives to align research with true pediatric needs, especially those targeting childhood-specific syndromes and age-appropriate pharmacology, is essential.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1399-1414"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ustekinumab versus vedolizumab and ustekinumab versus tumor necrosis factor alpha agent infectious adverse effects in patients with ulcerative colitis, a real-world data study. Ustekinumab与vedolizumab和Ustekinumab对抗肿瘤坏死因子α因子在溃疡性结肠炎患者中的感染不良反应，一项真实世界的数据研究。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-09-01 Epub Date: 2025-09-21 DOI: 10.1080/14656566.2025.2564333

Hussam Almasri, Abdellatif Ismail, Himsikhar Khataniar, Muhammad Ali Butt, Rahul Karna, John Bassett, Daphne Moutsoglou

{"title":"Ustekinumab versus vedolizumab and ustekinumab versus tumor necrosis factor alpha agent infectious adverse effects in patients with ulcerative colitis, a real-world data study.","authors":"Hussam Almasri, Abdellatif Ismail, Himsikhar Khataniar, Muhammad Ali Butt, Rahul Karna, John Bassett, Daphne Moutsoglou","doi":"10.1080/14656566.2025.2564333","DOIUrl":"10.1080/14656566.2025.2564333","url":null,"abstract":"Introduction: Ulcerative colitis (UC) often requires immunomodulatory therapies that balance efficacy with safety. Among biologics, vedolizumab and ustekinumab have emerged as alternatives to anti-tumor necrosis factor alpha (TNF-α) agents. We aim to address the incidence of specific infectious adverse events associated with these agents outside clinical trials using a real-world database.Methods: We conducted a retrospective cohort study using the TriNetX database. Three cohorts were defined as adult patients with UC, each treated with one of the following: ustekinumab, anti-TNFα agents, or vedolizumab. We used propensity score matching to balance groups. Outcomes included a new infection diagnosis.Results: Participants receiving ustekinumab demonstrated a significantly lower risk of several infections compared to those on anti-TNFα therapy, including pneumonia, urinary tract infection, cellulitis, Clostridioides difficile infection, infectious diarrhea, and sepsis. Compared to vedolizumab, ustekinumab was associated with a reduced risk of cellulitis and Clostridioides difficile infection.Discussion: Our findings demonstrate that ustekinumab is associated with a significantly lower risk of several infections. However, there is a less prominent difference in infectious risk when compared to vedolizumab. These results suggest that ustekinumab may offer a safer alternative, compared to anti-TNFα agents and possibly to vedolizumab, particularly those at higher risk of infections.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1467-1471"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Emerging pharmacological strategies for the treatment of cannabis use disorder. 治疗大麻使用障碍的新药理学策略。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-09-01 Epub Date: 2025-09-10 DOI: 10.1080/14656566.2025.2558999

Anees Bahji

{"title":"Emerging pharmacological strategies for the treatment of cannabis use disorder.","authors":"Anees Bahji","doi":"10.1080/14656566.2025.2558999","DOIUrl":"10.1080/14656566.2025.2558999","url":null,"abstract":"Introduction: Cannabis use disorder (CUD) is a growing global health concern, with limited pharmacological treatments currently available despite increasing prevalence and legalization trends.Areas covered: This review explores the landscape of pharmacotherapies for CUD, including both repurposed agents and emerging investigational compounds. We summarize findings from recent systematic reviews and meta-analyses, with attention to mechanisms of action and clinical relevance. Agents discussed include gabapentin, N-acetylcysteine, synthetic cannabinoids, fatty acid amide hydrolase (FAAH) inhibitors, orexin receptor antagonists, and psychedelics. A narrative approach was used, informed by targeted searches of PubMed, Google Scholar, and clinical trial registries from 2000 to 2025, focusing on human studies, randomized trials, and meta-analyses relevant to pharmacologic management of CUD.Expert opinion: The pharmacologic treatment of CUD is in its early stages, with no approved agents and modest efficacy demonstrated to date. Novel compounds targeting endocannabinoid tone and motivational circuits show promise, but significant research is still needed. Future progress depends on better integration with behavioral care, trial stratification by clinical phenotype, and increased investment in translational research to move beyond withdrawal symptom management toward sustained recovery.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1373-1377"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recent advances and future directions in newly diagnosed mantle cell lymphoma. 新诊断套细胞淋巴瘤的最新进展及未来方向。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-09-01 Epub Date: 2025-09-04 DOI: 10.1080/14656566.2025.2556138

Wan Danial Noor, Chan Yoon Cheah

{"title":"Recent advances and future directions in newly diagnosed mantle cell lymphoma.","authors":"Wan Danial Noor, Chan Yoon Cheah","doi":"10.1080/14656566.2025.2556138","DOIUrl":"10.1080/14656566.2025.2556138","url":null,"abstract":"Introduction: There have been recent major advances in the management and treatment of mantle cell lymphoma (MCL). This uncommon subtype of mature B-cell lymphoma has a heterogeneous clinical course, including a spectrum of indolent and aggressive disease. While historically regarded as an incurable disease with a poor long-term prognosis, recent developments have improved outcomes.Areas covered: The incorporation of targeted treatments, such as covalent Bruton's tyrosine kinase inhibitors (cBTKi), with or without chemo-immunotherapy in the upfront treatment setting is supported by recent clinical trials indicating encouraging efficacy and safety. Measurable residual disease (MRD) testing is emerging as a potent tool in guiding treatment decision and improving outcomes while minimizing toxicities. Therapies utilized in relapsed/refractory disease, such as BCL2 inhibitors as well as immune-leveraging therapies, including T-cell engaging antibodies and chimeric antigen receptor (CAR) T-cells therapy, are being evaluated in upfront settings.Expert opinion: This review will discuss recent advances in the upfront management of this challenging disease as well as a suggested treatment algorithm considering both availability and unavailability of first-line cBTKi. The incorporation of cBTKi to chemo-immunotherapy regimens appears effective and safe. However, patients with high-risk disease may require novel therapeutic approaches due to suboptimal outcomes with chemo-immunotherapy.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1415-1432"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pharmacological management of PCOS: trends and insights from a 10-year bibliometric analysis. 多囊卵巢综合征的药物管理：10年文献计量学分析的趋势和见解。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-08-01 Epub Date: 2025-07-29 DOI: 10.1080/14656566.2025.2535175

Rohit Gautam, Anshu Jyoti, Asmitha Bhateja, Neena Malhotra, Taruna Arora

{"title":"Pharmacological management of PCOS: trends and insights from a 10-year bibliometric analysis.","authors":"Rohit Gautam, Anshu Jyoti, Asmitha Bhateja, Neena Malhotra, Taruna Arora","doi":"10.1080/14656566.2025.2535175","DOIUrl":"10.1080/14656566.2025.2535175","url":null,"abstract":"Background: PCOS is an endocrine disorder affecting women of reproductive-aged group. It has multiple manifestations, including metabolic, reproductive, and psychological domains. Among PCOS patients, pharmaceutical management remains a primary approach to its treatment, particularly when lifestyle changes do not yield improvements.Objective: This study aims to highlight trends in global research concerning PCOS and its pharmacological treatment within the last decade using bibliometric analysis.Methods: A bibliometric analysis was conducted for the 2015-2024 timeframe using Web of Science database. Search queries were designed for PCOS as well as its pharmacological treatment options. Data analysis was performed through visualization of collaborations, research trends, etc. in VOS viewer.Results: 2607 publications qualified for inclusion criteria. The most frequently treated topics were combined oral contraceptives, metformin, letrozole, and inositols. China is the leading contributor toward publication volume, while the U.S.A. was the most cited and had the strongest links. Influence appeared to stem from Monash University, and Legro RS was the most influential the most impactful author.Conclusion: The study reveals global trends in PCOS pharmacotherapy, with a growing focus on metabolic and molecular aspects. Key contributors and emerging therapies highlight the expanding scope and future potential of PCOS treatment research.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1351-1358"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lomitapide for the treatment of pediatric homozygous familial hypercholesterolemia. 利米他胺治疗儿童纯合子家族性高胆固醇血症。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-08-01 Epub Date: 2025-08-19 DOI: 10.1080/14656566.2025.2545800

Amanda J Hooper, Damon A Bell, John R Burnett

{"title":"Lomitapide for the treatment of pediatric homozygous familial hypercholesterolemia.","authors":"Amanda J Hooper, Damon A Bell, John R Burnett","doi":"10.1080/14656566.2025.2545800","DOIUrl":"10.1080/14656566.2025.2545800","url":null,"abstract":"Introduction: Homozygous familial hypercholesterolemia (HoFH) is a rare, inherited disorder characterized by severe LDL-hypercholesterolemia and accelerated atherosclerotic cardiovascular disease. It typically presents in childhood or adolescence, and if untreated, may be fatal in the first decades of life. The microsomal triglyceride transfer protein (MTP) is essential for the assembly and secretion of apolipoprotein (apo)B-containing lipoproteins. MTP inhibition with lomitapide effectively lowers plasma LDL-cholesterol as an adjunct therapy in adults with HoFH.Areas covered: We discuss the role of MTP as a therapeutic target for HoFH, describe the pharmacodynamics, pharmacokinetics, and metabolism of lomitapide, and report on the findings of the phase III APH-19 trial in pediatric HoFH.Expert opinion: Lomitapide is an oral small molecule inhibitor of MTP, which reduces LDL-cholesterol by 53.5% in pediatric patients with HoFH on maximal standard lipid-lowering therapy, including lipoprotein apheresis. Moreover, small case series have shown that pediatric HoFH patients on lomitapide were able to cease or reduce the frequency of lipoprotein apheresis. Safety and tolerability studies are consistent with the known mechanism of lomitapide on the gastrointestinal and hepatic systems, and are generally mild and manageable in pediatric HoFH patients. The results of longer-term safety data are awaited.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1289-1295"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy and safety of pitolisant in children above 6 years with narcolepsy. 匹立抗治疗6岁以上儿童发作性睡病的疗效和安全性。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-08-01 Epub Date: 2025-07-06 DOI: 10.1080/14656566.2025.2523989

Beatrice Bertini, Claudio Liguori

{"title":"Efficacy and safety of pitolisant in children above 6 years with narcolepsy.","authors":"Beatrice Bertini, Claudio Liguori","doi":"10.1080/14656566.2025.2523989","DOIUrl":"10.1080/14656566.2025.2523989","url":null,"abstract":"Introduction: The newly approved use of pitolisant in pediatric narcolepsy marks a significant advancement for patients and clinicians, given the scarcity of medications for this age group that are both safe and effective in reducing narcolepsy symptoms and improving quality of life.Areas covered: This article covers the use of pitolisant for treating narcolepsy type 1 (NT1) and 2 (NT2) in pediatric patients considering drug's pharmacokinetics and pharmacodynamics. By integrating recent literature and real-world data, the safety, the tolerability and the efficacy of this drug have been analyzed, also including evidence drawn from studies involving patients with Prader-Willi Syndrome.Expert opinion: Pitolisant represents a groundbreaking treatment for pediatric narcolepsy, addressing the paucity of safe and effective options for this age group. Its unique mechanism as a histamine H3 receptor antagonist reduces excessive daytime sleepiness and cataplexy while offering cognitive benefits. With a favorable safety profile and good tolerability, pitolisant efficiently outperforms traditional therapies, which often have distressing side effects. Its use is particularly critical in childhood, a developmental stage where factors like growth, school performance, and socialization must be carefully considered, making it a transformative option for pediatric care.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1279-1288"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Profiling opnurasib (JDQ-443) for the treatment of non-small cell lung cancer (NSCLC). opnurasib （JDQ-443）用于治疗非小细胞肺癌（NSCLC）的分析。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-08-01 Epub Date: 2025-07-24 DOI: 10.1080/14656566.2025.2536352

Amanda Herrmann, Tali Azenkot, Van Hilburn, Lyudmila Bazhenova

{"title":"Profiling opnurasib (JDQ-443) for the treatment of non-small cell lung cancer (NSCLC).","authors":"Amanda Herrmann, Tali Azenkot, Van Hilburn, Lyudmila Bazhenova","doi":"10.1080/14656566.2025.2536352","DOIUrl":"10.1080/14656566.2025.2536352","url":null,"abstract":"Introduction: Oncogenic activation of KRAS is a common driver of solid tumor malignancies and has been considered 'undruggable' for several decades. Oral small molecule inhibitors, including sotorasib and adagrasib, have demonstrated moderate efficacy in targeting KRAS G12C in NSCLC. More potent inhibitors are needed, and the landscape is rapidly evolving.Areas covered: Opnurasib (JDQ-443) is an irreversible covalent inhibitor of GDP-bound KRAS G12C that has been under investigation in patients with KRAS G12C-mutated solid tumors, including NSCLC. Here, we review its mechanism of action, pharmacologic properties, clinical efficacy, role within the NSCLC landscape prior to its withdrawal from the market, as well as the regulatory and market-driven dynamics that may result in the abandonment of aspiring drugs.Expert opinion: JDQ-443's unique binding within the Switch II pocket of KRAS G12C allows for novel interactions and helps define its characteristic profile of anti-tumor activity, tolerability, and resistance. JDQ-443 has demonstrated promising early clinical activity in KRAS G12C-mutated NSCLC. More data is necessary to allow comparison of available agents and combination strategies. In the face of an expanding market, development of JDQ-443 has been halted despite promising safety and efficacy outcomes and ongoing innovative trials, highlighting critical challenges in the drug development process. The existing body of work characterizing JDQ-443 remains extremely informative.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1271-1278"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Immunotherapy in older adults with gynecologic cancers: rethinking age as a limiting factor. 老年妇科癌症患者的免疫治疗：重新考虑年龄是一个限制因素。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-08-01 Epub Date: 2025-08-19 DOI: 10.1080/14656566.2025.2548887

Yoshio Yoshida, Makoto Orisaka, Daisuke Inoue, Hiromasa Sasaki

{"title":"Immunotherapy in older adults with gynecologic cancers: rethinking age as a limiting factor.","authors":"Yoshio Yoshida, Makoto Orisaka, Daisuke Inoue, Hiromasa Sasaki","doi":"10.1080/14656566.2025.2548887","DOIUrl":"10.1080/14656566.2025.2548887","url":null,"abstract":"Introduction: As the global population ages, understanding immune checkpoint inhibitor (ICI) efficacy and safety in the older cancer patients is critical. ICIs represent a major advance, but their effectiveness relative to age-related immune changes warrants investigation.Areas covered: This review synthesizes current clinical and preclinical evidence examining how aging influences ICIs response. We discuss age-related immunological changes (immunosenescence), alterations in the tumor microenvironment, mechanistic insights from preclinical aging models, and clinical trial/real-world data on ICIs efficacy and safety including immune-related adverse events (irAEs) across various cancers in older patient, referencing meta-analyses and specific trial outcomes.Expert opinion: Extensive clinical data suggest ICIs often provide significant survival benefits and are generally well-tolerated in appropriately selected older patients, with outcomes frequently comparable to younger cohorts, although efficacy can vary by tumor type, performance status (PS), and biomarkers. While irAEs require careful management considering comorbidities and frailty, overall incidence is not consistently higher in older adults. Treatment decisions should be individualized, integrating biological age indicators, PS, and comorbidities, rather than relying solely on chronological age. Future research should focus on identifying robust biomarkers and tailored strategies to optimize ICIs use in this demographic.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1311-1320"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0