Older adults with cancer respond just as well as younger patients to immune checkpoint inhibitors, despite the natural weakening of the immune system that occurs with age. This promising conclusion comes from a new study conducted by researchers at the Johns Hopkins Kimmel Cancer Center, the Bloomberg~Kimmel Institute for Cancer Immunotherapy, and the Johns Hopkins Convergence Institute.
The study, published in Nature Communications, was partially supported by the National Institutes of Health, including the National Cancer Institute’s Specialized Programs of Research Excellence.
Addressing a Common Disparity in Cancer Outcomes
Most solid tumor cancer diagnoses occur in people aged 65 or older. Historically, this group has shown worse outcomes compared to younger patients. Researchers sought to investigate whether newer immune-boosting therapies could overcome age-related declines in immune function.
“Older patients do just as well, sometimes better than younger patients with immunotherapy treatments,” said Dr. Daniel Zabransky, assistant professor of oncology at Johns Hopkins and senior author of the study. “We found clues about important pathways mediating the immune response that may help us improve and personalize therapies.”
The Study: Immune Differences and Shared Benefits
The team studied blood samples from about 100 patients undergoing treatment with immune checkpoint inhibitors. About half the patients were aged 65 or older. While both groups benefited equally from the therapy, there were differences in how their immune systems responded.
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A notable difference involved “inexperienced” T cells, which are on standby to fight threats. In older adults, these cells appeared “aged” or previously activated—suggesting that checkpoint inhibitors may be especially helpful in reinvigorating their cancer-fighting capacity.
Future Focus: Tumor-Level Insights and Personalized Therapies
Dr. Zabransky and his team plan to investigate how immune cells behave within tumors across age groups. The goal is to better understand age-specific immune responses and create more effective, tailored treatments.
“Right now, we treat patients with these therapies without major consideration of age-related immune changes,” said Zabransky. “We want to change that by identifying new strategies that make these therapies even more effective for all patients.”
Research Team and Support
In addition to Zabransky, the study included researchers from Johns Hopkins, Genentech Inc., and F. Hoffman-La Roche Ltd. Support was provided by:
- Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy
- Swim Across America
- imCORE-Genentech
- The MacMillan Pathway to Independence Award
- The MD Anderson GI SPORE Career Enhancement Award
- The Maryland Cancer Moonshot Research Grant
Disclosures and Conflicts of Interest
Several authors reported industry affiliations and research funding:
- Evan J. Lipson has consulted for pharmaceutical companies and owns stock in Iovance.
- Madelena Brancati has received grant support and consults for multiple firms.
- Elizabeth Jaffee has commercial ties through Adventris Pharmaceuticals, which licensed technology from this study.
- Won Jin Ho and Mark Yarchoan also reported grant support and industry honoraria.
- Daniel Zabransky disclosed consulting and grant relationships, managed under Johns Hopkins’ conflict-of-interest policies.
