Should age disqualify from life-prolonging therapy? Successful adjuvant immunotherapy in an 88-year-old octogenarian with melanoma and high cardiovascular risk. Case report
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Abstract
Advanced chronological age should not automatically lead to patients' disqualification from cancer therapies, which have the potential to prolong life. When functional status is prioritized over metric age, even octogenarians with significant comorbidities can have access to even modern oncological therapies. We present the case of an 88-year-old patient with high cardiovascular risk, who was enrolled in adjuvant nivolumab therapy due to melanoma recurrence. In 2021, the patient was diagnosed with malignant melanoma of the lumbar region at stage T2a, which was initially successfully surgically treated. After 3 years, regional melanoma recurrence in the axillary lymph nodes was detected (stage III, BRA F-) indicating the necessity for systemic treatment. During cardiological consultation before planned immunotherapy, severe aortic stenosis was confirmed. The patient finally was qualified for nivolumab therapy under cardio-oncological supervision, despite advanced age and high cardiovascular risk. After 5 courses of immunotherapy, no recurrence was found on follow-up computed tomography, and no cardiac status worsening was observed. This case demonstrates that advanced age combined even with high cardiovascular risk should no longer be a barrier to immunotherapy under an appropriate monitoring protocol preserving the safety and continuity of oncological treatment.
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Copyright: ? Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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