Immune checkpoint inhibitors in SARS-CoV-2 infected cancer patients: the spark that ignites the fire?

Noia, Vincenzo Di; D’Aveni, Alessandro; Squadroni, M.; Beretta, Giordano Domenico; Ceresoli, Giovanni Luca

doi:10.1016/j.lungcan.2020.05.006

Cited by 13 publications

(11 citation statements)

References 12 publications

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“…The adverse events are rare and extremely heterogeneous, including: Gastrointestinal toxicity, mucosal inflammation, endocrine dysregulation and dermatological abnormalities. Additionally, a 1–5% of irAEs are associated with the development of interstitial pneumonitis, which for some extents, resembles the pneumonitis caused by SARS-CoV-2 [ 63 ].…”

Section: Covid-19 and Anti-cancer Therapy: Advantages And Disadvanmentioning

confidence: 99%

Cancer Management during COVID-19 Pandemic: Is Immune Checkpoint Inhibitors-Based Immunotherapy Harmful or Beneficial?

Vivarelli

Falzone

Grillo

et al. 2020

Cancers

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The coronavirus disease 2019 (COVID-19) is currently representing a global health threat especially for fragile individuals, such as cancer patients. It was demonstrated that cancer patients have an increased risk of developing a worse symptomatology upon severe acute respiratory syndrome associated coronavirus-2 (SARS-CoV-2) infection, often leading to hospitalization and intensive care. The consequences of this pandemic for oncology are really heavy, as the entire healthcare system got reorganized. Both oncologists and cancer patients are experiencing rescheduling of treatments and disruptions of appointments with a concurrent surge of fear and stress. In this review all the up-to-date findings, concerning the association between COVID-19 and cancer, are reported. A remaining very debated question regards the use of an innovative class of anti-cancer molecules, the immune checkpoint inhibitors (ICIs), given their modulating effects on the immune system. For that reason, administration of ICIs to cancer patients represents a question mark during this pandemic, as its correlation with COVID-19-associated risks is still under investigation. Based on the mechanisms of action of ICIs and the current evidence, we suggest that ICIs not only can be safely administered to cancer patients, but they might even be beneficial in COVID-19-positive cancer patients, by exerting an immune-stimulating action.

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Section: Covid-19 and Anti-cancer Therapy: Advantages And Disadvanmentioning

confidence: 99%

Cancer Management during COVID-19 Pandemic: Is Immune Checkpoint Inhibitors-Based Immunotherapy Harmful or Beneficial?

Vivarelli

Falzone

Grillo

et al. 2020

Cancers

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“…The atypical time of onset and the explosive clinical course could be due to an overlap between the underlying disease, the current treatment regimen, and the infection. This negative synergy, combined with a possible diagnostic delay, cannot be excluded or overshadow the safety of immunotherapy during this pandemic [ 38 ].…”

Section: Icis’ Impact On Covid-19 Outcome In Cancer Patients: Clinical Datamentioning

confidence: 99%

Lights and Shadows on Managing Immune Checkpoint Inhibitors in Oncology during the COVID-19 Era

Burgaletto

Brunetti

Munafò

et al. 2021

Cancers

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Since the start of the global spread of coronavirus disease (COVID-19) pandemic, cancer patients were identified as a specifically susceptible subgroup of the patient population. Several reports have shown that cancer patients have an increased risk of both contracting the infection and of experiencing a more severe disease course, with a rapidly evolving picture associated with higher mortality. The assumption of cancer patients as “COVID-19 vulnerable” has led, irretrievably, to profound changes in the decision making of oncological treatments. Potential justifications for such concerns encompass the cancer-dependent suppression of the immune response, as well as the influence of administration of systemic anticancer treatments, including chemotherapy and immunotherapy. Nevertheless, to date, it is not clear whether the use of immune checkpoint inhibitors (ICIs) in cancer patients is safe, given their modulating effects on the immune system, or that they may rather conceal detrimental consequences. Theoretically, on the one hand, ICIs may enhance the immunological control of viral infections through their immunostimulating mechanisms; on the other hand, they could contribute to the hyper-inflammatory phase of COVID-19, worsening its clinical outcomes. In this study, we report the foremost clinical observations on the safety of ICI administration in cancer patients affected by COVID-19.

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“…Immunotherapy related pneumonitis usually occurs during the first 3 months of therapy, and the sudden onset could be attributed to the negative synergy of the concomitant use of Nivolumab and SARS-CoV-2 infection. 36 A pan-cancer analysis by Cai et al that looked at cancer types with the highest risk for COVID-19 found that endometrial carcinoma expressed both Transmembrane Protease Serine 2 (TMPRSS2) and Angiotensin-Converting Enzyme 2 (ACE2) receptors which are launching pads for SARS-CoV-2. Therefore, these subgroups of cancer patients could be at higher risk.…”

Section: Incidence Of Covid-19 In Cancer Patientsmentioning

confidence: 99%

<p>The Landscape of COVID-19 in Cancer Patients: Prevalence, Impacts, and Recommendations</p>

Abdihamid¹,

Cai²,

Kapesa³

et al. 2020

CMAR

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Cancer patients are susceptible groups to COVID-19, and risk-adjusted models show that most cancer patients have a 25-39% mortality risk if infected with COVID-19. The infection rate of SARS-CoV-2 in cancer patients in China was 0.79% (12 of 1524 patients; 95% CI, 0.31.2%). The case fatality rate of COVID-19 in the overall population ranges from 2.3 to 8.0%; among these, the case fatality rate for cancer patients is at 5.6%. In a retrospective cohort study of 28 COVID-19-infected cancer patients, a total of 15 (53.6%) patients had severe outcomes with a mortality rate of 28.6%. In a pooled analysis by Aakash et al, a 2% cancer prevalence was found among admitted patients with COVID-19. In Italy, a report shows that among the 3200 patients who died of SARS-CoV-2, 19.4% were patients with cancer. In New York, 61 (28%) cancer patients succumbed to COVID-19 with a case fatality rate of 37% (20/54) and 25% (41/164) for hematologic and solid malignancies, respectively. Impacts of COVID-19 in cancer care include interruptions of life-saving therapies, distraction effects, and diagnostic overshadowing that involve diverting attention to the pandemic rather than to cancer patients and disruptions of primary palliative care to patients due to forced quarantine. Herein, we review the landscape of COVID-19 in cancer care. We also briefly share our experience and the measures in place to protect cancer patients against COVID-19 in our center.

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Immune checkpoint inhibitors in SARS-CoV-2 infected cancer patients: the spark that ignites the fire?

Cited by 13 publications

References 12 publications

Cancer Management during COVID-19 Pandemic: Is Immune Checkpoint Inhibitors-Based Immunotherapy Harmful or Beneficial?

Cancer Management during COVID-19 Pandemic: Is Immune Checkpoint Inhibitors-Based Immunotherapy Harmful or Beneficial?

Lights and Shadows on Managing Immune Checkpoint Inhibitors in Oncology during the COVID-19 Era

<p>The Landscape of COVID-19 in Cancer Patients: Prevalence, Impacts, and Recommendations</p>

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