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Rago V, Bossio S, Lofaro D, Perri A, Di Agostino S. New Insights into the Link between SARS-CoV-2 Infection and Renal Cancer. Life (Basel) 2023; 14:52. [PMID: 38255667 PMCID: PMC10817602 DOI: 10.3390/life14010052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/17/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024] Open
Abstract
Cancer has been described as a risk factor for greater susceptibility to SARS-CoV-2 infection and severe COVID-19, mainly for patients with metastatic disease. Conversely, to that reported for most solid and hematological malignancies, the few available clinical studies reported that the infection did not increase the risk of death in renal cancer patients. The expression on proximal tubular renal cells of the key players in cellular viral uptake, ACE2, TMPRSS2, and NRP1, seems to be the mechanism for the direct kidney injury seen in patients with COVID-19. Interestingly, data from The Cancer Genome Atlas and experimental analyses on various renal cancer cell lines demonstrated that the above-reported receptors/cofactors are maintained by renal cancer cells. However, whether SARS-CoV-2 infection directly kills renal cancer cells or generates enhanced immunogenicity is a question worth investigating. In addition, some researchers have further addressed the topic by studying the expression and prognostic significance of gene signatures related to SARS-CoV-2 infection in renal cancer patients. The emerging data highlights the importance of better understanding the existence of a link between renal cancer and COVID-19 since it could lead to the identification of new prognostic factors and the development of new therapeutic targets in the management of renal cancer patients.
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Affiliation(s)
- Vittoria Rago
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy;
| | - Sabrina Bossio
- Department of Experimental and Clinical Medicine, Magna Græcia University of Catanzaro, 88100 Catanzaro, Italy;
| | - Danilo Lofaro
- de-Health Lab, Department of Mechanical, Energy, Management Engineering, University of Calabria, 87036 Rende, Italy;
| | - Anna Perri
- Department of Experimental and Clinical Medicine, Magna Græcia University of Catanzaro, 88100 Catanzaro, Italy;
| | - Silvia Di Agostino
- Department of Health Sciences, Magna Græcia University of Catanzaro, 88100 Catanzaro, Italy;
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2
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Li Y, Wang T, Zhang Y, Li M, Feng X, Xu R, Xu H, Xia W, Zhao Y, Hou X, Wei H, Liu Z, Zan Y, Zhao B, Liu C, He X, Liang X, Liu M, Jiang L, Wang W, Shen Y, Wang D, Mi B, Bai Y, Yu X, Huang X, Jia X, Fu X, Guo H, Jiao M. Association of lung diseases with coronavirus disease 2019 in cancer patients receiving immune checkpoint inhibitors: A multicenter study during national Omicron outbreak in China. Clin Transl Med 2023; 13:e1497. [PMID: 38093559 PMCID: PMC10719537 DOI: 10.1002/ctm2.1497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/12/2023] [Accepted: 11/16/2023] [Indexed: 12/17/2023] Open
Affiliation(s)
- Yanlin Li
- Department of Medical OncologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Tongfei Wang
- Department of Medical OncologyXi 'an No.3 Hospitalthe Affiliated Hospital of Northwest UniversityXi'anChina
| | - Yamin Zhang
- Department of OncologyXi'an International Medical Center HospitalXi'anChina
| | - Miao Li
- Department of Medical OncologyQinghai Provincial Cancer HospitalFifth People's Hospital of Qinghai ProvinceXi'anChina
| | - Xiemin Feng
- Department of Medical OncologyYan'an University Affiliated HospitalYan'anChina
| | - Rui Xu
- Department of Medical OncologyShaanxi Provincial Cancer HospitalXi'anChina
| | - Hong Xu
- Department of Medical OncologyXi 'an No.3 Hospitalthe Affiliated Hospital of Northwest UniversityXi'anChina
| | - Weihu Xia
- Department of OncologyXi'an International Medical Center HospitalXi'anChina
| | - Yaning Zhao
- Department of Medical OncologyBaoji Central HospitalBaojiChina
| | - Xinli Hou
- Department of Medical OncologyHanzhong Central HospitalHanzhongChina
| | - Hui Wei
- 4th Department of OncologyAffiliated Hospital of Shaanxi University of Chinese MedicineXianyangChina
| | - Zhiyan Liu
- Department of Respiratory and Critical Care MedicineXi 'an No.3 Hospitalthe Affiliated Hospital of Northwest UniversityXi'anChina
| | - Ying Zan
- Department of Medical OncologySecond Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Bing Zhao
- Department of Pulmonary MedicineAffiliated Cancer Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Chunling Liu
- Department of Pulmonary MedicineAffiliated Cancer Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Xiaopeng He
- Department of Respiratory MedicineXianyang Central HospitalXianyangChina
| | - Xuan Liang
- Department of Medical OncologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Mengjie Liu
- Department of Medical OncologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Lili Jiang
- Department of Medical OncologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Wenjuan Wang
- Department of Medical OncologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Yuan Shen
- Department of Epidemiology and BiostatisticsSchool of Public HealthXi'an Jiaotong University Health Science CenterXi'anChina
| | - Duolao Wang
- Department of Epidemiology and BiostatisticsSchool of Public Health, Xi'an Jiaotong University Health Science CenterXi’anChina
| | - Baibing Mi
- Department of Epidemiology and BiostatisticsSchool of Public HealthXi'an Jiaotong University Health Science CenterXi'anChina
| | - Yixue Bai
- Department of Medical OncologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Xin Yu
- Department of Medical OncologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Xubo Huang
- Department of Medical OncologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Xiaohui Jia
- Department of Medical OncologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Xiaolan Fu
- Department of Medical OncologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Hui Guo
- Department of Medical OncologySecond Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
- Key Laboratory of Environment and Genes Related to DiseasesXi'an Jiaotong UniversityXi'anChina
- Bioinspired Engineering and Biomechanics CenterXi'an Jiaotong UniversityXi'anChina
| | - Min Jiao
- Department of Medical OncologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
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3
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Yang Y, Xu G. SARS-CoV-2 infection and COVID-19 vaccination in cancer patients undergoing immune checkpoint inhibitors. Cell Death Dis 2023; 14:390. [PMID: 37391394 PMCID: PMC10313683 DOI: 10.1038/s41419-023-05922-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/17/2023] [Accepted: 06/22/2023] [Indexed: 07/02/2023]
Abstract
Cancer patients are susceptible to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Different antitumor treatments have attracted wide attention in the context of coronavirus disease 2019 (COVID-19), especially immune checkpoint inhibitors (ICIs) that have revolutionized oncology changes. It may also have protective and therapeutic roles in viral infections. In this article, we collected 26 cases of SARS-CoV-2 infection during ICIs therapy and 13 related to COVID-19 vaccination from Pubmed, EMBASE, and Wed of Science. Of these 26 cases, 19 (73.1%) presented mild cases and 7 (26.9%) were severe cases. Melanoma (47.4%) was a common cancer type in mild cases and lung cancer (71.4%) in severe cases (P = 0.016). The results showed that their clinical outcomes varied widely. Although there are similarities between the immune checkpoint pathway and COVID-19 immunogenicity, ICIs therapy overactivated T cells, which often leads to immune-related adverse events. In fact, the COVID-19 vaccine has been shown to be safe and effective in patients treated with ICIs. In this review, we report the vital clinical observations of SARS-CoV-2 infection or vaccination in cancer patients treated with ICIs and explore the potential interaction between them.
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Affiliation(s)
- Yang Yang
- Department of Nephrology, The Second Affiliated Hospital of Nanchang University, Nanchang, PR China
| | - Gaosi Xu
- Department of Nephrology, The Second Affiliated Hospital of Nanchang University, Nanchang, PR China.
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4
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Clinical Outcomes after Immunotherapies in Cancer Setting during COVID-19 Era: A Systematic Review and Meta-Regression. REPORTS 2022. [DOI: 10.3390/reports5030031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: This study aims to describe COVID-19–related clinical outcomes after immunotherapies (ICIs) for cancer patients. Methods: In this meta-analysis, we searched databases to collect data that addressed outcomes after immunotherapies (ICIs) during the COVID-19 pandemic. The primary endpoint was COVID-19–related mortality. Secondary endpoints included COVID-related hospital readmission, emergency room (ER) visits, opportunistic infections, respiratory complications, need for ventilation, and thrombo-embolic events. Pooled event rates (PERs) were calculated and a meta-regression analysis was performed. Results: A total of 262 studies were identified. Twenty-two studies with a total of forty-four patients were eligible. The PER of COVID-19–related mortality was 39.73%, while PERs of COVID-19–related ER visits, COVID-19–related pulmonary complications, and COVID-19–related ventilator needs were 40.75%, 40.41%, and 34.92%, respectively. The PER of opportunistic infections was 34.92%. The PERs of the use of antivirals, antibiotics, steroids, prophylactic anticoagulants, and convalescent plasma were 62.12%, 57.12%, 51.36%, 41.90%, and 26.48%, respectively. There was a trend toward an association between previous respiratory diseases and COVID-19–related mortality. Conclusion: The rates of COVID-19–related mortality, ER visits, pulmonary complications, need for a ventilator, and opportunistic infections are still high after ICIs during the COVID-19 pandemic. There was a trend toward an association between previous respiratory diseases and COVID-19–related mortality.
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5
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Bersanelli M, Buti S, Rizzo M, Cortellini A, Cattrini C, Massari F, Masini C, Vitale MG, Fornarini G, Caffo O, Atzori F, Gatti A, Macrini S, Mucciarini C, Galli L, Morelli F, Stellato M, Fanelli M, Corti F, Zucali PA, Toscani I, Dalla Volta A, Gernone A, Baldessari C, La Torre L, Zara D, Gennari A, Bracarda S, Procopio G, Porta C. GU-CA-COVID: a clinical audit among Italian genitourinary oncologists during the first COVID-19 outbreak. Ther Adv Urol 2021; 13:17562872211054302. [PMID: 34707691 PMCID: PMC8543560 DOI: 10.1177/17562872211054302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 09/30/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Considering the growing genitourinary (GU) cancer population undergoing systemic treatment with immune checkpoint inhibitors (ICIs) in the context of the COVID-19 pandemic, we planned a clinical audit in 24 Italian institutions treating GU malignancies. Objective: The primary objective was investigating the clinical impact of COVID-19 in GU cancer patients undergoing ICI-based therapy during the first outbreak of SARS-CoV-2 contagion in Italy. Design, setting, and participants: The included centers were 24 Oncology Departments. Two online forms were completed by the responsible Oncology Consultants, respectively, for metastatic renal cell carcinoma (mRCC) and metastatic urothelial carcinoma (mUC) patients receiving at least one administration of ICIs between 31 January 2020 and 30 June 2020. Results and limitation: In total, 287 mRCC patients and 130 mUC patients were included. The COVID-19 incidence was, respectively, 3.5%, with mortality 1%, in mRCC patients and 7.7%, with mortality 3.1%, in mUC patients. In both groups, 40% of patients developing COVID-19 permanently discontinued anticancer treatment. The pre-test SARS-CoV-2 probability in the subgroup of patients who underwent nasal/pharyngeal swab ranged from 14% in mRCC to 26% in mUC. The main limitation of the work was its nature of audit: data were not recorded at the single-patient level. Conclusion: GU cancer patients undergoing active treatment with ICIs have meaningful risk factors for developing severe events from COVID-19 and permanent discontinuation of therapy after the infection. Treatment delays due to organizational issues during the pandemic were unlikely to affect the treatment outcome in this population.
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Affiliation(s)
| | - Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Mimma Rizzo
- Division of Translational Oncology, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy
| | - Alessio Cortellini
- Department of Biotechnology and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Carlo Cattrini
- Division of Oncology, Maggiore della Carità Hospital, Novara, Italy
| | - Francesco Massari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Cristina Masini
- Oncology Unit, Clinical Cancer Centre, AUSL-IRCCS di Reggio Emilia, Emilia, Italy
| | - Maria Giuseppa Vitale
- Department of Oncology and Haematology, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Giuseppe Fornarini
- Department of Medical Oncology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Orazio Caffo
- Medical Oncology Department, Santa Chiara Hospital, Trento, Italy
| | - Francesco Atzori
- Medical Oncology Unit, University Hospital and University of Cagliari, Cagliari, Italy
| | - Alice Gatti
- Division of Oncology, Maggiore della Carità Hospital, Novara, Italy
| | - Serena Macrini
- Department of Oncology, Azienda USL Toscana Sud Est, Arezzo, Italy
| | | | - Luca Galli
- Medical Oncology Unit, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Franco Morelli
- Medical Oncology Department, Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Marco Stellato
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Martina Fanelli
- Department of Oncology and Haematology, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Francesca Corti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Andrea Zucali
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Oncology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Ilaria Toscani
- Oncology & Hematology Department, Oncology Unit, Piacenza General Hospital, Piacenza, Italy
| | - Alberto Dalla Volta
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Medical Oncology, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - Angela Gernone
- Division of Oncology, AOU Consorziale Policlinico di Bari, Bari, Italy
| | - Cinzia Baldessari
- Department of Oncology and Haematology, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Leonardo La Torre
- Medical Oncology Department, Santa Maria della Scaletta Hospital, Imola, Italy
| | - Diego Zara
- Department of Medicine (DAME), University of Udine, Udine, Italy
- Department of Oncology, ASUFC University Hospital of Udine, Udine, Italy
| | - Alessandra Gennari
- Department of Translational Medicine, University of Piemonte Orientale, Vercelli, Italy; Division of Oncology, Maggiore della Carità Hospital, Novara, Italy
| | - Sergio Bracarda
- Department of Oncology, Azienda USL Toscana Sud Est, Arezzo, Italy
| | - Giuseppe Procopio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Camillo Porta
- Division of Oncology, AOU Consorziale Policlinico di Bari, Bari, Italy
- Chair of Oncology, Department of Biomedical Sciences and Human Oncology, University of Bari ‘A. Moro’, Bari, Italy
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6
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Morelli T, Fujita K, Redelman-Sidi G, Elkington PT. Infections due to dysregulated immunity: an emerging complication of cancer immunotherapy. Thorax 2021; 77:304-311. [PMID: 34607905 PMCID: PMC8867274 DOI: 10.1136/thoraxjnl-2021-217260] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/12/2021] [Indexed: 01/01/2023]
Abstract
Immune checkpoint inhibitors (ICIs) have revolutionised cancer treatment. However, immune-related adverse events (irAEs) are a common side effect which can mimic infection. Additionally, treatment of irAEs with corticosteroids and other immunosuppressant agents can lead to opportunistic infection, which we have classed as immunotherapy infections due to immunosuppression. However, emerging reports demonstrate that some infections can be precipitated by ICIs in the absence of immunosuppressive treatment, in contrast to the majority of reported cases. These infections are characterised by a dysregulated inflammatory immune response, and so we propose they are described as immunotherapy infections due to dysregulated immunity. This review summarises the rapidly emerging evidence of these phenomena and proposes a new framework for considering infection in the context of cancer immunotherapy.
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Affiliation(s)
- Tommaso Morelli
- NIHR Biomedical Research Centre, School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Kohei Fujita
- Respiratory Medicine, National Hospital Organisation Kyoto Medical Center, Kyoto, Japan
| | - Gil Redelman-Sidi
- Division of Infectious Diseases, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Paul T Elkington
- NIHR Biomedical Research Centre, School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK .,Institute for Life Sciences, University of Southampton, Southampton, UK
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7
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Qian W, Ye Y, Zuo L, Song T, Xu Q, Wang Y, Qian J, Tian Y. Immune checkpoint inhibitors use and effects on prognosis of COVID-19 infection: a systematic review and meta-analysis. Immunotherapy 2021; 13:1271-1282. [PMID: 34431319 PMCID: PMC8388614 DOI: 10.2217/imt-2021-0007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/29/2021] [Indexed: 12/18/2022] Open
Abstract
Aim: We aimed to quantify the effects of immune checkpoint inhibitors (ICIs) on the prognosis of COVID-19. Materials & methods: A meta-analysis was conducted and the hospitalization, severe disease and mortality rates were assessed. Thirteen studies comprising of 4614 cancer patients with COVID-19 were included. Results: When compared with cancer patients without prior ICI exposure, patients with prior ICI treatment exhibited a higher rate of hospitalization (odds ratio [OR] 2.0, 95% CI 1.19-3.38, p = 0.01). However, the OR of severe disease and mortality in ICI exposed cases was similar to non-ICI exposed patients (OR 1.55, 95% CI 0.69-3.51, p = 0.29; OR 1.12, 95% CI 0.85-1.48, p = 0.42, respectively). Conclusion: It is uncertain whether prior exposure to ICIs increases the risk of severe disease and death, however the observed OR suggest a higher rate of hospitalization.
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Affiliation(s)
- Wenwei Qian
- Department of General Surgery, Jinling Hospital, Medical School of Southeast University, No. 305 East Zhongshan Road, Nanjing, PR China
| | - Ying Ye
- Emergency Center, Affiliated Hospital of Xuzhou Medical College. 99 Huaihaixi Road, Xuzhou, Jiangsu, 221002, China
| | - Lugen Zuo
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, 233004, China
| | - Ting Song
- Department of Infectious Diseases, The Sixth People’s Hospital of Qingdao, No. 9 Fushun Road, Qingdao, Shandong, 266033, China
| | - Qing Xu
- Department of Oncology, Tongji University Cancer Center, The Shanghai Tenth People’s Hospital, Tongji University, Shanghai, China
| | - Yinghong Wang
- Department of Gastroenterology, Hepatology & Nutrition, The University of MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jun Qian
- Department of Oncology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China
| | - Yun Tian
- Department of Oncology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China
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8
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Switzer B, Haanen J, Lorigan PC, Puzanov I, Turajlic S. Clinical and immunologic implications of COVID-19 in patients with melanoma and renal cell carcinoma receiving immune checkpoint inhibitors. J Immunother Cancer 2021; 9:e002835. [PMID: 34272309 PMCID: PMC8288220 DOI: 10.1136/jitc-2021-002835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 12/13/2022] Open
Abstract
The clinical and immunologic implications of the SARS-CoV-2 pandemic for patients with cancer receiving systemic anticancer therapy have introduced a multitude of clinical challenges and academic controversies. This review summarizes the current evidence, discussion points, and recommendations regarding the use of immune checkpoint inhibitors (ICIs) in patients with cancer during the SARS-CoV-2 pandemic, with a focus on patients with melanoma and renal cell carcinoma (RCC). More specifically, we summarize the theoretical concepts and available objective data regarding the relationships between ICIs and the antiviral immune response, along with recommended clinical approaches to the management of melanoma and RCC patient cohorts receiving ICIs throughout the course of the COVID-19 pandemic. Additional insights regarding the use of ICIs in the setting of current and upcoming COVID-19 vaccines and broader implications toward future pandemics are also discussed.
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Affiliation(s)
- Benjamin Switzer
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - John Haanen
- Division of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Paul C Lorigan
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
- Division of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Igor Puzanov
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Samra Turajlic
- Renal and Skin Units, Royal Marsden NHS Foundation Trust, London, UK
- Cancer Dynamics Laboratory, The Francis Crick Institute, London, UK
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9
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Luo B, Li J, Hou X, Yang Q, Zhou Y, Ye J, Wu X, Feng Y, Hu T, Xu Z, He Y, Sun J. Indications for and contraindications of immune checkpoint inhibitors in cancer patients with COVID-19 vaccination. Future Oncol 2021; 17:3477-3484. [PMID: 34189948 PMCID: PMC8244550 DOI: 10.2217/fon-2021-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic has lasted over 1 year and will not disappear in a short time. There is no specific remedy against the virus as yet. Vaccination is thus far one of the most important strategies for preventing COVID-19. Cancer patients with COVID-19 have a higher mortality because of immunosuppression. Immune checkpoint inhibitors (ICIs) are a novel anticancer strategy for blocking inhibitory pathways, which are related to the immune response. There is a question regarding whether COVID-19 vaccination and ICI treatment impact each other in cancer patients. This review explores both sides of the relationship between ICI treatment and COVID-19 vaccination and suggests good efficacy and safety of ICI treatment after COVID-19 vaccination as well as little impact on the virus protection and toxicity associated with COVID-19 vaccination during ICI treatment. The novel coronavirus disease 2019 (COVID-19) pandemic has lasted over 1 year. Vaccination is a promising strategy for preventing COVID-19. Cancer patients are prone to infection with COVID-19, and these patients have high mortality. Immune checkpoint inhibitors (ICIs) are a novel anticancer strategy. Whether COVID-19 vaccination and ICI treatment impact each other in cancer patients remains unknown. This review explores both sides of the relationship between ICI treatment and COVID-19 vaccination and suggests good efficacy and safety of ICI treatment after COVID-19 vaccination as well as little impact on the virus protection and toxicity associated with COVID-19 vaccination during ICI treatment.
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Affiliation(s)
- Bangyu Luo
- Cancer Institute, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Jixi Li
- Cancer Institute, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Xianhua Hou
- Department of Neurology, First Affiliated Hospital, Army Medical University, Chongqing, China
| | - Qiao Yang
- Department of Ultrasound, 941 Hospital of The Chinese People's Liberation Army, Xining, China
| | - Yi Zhou
- Cancer Institute, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Jun Ye
- Department of Gastroenterology, First Affiliated Hospital, Army Medical University, Chongqing, China
| | - Xiaocheng Wu
- Department of Emergency, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Yimei Feng
- Department of Hematology, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Tianyu Hu
- Department of Nosocomial Infection Control, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Zhi Xu
- Institute of Respiratory Diseases, Key Laboratory of Respiratory Diseases Research, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Ying He
- Department of Neurology, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Jianguo Sun
- Cancer Institute, Second Affiliated Hospital, Army Medical University, Chongqing, China
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10
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Bersanelli M, Porta C. Impact of SARS-CoV-2 Pandemic on Kidney Cancer Management. KIDNEY CANCER 2021. [DOI: 10.3233/kca-210112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The SARS-CoV-2 pandemic still has a huge impact on the management of many chronic diseases such as cancer. Few data are presently available reagarding how the management of renal cell carcinoma (RCC) has changed due to this unprecedented situation. OBJECTIVE: To discuss the challenges and issues of the diagnosis and treatment of RCC in the COVID-19 era, and to provide recommendations based on the collected literature and our personal experience. METHODS: Systematic review of the available Literature regarding the management of RCC during the SARS-CoV-2 pandemic. RESULTS: Our review showed a prevalence of narrative publications, raising the issue of the real relevance of the evidence retrieved. Indeed, the only original data about RCC and COVID-19 found were a small retrospective case series and two surveys, providing either patients’ or physicians’ viewpoints. CONCLUSIONS: The expected delayed diagnosis of RCC could lead to an increase of advanced/metastatic cases; thus, proper therapeutic choices for patients with small renal masses should be carefully evaluated case by case, in order to avoid negative effects on long-term survival rates. The controversial interaction between immune checkpoint blockade and COVID-19 pathogenesis is more hypothetical than evidence-based, and thus immunotherapy should not be denied, whenever appropriate. To avoid treatments which won’t have an impact on patients’ survival, a honest and accurate evaluation of the cost/benefit ratio of each treatment option should be always performed. Finally, SARS-CoV-2 swab positivity should not prevent the continuation of ongoing active treatments in asymptomatic cases, or or after symptoms’ resolution.
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Affiliation(s)
- Melissa Bersanelli
- Medicine and Surgery Department, University of Parma and Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Camillo Porta
- Department of Biomedical Sciences and Human Oncology, University of Bari ‘A. Moro’ and Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Bari, Italy
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Lights and Shadows on Managing Immune Checkpoint Inhibitors in Oncology during the COVID-19 Era. Cancers (Basel) 2021; 13:cancers13081906. [PMID: 33921021 PMCID: PMC8071446 DOI: 10.3390/cancers13081906] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/06/2021] [Accepted: 04/12/2021] [Indexed: 12/30/2022] Open
Abstract
Simple Summary The potential interference at the immune response level between COVID-19 and cancer therapy raises key clinical questions and points out scientific issues that need to be promptly addressed. Among the therapeutic strategies available in oncological clinics, major concerns are raised by immunomodulatory drugs and, particularly, by immune checkpoint inhibitors (ICIs), which currently constitute a crucial drug in the management of several types of advanced and metastatic solid tumors. To date, the debate about the real impact of ICIs on the clinical outcome of COVID infection is still open. Here, we report and review the results of pertinent studies designed to evaluate the relationships between ICI treatment and COVID-19. Abstract 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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12
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Urological cancer patients receiving treatment during COVID-19: a single-centre perspective. Br J Cancer 2021; 124:1513-1515. [PMID: 33558714 PMCID: PMC7869760 DOI: 10.1038/s41416-021-01263-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/15/2020] [Accepted: 01/06/2021] [Indexed: 12/30/2022] Open
Abstract
Background Active cancer, immunosuppressive treatments and immunotherapies have been reported to increase cancer patients’ risk of developing severe COVID-19 infection. For patients and clinicians, treatment risk must be weighed against disease progression. Methods This retrospective case series surveys urological cancer patients who made informed decisions to continue anticancer treatment (ACT) at one centre from March to June 2020. Results Sixty-one patients (44 bladder, 10 prostate, 7 upper urinary tract cancers) received 195 cycles of ACT (99 chemotherapy, 59 immunotherapy, 37 as part of ongoing clinical trials), with a range of indications: 43 palliative, 10 neoadjuvant, 8 adjuvant. One patient tested positive for COVID-19 but experienced only mild symptoms. Fourteen patients interrupted treatment outside of their schedule, seven of these due to potential COVID-19 associated risk. ACT supportive steroids were not associated with higher rates of COVID-19. Conclusions This single-centre series reports that ACT administration did not result in an apparent excess in symptomatic COVID-19 infections.
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13
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de Joode K, Oostvogels AAM, GeurtsvanKessel CH, de Vries RD, Mathijssen RHJ, Debets R, van der Veldt AAM. Case Report: Adequate T and B Cell Responses in a SARS-CoV-2 Infected Patient After Immune Checkpoint Inhibition. Front Immunol 2021; 12:627186. [PMID: 33613575 PMCID: PMC7889602 DOI: 10.3389/fimmu.2021.627186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 01/07/2021] [Indexed: 01/01/2023] Open
Abstract
After the COVID-19 outbreak, non-evidence based guidelines were published to advise clinicians on the adjustment of oncological treatment during this pandemic. As immune checkpoint inhibitors directly affect the immune system, concerns have arisen about the safety of immunotherapy during this pandemic. However, data on the immune response in oncology patients treated with immunotherapy are still lacking. Here, we present the adaptive immune response in a SARS-CoV-2 infected patient who was treated with immune checkpoint inhibitors for advanced renal cell cancer. To evaluate the immune response in this patient, the number of T cells and their major subsets were measured according to expression of markers for co-signalling, maturation, and chemotaxis at baseline, during therapy, and during the SARS-CoV-2 infection. In addition, plasma samples were analyzed for IgM and IgG antibodies and the ability of these antibodies to neutralise SARS-CoV-2. Despite several risk factors for an impaired immune response to SARS-CoV-2, both T- and B-cell responses were observed. Moreover, after treatment with immune checkpoint inhibitors, a sufficient cellular and humoral immune response was achieved in this SARS-CoV-2 infected patient. These findings warrant renewed discussion on withholding of immune checkpoint inhibitors during an ongoing COVID-19 pandemic.
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Affiliation(s)
- K de Joode
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - A A M Oostvogels
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | | | - R D de Vries
- Department of Viroscience, Erasmus Medical Center, Rotterdam, Netherlands
| | - R H J Mathijssen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - R Debets
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - A A M van der Veldt
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.,Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, Netherlands
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14
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Ruetsch C, Brglez V, Crémoni M, Zorzi K, Fernandez C, Boyer-Suavet S, Benzaken S, Demonchy E, Risso K, Courjon J, Cua E, Ichai C, Dellamonica J, Passeron T, Seitz-Polski B. Functional Exhaustion of Type I and II Interferons Production in Severe COVID-19 Patients. Front Med (Lausanne) 2021; 7:603961. [PMID: 33585507 PMCID: PMC7873370 DOI: 10.3389/fmed.2020.603961] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/18/2020] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged in Wuhan in December 2019 and has since spread across the world. Even though the majority of patients remain completely asymptomatic, some develop severe systemic complications. In this prospective study we compared the immunological profile of 101 COVID-19 patients with either mild, moderate or severe form of the disease according to the WHO classification, as well as of 50 healthy subjects, in order to identify functional immune factors independently associated with severe forms of COVID-19. Plasma cytokine levels, and cytokine levels upon in vitro non-specific stimulation of innate and adaptive immune cells, were measured at several time points during the course of the disease. As described previously, inflammatory cytokines IL1β, IL6, IL8, and TNFα associated with cytokine storm were significantly increased in the plasma of moderate and severe COVID-19 patients (p < 0.0001 for all cytokines). During follow-up, plasma IL6 levels decreased between the moment of admission to the hospital and at the last observation carried forward for patients with favorable outcome (p = 0.02148). After in vitro stimulation of immune cells from COVID-19 patients, reduced levels of both type I and type II interferons (IFNs) upon in vitro stimulation were correlated with increased disease severity [type I IFN (IFNα): p > 0.0001 mild vs. moderate and severe; type II IFN (IFNγ): p = 0.0002 mild vs. moderate and p < 0.0001 mild vs. severe] suggesting a functional exhaustion of IFNs production. Stimulated IFNα levels lower than 2.1 pg/ml and IFNγ levels lower than 15 IU/mL at admission to the hospital were associated with more complications during hospitalization (p = 0.0098 and p =0.0002, respectively). A low IFNγ level was also confirmed by multivariable analysis [p = 0.0349 OR = 0.98 (0.962; 0.999)] as an independent factor of complications. In vitro treatment with type IFNα restored type IFNγ secretion in COVID-19 patients while the secretion of pro-inflammatory cytokines IL6 and IL1β remained stable or decreased, respectively. These results (a) demonstrate a functional exhaustion of both innate and adaptive immune response in severe forms of COVID-19; (b) identify IFNα and IFNγ as new potential biomarkers of severity; and (c) highlight the importance of targeting IFNs when considering COVID-19 treatment in order to re-establish a normal balance between inflammatory and Th1 effector cytokines.
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Affiliation(s)
- Caroline Ruetsch
- Laboratoire d'Immunologie, Centre Hospitalier Universitaire (CHU) de Nice, Université Côte d'Azur, Nice, France
- Centre Méditerranéen de Médecine Moléculaire (C3M), INSERM U1065, Université Côte d'Azur, Nice, France
| | - Vesna Brglez
- Unité de Recherche Clinique de la Côte d'Azur (UR2CA), Université Côte d'Azur, Nice, France
| | - Marion Crémoni
- Unité de Recherche Clinique de la Côte d'Azur (UR2CA), Université Côte d'Azur, Nice, France
| | - Kévin Zorzi
- Unité de Recherche Clinique de la Côte d'Azur (UR2CA), Université Côte d'Azur, Nice, France
| | - Céline Fernandez
- Unité de Recherche Clinique de la Côte d'Azur (UR2CA), Université Côte d'Azur, Nice, France
| | - Sonia Boyer-Suavet
- Unité de Recherche Clinique de la Côte d'Azur (UR2CA), Université Côte d'Azur, Nice, France
| | - Sylvia Benzaken
- Laboratoire d'Immunologie, Centre Hospitalier Universitaire (CHU) de Nice, Université Côte d'Azur, Nice, France
| | - Elisa Demonchy
- Service d'Infectiologie, Centre Hospitalier Universitaire (CHU) de Nice, Université Côte d'Azur, Nice, France
| | - Karine Risso
- Service d'Infectiologie, Centre Hospitalier Universitaire (CHU) de Nice, Université Côte d'Azur, Nice, France
| | - Johan Courjon
- Service d'Infectiologie, Centre Hospitalier Universitaire (CHU) de Nice, Université Côte d'Azur, Nice, France
| | - Eric Cua
- Service d'Infectiologie, Centre Hospitalier Universitaire (CHU) de Nice, Université Côte d'Azur, Nice, France
| | - Carole Ichai
- Service de réanimation, Centre Hospitalier Universitaire (CHU) de Nice, Université Côte d'Azur, Nice, France
| | - Jean Dellamonica
- Unité de Recherche Clinique de la Côte d'Azur (UR2CA), Université Côte d'Azur, Nice, France
- Service de réanimation, Centre Hospitalier Universitaire (CHU) de Nice, Université Côte d'Azur, Nice, France
| | - Thierry Passeron
- Centre Méditerranéen de Médecine Moléculaire (C3M), INSERM U1065, Université Côte d'Azur, Nice, France
- Service de dermatologie, Centre Hospitalier Universitaire (CHU) de Nice, Université Côte d'Azur, Nice, France
| | - Barbara Seitz-Polski
- Laboratoire d'Immunologie, Centre Hospitalier Universitaire (CHU) de Nice, Université Côte d'Azur, Nice, France
- Unité de Recherche Clinique de la Côte d'Azur (UR2CA), Université Côte d'Azur, Nice, France
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15
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Aapro M, Lyman GH, Bokemeyer C, Rapoport BL, Mathieson N, Koptelova N, Cornes P, Anderson R, Gascón P, Kuderer NM. Supportive care in patients with cancer during the COVID-19 pandemic. ESMO Open 2020; 6:100038. [PMID: 33421735 PMCID: PMC7808078 DOI: 10.1016/j.esmoop.2020.100038] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/25/2020] [Accepted: 12/10/2020] [Indexed: 12/11/2022] Open
Abstract
Cancer care has been profoundly impacted by the global pandemic of severe acute respiratory syndrome coronavirus 2 disease (coronavirus disease 2019, COVID-19), resulting in unprecedented challenges. Supportive care is an essential component of cancer treatment, seeking to prevent and manage chemotherapy complications such as febrile neutropenia, anaemia, thrombocytopenia/bleeding, thromboembolic events and nausea/vomiting, all of which are common causes of hospitalisation. These adverse events are an essential consideration under routine patient management, but particularly so during a pandemic, a setting in which clinicians aim to minimise patients' risk of infection and need for hospital visits. Professional medical oncology societies have been providing updated guidelines to support health care professionals with the management, treatment and supportive care needs of their patients with cancer under the threat of COVID-19. This paper aims to review the recommendations made by the most prominent medical oncology societies for devising and modifying supportive care strategies during the pandemic. Cancer care has been profoundly impacted by the global pandemic of COVID-19, resulting in unprecedented challenges. Oncology societies have updated guidelines for the supportive care needs of patients with cancer under the threat of COVID-19. This paper reviews recommendations from prominent oncology societies for providing supportive care during the pandemic.
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Affiliation(s)
- M Aapro
- Genolier Cancer Centre, Clinique de Genolier, Genolier, Switzerland
| | - G H Lyman
- Hutchinson Institute for Cancer Outcomes Research, Public Health Sciences and Clinical Research Divisions, Fred Hutchinson Cancer Research Center and the University of Washington Schools of Medicine, Public Health and Pharmacy, Seattle, USA.
| | - C Bokemeyer
- Department of Oncology, Hematology & BMT with Section of Pneumology, Universitaetsklinikum Hamburg Eppendorf, Hamburg, Germany
| | - B L Rapoport
- Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; The Medical Oncology Centre of Rosebank, Johannesburg, South Africa; Neutropenia, Infection and Myelosuppression Study Group (Chair), The Multinational Association for Supportive Care in Cancer, Aurora, Canada
| | | | | | - P Cornes
- Comparative Outcomes Group, Bristol, UK
| | - R Anderson
- Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - P Gascón
- Department of Hematology-Oncology, Laboratory of Molecular & Translational Oncology-CELLEX University of Barcelona, Barcelona, Spain
| | - N M Kuderer
- Advanced Cancer Research Group, Seattle, USA
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Cancer and Immune Checkpoint Inhibitor Treatment in the Era of SARS-CoV-2 Infection. Cancers (Basel) 2020; 12:cancers12113383. [PMID: 33207589 PMCID: PMC7698088 DOI: 10.3390/cancers12113383] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/13/2020] [Accepted: 11/13/2020] [Indexed: 12/17/2022] Open
Abstract
Simple Summary The introduction of immune checkpoint inhibitors (ICI) in 2011 revolutionized the management of many solid cancers and hematological malignancies. However, there are concerns regarding the use of ICI in the era of COVID-19. We present currently available information on the pros and cons of using ICI in cancer patients with respect to the risk of acquiring an infection by SARS-CoV2 and mortality from COVID-19. By means of the present paper, clinicians and researchers may update their knowledge on a highly topical clinical question—is the use of ICI in cancer patients with SARS-CoV2 infection harmful with respect to COVID-19 outcome? Abstract Whether cancer patients receiving immune checkpoint inhibitors (ICI) are at an increased risk of severe infection and mortality during the corona pandemic is a hotly debated topic that will continue to evolve. Here, we summarize and discuss current studies regarding COVID-19 and anti-cancer treatment with an emphasis on ICI. Importantly, several lines of evidence suggest that patients currently treated with ICI do not display an increased vulnerability to infection with SARS-CoV-2. Data regarding morbidity and mortality associated with COVID-19 in cancer patients receiving ICI are less clear and often conflicting. Although mostly based on experimental data, it is possible that ICI can promote the exacerbated immune response associated with adverse outcome in COVID-19 patients. On the other hand, mounting evidence suggests that ICI might even be useful in the treatment of viral infections by preventing or ameliorating T cell exhaustion. In this context, the right timing of treatment might be essential. Nevertheless, some cancer patients treated with ICI experience autoimmune-related side effects that require the use of immunosuppressive therapies, which in turn may promote a severe course of infection with SARS-CoV-2. Although there is clear evidence that withholding ICI will have more serious consequences, further studies are urgently needed in to better evaluate the effects of ICI in patients with COVID-19 and the use of ICI during the corona pandemic in general.
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17
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Zhai M, Zhang S. A Nasopharyngeal Carcinoma Patient With COVID-19 Infection After Immunotherapy: A Case Report and Literature Review. In Vivo 2020; 34:3753-3756. [PMID: 33144494 DOI: 10.21873/invivo.12225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND/AIM Novel coronavirus infection in a cancer patient treated with immunotherapy, requires high attention. CASE REPORT Clinical and radiological data were obtained from the electronic medical record. Pharynx swab was tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA by reverse transcription-polymerase chain reaction (RT-PCR). The nasopharyngeal carcinoma patient developed fever on the third day after chemotherapy and immunotherapy. Laboratory examination showed lymphocytopenia. On the sixth day, chest computed tomography (CT) images showed bilateral scattered ground-glass opacities and reticulation. Pharynx swab was positive for SARS-CoV-2 nucleic acid and the patient was confirmed as having Coronavirus Disease 2019 (COVID-19). Unfortunately, despite aggressive treatment after the diagnosis of COVID-19, the patient died quickly. CONCLUSION The patient with nasopharyngeal carcinoma in this case developed severe COVID-19 after receiving immunotherapy. For patients treated with immune checkpoint inhibitors (ICIs) in epidemic areas, the safety of ICIs in cancer patients infected with SARS-CoV-2 should be considered.
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Affiliation(s)
- Menglan Zhai
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Sheng Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
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18
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The Impact of the COVID-19 Pandemic on Genitourinary Cancer Care: Re-envisioning the Future. Eur Urol 2020; 78:731-742. [PMID: 32893062 PMCID: PMC7471715 DOI: 10.1016/j.eururo.2020.08.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/20/2020] [Indexed: 12/14/2022]
Abstract
CONTEXT The coronavirus disease 2019 (COVID-19) pandemic necessitated rapid changes in medical practice. Many of these changes may add value to care, creating opportunities going forward. OBJECTIVE To provide an evidence-informed, expert-derived review of genitourinary cancer care moving forward following the initial COVID-19 pandemic. EVIDENCE ACQUISITION A collaborative narrative review was conducted using literature published through May 2020 (PubMed), which comprised three main topics: reduced in-person interactions arguing for increasing virtual and image-based care, optimisation of the delivery of care, and the effect of COVID-19 in health care facilities on decision-making by patients and their families. EVIDENCE SYNTHESIS Patterns of care will evolve following the COVID-19 pandemic. Telemedicine, virtual care, and telemonitoring will increase and could offer broader access to multidisciplinary expertise without increasing costs. Comprehensive and integrative telehealth solutions will be necessary, and should consider patients' mental health and access differences due to socioeconomic status. Investigations and treatments will need to maximise efficiency and minimise health care interactions. Solutions such as one stop clinics, day case surgery, hypofractionated radiotherapy, and oral or less frequent drug dosing will be preferred. The pandemic necessitated a triage of those patients whose treatment should be expedited, delayed, or avoided, and may persist with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in circulation. Patients whose demographic characteristics are at the highest risk of complications from COVID-19 may re-evaluate the benefit of intervention for less aggressive cancers. Clinical research will need to accommodate virtual care and trial participation. Research dissemination and medical education will increasingly utilise virtual platforms, limiting in-person professional engagement; ensure data dissemination; and aim to enhance patient engagement. CONCLUSIONS The COVID-19 pandemic will have lasting effects on the delivery of health care. These changes offer opportunities to improve access, delivery, and the value of care for patients with genitourinary cancers but raise concerns that physicians and health administrators must consider in order to ensure equitable access to care. PATIENT SUMMARY The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the care provided to many patients with genitourinary cancers. This has necessitated a transition to telemedicine, changes in threshold or delays in many treatments, and an opportunity to reimagine patient care to maintain safety and improve value moving forward.
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19
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Bersanelli M, Zielli T, Perrone F, Casartelli C, Pratticò F, Rapacchi E, Camisa R, Tognetto M, Clemente A, Giannarelli D, Rebuzzi SE, Leonetti A, Bordi P, Tiseo M, Buti S. Clinical impact of COVID-19 in a single-center cohort of a prospective study in cancer patients receiving immunotherapy. Immunotherapy 2020; 12:1139-1148. [PMID: 32933369 PMCID: PMC7493722 DOI: 10.2217/imt-2020-0211] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/03/2020] [Indexed: 12/24/2022] Open
Abstract
Aim: Evaluating the incidence and course of COVID-19 in cancer patients treated with immunotherapy. Patients & methods: We reported the influenza-like illness events with diagnosis of COVID-19 within the patient cohort enrolled in the prospective observational multicenter INVIDIa-2 study in the single center of Parma. Results: Among 53 patients, eight experienced influenza-like illness during the influenza season 2019/2020, and three of them had diagnosis of COVID-19. They were males, elderly, with cardiovascular disease. Radiological features of COVID-19 pneumonitis were found in all of three cases, although the pharyngeal swab resulted positive in only two. Two of these three patients died due to respiratory failure. Conclusion: Cancer patients are at high risk of severe events from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
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Affiliation(s)
- Melissa Bersanelli
- Medical Oncology Unit, University of Parma, 43126, Parma, Italy
- Medicine & Surgery Department, University of Parma, Parma, Italy
| | | | | | | | - Fabiana Pratticò
- Medicine & Surgery Department, University of Parma, Parma, Italy
| | - Elena Rapacchi
- Medical Oncology Unit, University of Parma, 43126, Parma, Italy
| | - Roberta Camisa
- Medical Oncology Unit, University of Parma, 43126, Parma, Italy
| | | | - Alberto Clemente
- Biostatistics & Clinical Research Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014, Meldola, Italy
| | - Diana Giannarelli
- Biostatistical Unit, Regina Elena National Cancer Institute, IRCCS, 00144, Rome, Italy
| | | | - Alessandro Leonetti
- Medical Oncology Unit, University of Parma, 43126, Parma, Italy
- Medicine & Surgery Department, University of Parma, Parma, Italy
| | - Paola Bordi
- Medical Oncology Unit, University of Parma, 43126, Parma, Italy
| | - Marcello Tiseo
- Medicine & Surgery Department, University of Parma, Parma, Italy
| | - Sebastiano Buti
- Medical Oncology Unit, University of Parma, 43126, Parma, Italy
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Antineoplastics/corticosteroids/immunoconjugates. REACTIONS WEEKLY 2020. [PMCID: PMC7474509 DOI: 10.1007/s40278-020-82870-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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