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Retnakumar SV, Chauvin C, Bayry J. The implication of anti-PD-1 therapy in cancer patients for the vaccination against viral and other infectious diseases. Pharmacol Ther 2023; 245:108399. [PMID: 37001736 DOI: 10.1016/j.pharmthera.2023.108399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
The phenomenon of 'T cell exhaustion', a state of T cell dysfunction observed during chronic infections and cancers, has been a major obstacle in mounting appropriate immune responses against infectious agents or tumor antigens. The exhausted T cells are characterized by poor effector functions mainly due to the overexpression of inhibitory receptors such as programmed cell death protein 1 (PD-1), cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), T cell immunoglobulin and mucin-domain containing 3 (TIM3), lymphocyte activation gene 3 (LAG3), and T cell immunoreceptor with immunoglobulin and immunoreceptor tyrosine-based inhibitory motif (ITIM) domain (TIGIT), commonly referred to as immune checkpoint (ICP) molecules. ICP blockade, especially of PD-1 that can potentially reverse T cell exhaustion and thereby re-stimulate the impaired immune system, is widely used in clinics as a promising therapeutic strategy for various cancers and is more recently being investigated in infectious diseases as well. In fact, cancer patients represent a population of immunocompromised individuals who are more susceptible to infections and associated complications, and thus the need for protective vaccinations against these diseases is of prime importance in this category. When it comes to vaccinating anti-PD-1-treated cancer patients against infectious diseases including COVID-19 and influenza, a special focus should be brought on the revived immune cells, which could be dynamically affected by the antigenic stimulation. However, since cancer patients are not generally included in clinical trials for designing vaccines against infectious diseases, the possible interaction between vaccine immune responses and ICP therapy is largely unexplored. Mechanistically, the reversal of T cell exhaustion by ICP in an otherwise immunocompromised population could be beneficial for the vaccine's efficacy, helping the immune system to mount a robust immune response. Nevertheless, patients with cancer undergoing anti-PD-1 blockade are known to experience immune-related adverse effects (irAEs). The risk of increasing the irAEs due to the overstimulation of the immune system during vaccination is a major concern. Therefore, while routine vaccination is indispensable for the protection of cancer patients, the impact of PD-1 blockade on vaccine responses against infectious agents requires careful consideration to avoid undesirable adverse effects that could impair the efficacy of anti-cancer treatment.
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Brest P, Mograbi B, Hofman P, Milano G. COVID-19 vaccination and cancer immunotherapy: should they stick together? Br J Cancer 2022; 126:1-3. [PMID: 34799696 PMCID: PMC8603902 DOI: 10.1038/s41416-021-01618-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/29/2021] [Accepted: 10/27/2021] [Indexed: 02/08/2023] Open
Abstract
The combination of COVID-19 vaccination with immunotherapy by checkpoint inhibitors in cancer patients could intensify immunological stimulation with potential reciprocal benefits. Here, we examine more closely the possible adverse events that can arise in each treatment modality. Our conclusion is that caution should be exercised when combining both treatments.
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Affiliation(s)
- Patrick Brest
- grid.417812.90000 0004 0639 1794Université Côte d’Azur, CNRS, Inserm, IRCAN, Centre Antoine Lacassagne, FHU-OncoAge, 06189 Nice, France
| | - Baharia Mograbi
- grid.417812.90000 0004 0639 1794Université Côte d’Azur, CNRS, Inserm, IRCAN, Centre Antoine Lacassagne, FHU-OncoAge, 06189 Nice, France
| | - Paul Hofman
- grid.417812.90000 0004 0639 1794Université Côte d’Azur, CNRS, Inserm, IRCAN, Centre Antoine Lacassagne, FHU-OncoAge, 06189 Nice, France ,grid.460782.f0000 0004 4910 6551Université Côte d’Azur, Laboratory of Clinical and Experimental Pathology, CHU-Nice, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), Nice, France
| | - Gerard Milano
- Université Côte d'Azur, Centre Antoine Lacassagne, EA7497, Nice, France.
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Trillo Aliaga P, Trapani D, Sandoval JL, Crimini E, Antonarelli G, Vivanet G, Morganti S, Corti C, Tarantino P, Friedlaender A, Belli C, Minchella I, Locatelli M, Esposito A, Criscitiello C, Curigliano G. Safety of COVID-19 mRNA Vaccines in Patients with Cancer Enrolled in Early-Phase Clinical Trials. Cancers (Basel) 2021; 13:cancers13225829. [PMID: 34830983 PMCID: PMC8616209 DOI: 10.3390/cancers13225829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary We investigated for the first time the safety profile of COVID-19 vaccines in patients receiving new antineoplastic agents in early-stage clinical trials, including new immuno-regulatory anti-cancer investigational compounds and drug combinations. We found that about three-quarters of the patients under active anticancer treatments experienced mild to moderate adverse effects (AEs) related to COVID-19 vaccines. Patients enrolled in early-phase trials or receiving experimental immunotherapy agents did not experience worse AEs related to the vaccine than patients with cancer not enrolled in these trials, receiving approved drugs. The safety profile of COVID-19 vaccines in patients enrolled in early-phase clinical trials, including those treated with new immune checkpoint inhibitors, does not seem to differ from that of the general population of patients with cancer. Our data support the current vaccine prioritization of all cancer patients with active treatment and calls for data sharing from vaccinated patients enrolled in early-phase clinical trials. Abstract Pivotal trials of COVID-19 vaccines did not include cancer patients, with questions remaining about their safety and efficacy in this population. Patients enrolled in early-phase clinical trials receive novel treatments with unknown efficacy and safety profiles. Studies on the safety of COVID-19 vaccines in these patients are urgently required. This is a retrospective, real-world, cohort study of patients receiving anticancer treatments and COVID-19 vaccines between 1 February and 25 June 2021 at the Division of New Drugs Development for Innovative Therapies of the European Institute of Oncology. One hundred thirteen patients were enrolled, 40 in early-phase clinical trials, and 20 under novel immunotherapy agents. Nearly three-quarters of the patients experienced at least one adverse event (AE) after the first dose (1D) (74.3%) and second dose (2D) (72.6%). Most of the AEs were local (67.3% 1D and 61.9% after 2D), while 31.8% (1D) and 38.1% (2D) of the patients had systemic AEs. No AEs above grade 2 were observed. Therefore, COVID-19 vaccines appear to be safe in patients enrolled in early-phase clinical trials, including patients receiving novel immunotherapy compounds. All cancer patients should be prioritized for COVID-19 vaccination, regardless of ongoing treatments or enrollment in early-phase trials.
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Affiliation(s)
- Pamela Trillo Aliaga
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Dario Trapani
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
| | - José Luis Sandoval
- Unit of Population Epidemiology, Division and Department of Primary Care Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland;
- Department of Oncology, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Edoardo Crimini
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Gabriele Antonarelli
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Grazia Vivanet
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Stefania Morganti
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Chiara Corti
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Paolo Tarantino
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Alex Friedlaender
- Department of Oncology, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Carmen Belli
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
| | - Ida Minchella
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
| | - Marzia Locatelli
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
| | - Angela Esposito
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
| | - Carmen Criscitiello
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Giuseppe Curigliano
- Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, 20141 Milan, Italy; (P.T.A.); (D.T.); (E.C.); (G.A.); (G.V.); (S.M.); (C.C.); (P.T.); (C.B.); (I.M.); (M.L.); (A.E.); (C.C.)
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
- Correspondence:
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Shafiekhani M, Dehghani A, Shahisavandi M, Nabavizadeh SA, Kabiri M, Hassani AH, Haghpanah A. Pharmacotherapeutic approach toward urological medications and vaccination during COVID-19: a narrative review. Ther Adv Urol 2021; 13:17562872211046794. [PMID: 34603508 PMCID: PMC8481748 DOI: 10.1177/17562872211046794] [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: 06/17/2021] [Accepted: 08/30/2021] [Indexed: 01/08/2023] Open
Abstract
One year after the prevalence of the novel coronavirus pandemic, some aspects of the physiopathology, treatment and progression of coronavirus 2019 disease (COVID-19) have remained unknown. Since no comprehensive study on the use of urological medications in patients with COVID-19 has been carried out, this narrative review aimed to focus on clinically important issues about the treatment of COVID-19 and urologic medications regarding efficacy, modifications, side effects and interactions in different urologic diseases. In this review, we provide information about the pharmacotherapeutic approach toward urologic medications in patients with COVID-19 infection. This study provides an overview of medications in benign prostatic hyperplasia, prostate cancer, impotence and sexual dysfunction, urolithiasis, kidney transplantation and hypertension as the most frequent diseases in which the patients are on long-term medications. Also, the effect of urologic drugs on the efficacy of vaccination is briefly discussed.
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Affiliation(s)
- Mojtaba Shafiekhani
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anahita Dehghani
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mina Shahisavandi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Maryam Kabiri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Abdolreza Haghpanah
- Assistant Professor of Urology, Endourology Ward, Urology Department, Shiraz University of Medical Sciences, Shiraz, 71348-44119, Iran Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, 71348-44119, Iran
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Bayle A, Baldini C, Martin-Romano P, Michot JM, Champiat S, Bahleda R, Gazzah A, Marabelle A, Verlingue L, Geraud A, Morel D, Michiels S, Hollebecque A, Albiges L, Besse B, Soria JC, Massard C, Barlesi F, Postel-Vinay S. Sustained cancer clinical trial activity in a French hospital during the first wave of the COVID-19 pandemic. Cancer Cell 2021; 39:1039-1041. [PMID: 34197735 PMCID: PMC8243022 DOI: 10.1016/j.ccell.2021.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Arnaud Bayle
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France; Université Paris Saclay, Université Paris-Sud, Faculté de Médicine, Le Kremlin Bicêtre, Paris, France; Oncostat U1018, Inserm, Paris-Saclay University, Labeled Ligue Contre le Cancer, Villejuif, France.
| | - Capucine Baldini
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France
| | | | - Jean-Marie Michot
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France
| | - Stéphane Champiat
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France
| | - Rastilav Bahleda
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France
| | - Anas Gazzah
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France
| | - Aurélien Marabelle
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France
| | - Loic Verlingue
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France
| | - Arthur Geraud
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France
| | - Daphné Morel
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France
| | - Stefan Michiels
- Oncostat U1018, Inserm, Paris-Saclay University, Labeled Ligue Contre le Cancer, Villejuif, France; Biostatistics and Epidemiology Office, Gustave Roussy, Villejuif Cedex, France
| | - Antoine Hollebecque
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France
| | - Laurence Albiges
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Benjamin Besse
- Université Paris Saclay, Université Paris-Sud, Faculté de Médicine, Le Kremlin Bicêtre, Paris, France; Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Jean-Charles Soria
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France; Université Paris Saclay, Université Paris-Sud, Faculté de Médicine, Le Kremlin Bicêtre, Paris, France
| | - Christophe Massard
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France; Université Paris Saclay, Université Paris-Sud, Faculté de Médicine, Le Kremlin Bicêtre, Paris, France
| | - Fabrice Barlesi
- Department of Medical Oncology, Gustave Roussy, Villejuif, France; Aix Marseille University, CNRS, INSERM, CRCM, Marseille, France
| | - Sophie Postel-Vinay
- Drug Development Department (DITEP) Gustave Roussy-Cancer Campus, Villejuif, France; ATIP-Avenir, U981 INSERM, Villejuif, France.
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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: 1.3] [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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COVID-19 and Malignancy: Exploration of the possible genetic and epigenetic interlinks and overview of the vaccination scenario. Cancer Treat Res Commun 2021; 28:100425. [PMID: 34171559 PMCID: PMC8213508 DOI: 10.1016/j.ctarc.2021.100425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Malignancy is one of the prime global causes of mortality. Cancer Patients suffering from SARS-CoV-2 have demonstrated higher rates of severe complications exacerbating towards death. Possible genetic and epigenetic alterations may exist in cancer patients which have the potential to contribute towards their increased vulnerability towards COVID-19. METHOD An exhaustive literature search using 'COVID-19', 'SARS-CoV-2', 'Cancer', 'Malignancy', 'Relationships', Interlinks', 'Genetic', 'Epigenetic', 'Epidemiological studies', 'Clinical Studies', 'Vaccination', 'Vaccine scenario' were conducted in PubMed and EMBASE till 2nd June 2021. RESULT In this narrative review, 17 epidemiological studies were listed which focused on clinical parameters of several malignancy patient cohorts who contracted COVID-19. Besides, genetic and epigenetic alterations seen among cancer patients are also discussed which may plausibly increase the vulnerability of cancer patients to SARS-CoV-2 infection. Also, global vaccination scenario among malignant patients along with the necessity to prioritize them in the vaccination campaigns are also elaborated. CONCLUSION Genetic and epigenetic modifications present in ACE2, TMPRSS2, IL-6 and several cytokines require more in-depth research to elucidate the shared mechanisms of malignancy and SARS-CoV-2.
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Potter DA, Thomas A, Rugo HS. A Neoadjuvant Chemotherapy Trial for Early Breast Cancer is Impacted by COVID-19: Addressing Vaccination and Cancer Trials Through Education, Equity, and Outcomes. Clin Cancer Res 2021; 27:4486-4490. [PMID: 34108186 DOI: 10.1158/1078-0432.ccr-21-1133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/14/2021] [Accepted: 06/03/2021] [Indexed: 11/16/2022]
Abstract
While COVID-19 vaccine distribution has addressed vulnerabilities related to age and comorbidities, there is a need to ensure vaccination of patients with cancer receiving experimental and routine treatment, where interruption of treatment by infection is likely to result in inferior outcomes. Among patients with cancer, those undergoing neoadjuvant chemotherapy (NAC) or adjuvant chemotherapy (Adj chemo) for early breast cancer (EBC) are at particularly high risk for inferior outcomes, in part, because optimal timing of chemotherapy is essential for promoting distant disease-free survival. COVID-19 data from the ongoing multicenter I-SPY 2 trial of NAC for EBC provides a window into the magnitude of the problem of treatment interruption, not only for the trial itself but also for routine Adj chemo. In the I-SPY 2 trial, 4.5% of patients had disruption of therapy by COVID-19, prior to wide vaccine availability, suggesting that nationally up to 5,700 patients with EBC were at risk for adverse outcomes from COVID-19 infection in 2020. To address this problem, vaccine education and public engagement are essential to overcome hesitancy, while equity of distribution is needed to address access. To accomplish these goals, healthcare organizations (HCO) need to not only call out disinformation but also engage the public with vaccine education and find common ground for vaccine acceptance, while partnering with state/local governments to improve efficiency of vaccine distribution. These approaches are important to improve trial access and to reduce susceptibility to COVID-19, as the pandemic could continue to impact access to clinical trials and routine cancer treatment.
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Affiliation(s)
- David A Potter
- University of Minnesota Division of Hematology, Oncology and Transplantation, Masonic Cancer Center, Minneapolis, Minnesota.
| | - Alexandra Thomas
- Wake Forest Baptist Health Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - Hope S Rugo
- University of California San Francisco Comprehensive Cancer Center, San Francisco, California
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Gediz Erturk A, Sahin A, Bati Ay E, Pelit E, Bagdatli E, Kulu I, Gul M, Mesci S, Eryilmaz S, Oba Ilter S, Yildirim T. A Multidisciplinary Approach to Coronavirus Disease (COVID-19). Molecules 2021; 26:3526. [PMID: 34207756 PMCID: PMC8228528 DOI: 10.3390/molecules26123526] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/04/2021] [Accepted: 06/04/2021] [Indexed: 02/07/2023] Open
Abstract
Since December 2019, humanity has faced an important global threat. Many studies have been published on the origin, structure, and mechanism of action of the SARS-CoV-2 virus and the treatment of its disease. The priority of scientists all over the world has been to direct their time to research this subject. In this review, we highlight chemical studies and therapeutic approaches to overcome COVID-19 with seven different sections. These sections are the structure and mechanism of action of SARS-CoV-2, immunotherapy and vaccine, computer-aided drug design, repurposing therapeutics for COVID-19, synthesis of new molecular structures against COVID-19, food safety/security and functional food components, and potential natural products against COVID-19. In this work, we aimed to screen all the newly synthesized compounds, repurposing chemicals covering antiviral, anti-inflammatory, antibacterial, antiparasitic, anticancer, antipsychotic, and antihistamine compounds against COVID-19. We also highlight computer-aided approaches to develop an anti-COVID-19 molecule. We explain that some phytochemicals and dietary supplements have been identified as antiviral bioproducts, which have almost been successfully tested against COVID-19. In addition, we present immunotherapy types, targets, immunotherapy and inflammation/mutations of the virus, immune response, and vaccine issues.
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Affiliation(s)
- Aliye Gediz Erturk
- Department of Chemistry, Faculty of Arts and Sciences, Ordu University, Altınordu, Ordu 52200, Turkey;
| | - Arzu Sahin
- Department of Basic Medical Sciences—Physiology, Faculty of Medicine, Uşak University, 1-EylulUşak 64000, Turkey;
| | - Ebru Bati Ay
- Department of Plant and Animal Production, Suluova Vocational School, Amasya University, Suluova, Amasya 05100, Turkey;
| | - Emel Pelit
- Department of Chemistry, Faculty of Arts and Sciences, Kırklareli University, Kırklareli 39000, Turkey;
| | - Emine Bagdatli
- Department of Chemistry, Faculty of Arts and Sciences, Ordu University, Altınordu, Ordu 52200, Turkey;
| | - Irem Kulu
- Department of Chemistry, Faculty of Basic Sciences, Gebze Technical University, Kocaeli 41400, Turkey;
| | - Melek Gul
- Department of Chemistry, Faculty of Arts and Sciences, Amasya University, Ipekkoy, Amasya 05100, Turkey
| | - Seda Mesci
- Scientific Technical Application and Research Center, Hitit University, Çorum 19030, Turkey;
| | - Serpil Eryilmaz
- Department of Physics, Faculty of Arts and Sciences, Amasya University, Ipekkoy, Amasya 05100, Turkey;
| | - Sirin Oba Ilter
- Food Processing Department, Suluova Vocational School, Amasya University, Suluova, Amasya 05100, Turkey;
| | - Tuba Yildirim
- Department of Biology, Faculty of Arts and Sciences, Amasya University, Ipekkoy, Amasya 05100, Turkey;
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Desai A, Gainor JF, Hegde A, Schram AM, Curigliano G, Pal S, Liu SV, Halmos B, Groisberg R, Grande E, Dragovich T, Matrana M, Agarwal N, Chawla S, Kato S, Morgan G, Kasi PM, Solomon B, Loong HH, Park H, Choueiri TK, Subbiah IM, Pemmaraju N, Subbiah V. COVID-19 vaccine guidance for patients with cancer participating in oncology clinical trials. Nat Rev Clin Oncol 2021; 18:313-319. [PMID: 33723371 PMCID: PMC7957448 DOI: 10.1038/s41571-021-00487-z] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 12/11/2022]
Abstract
Emerging efficacy data have led to the emergency use authorization or approval of COVID-19 vaccines in several countries worldwide. Most trials of COVID-19 vaccines excluded patients with active malignancies, and thus data on the safety, tolerability and efficacy of the vaccines in patients with cancer are currently limited. Given the risk posed by the COVID-19 pandemic, decisions regarding the use of vaccines against COVID-19 in patients participating in trials of investigational anticancer therapies need to be addressed promptly. Patients should not have to choose between enrolling on oncology clinical trials and receiving a COVID-19 vaccine. Clinical trial sponsors, investigators and treating physicians need operational guidance on COVID-19 vaccination for patients with cancer who are currently enrolled or might seek to enrol in clinical trials. Considering the high morbidity and mortality from COVID-19 in patients with cancer, the benefits of vaccination are likely to far outweigh the risks of vaccine-related adverse events. Herein, we provide operational COVID-19 vaccine guidance for patients participating in oncology clinical trials. In our perspective, continued quality oncological care requires that patients with cancer, including those involved in trials, be prioritized for COVID-19 vaccination, which should not affect trial eligibility.
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Affiliation(s)
- Aakash Desai
- Division of Medical Oncology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Justin F Gainor
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Aparna Hegde
- Department of Hematology and Oncology, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Giuseppe Curigliano
- Department of Oncology and Hemato-Oncology, University of Milan and European Institute of Oncology, IRCCS, Milan, Italy
| | - Sumanta Pal
- Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Stephen V Liu
- Department of Developmental Therapeutics, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Balazs Halmos
- Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, NY, USA
| | - Roman Groisberg
- Department of Melanoma/Sarcoma Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Enrique Grande
- Department of Medical Oncology, MD Anderson Cancer Center Madrid, Madrid, Spain
| | - Tomislav Dragovich
- Department of Hematology/Oncology, MD Anderson Banner Cancer Center, Gilbert, AZ, USA
| | - Marc Matrana
- Precision Cancer Therapies (Phase I) Research Program, Experimental Therapeutics, Ochsner, New Orleans, LA, USA
| | - Neeraj Agarwal
- Division of Oncology, Department of Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Sant Chawla
- Sarcoma Oncology Center, Santa Monia, CA, USA
| | - Shumei Kato
- Center for Personalized Cancer Therapy, Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Gilberto Morgan
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - Pashtoon M Kasi
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Department of Medicine, University of Iowa, Iowa City, IA, USA
| | - Benjamin Solomon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Herbert H Loong
- Department of Clinical Oncology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Haeseong Park
- Division of Oncology, Department of Medicine, Washington University in St. Louis, St Louis, MO, USA
| | - Toni K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ishwaria M Subbiah
- Department of Palliative, Rehabilitation & Integrative Medicine, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Naveen Pemmaraju
- Department of Leukemia, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Vivek Subbiah
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- MD Anderson Cancer Network, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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