Lights and Shadows on Managing Immune Checkpoint Inhibitors in Oncology during the COVID-19 Era
Open Access
- 15 April 2021
- Vol. 13 (8), 1906
- https://doi.org/10.3390/cancers13081906
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.This publication has 48 references indexed in Scilit:
- Pneumonitis in Non–Small Cell Lung Cancer Patients Receiving Immune Checkpoint Immunotherapy: Incidence and Risk FactorsJournal of Thoracic Oncology, 2018
- Fundamental Mechanisms of Immune Checkpoint Blockade TherapyCancer Discovery, 2018
- Cancer immunotherapy using checkpoint blockadeScience, 2018
- Immune-Related Adverse Events Associated with Immune Checkpoint BlockadeThe New England Journal of Medicine, 2018
- Pneumonitis in Patients Treated With Anti–Programmed Death-1/Programmed Death Ligand 1 TherapyJournal of Clinical Oncology, 2017
- Current Diagnosis and Management of Immune Related Adverse Events (irAEs) Induced by Immune Checkpoint Inhibitor TherapyFrontiers in Pharmacology, 2017
- Targeting the programmed cell death 1: programmed cell death ligand 1 pathway reverses T cell exhaustion in patients with sepsisCritical Care, 2014
- Blocking the Natural Killer Cell Inhibitory Receptor NKG2A Increases Activity of Human Natural Killer Cells and Clears Hepatitis B Virus Infection in MiceGastroenterology, 2013
- Chemotherapy‐induced neutropeniaCancer, 2004
- Visualizing priming of virus-specific CD8+ T cells by infected dendritic cells in vivoNature Immunology, 2002