Department of Medical Oncology, University Campus Bio-Medico , Rome, Italy.
Department of Medical Oncology, St. Salvatore Hospital , L'Aquila, Italy.
Expert Opin Biol Ther. 2020 Sep;20(9):959-964. doi: 10.1080/14712598.2020.1789097. Epub 2020 Jul 2.
The COVID-19 pandemic occurred amid the cancer immunotherapy revolution. Immune checkpoint inhibitors (ICIs) have become the standard of care for several solid cancers and are associated with peculiar toxicities, including pneumonitis which has similar features to COVID-19 pneumonia.
We summarize the main hallmarks of lung injury induced by ICIs and severe acute respiratory syndrome coronavirus 2 and discuss the critical aspects for differential diagnosis and management. Symptoms and radiological findings are often similar; conversely, treatments are quite different. Furthermore, we focus on potential interactions generating hypotheses that need confirmatory studies.
All cancer patients treated with immunotherapy should receive screening for SARS-CoV-2. This would improve the diagnosis and management of pneumonia and guide therapeutic choices. Furthermore, clinicians could estimate the risk/benefit of continuing ICI treatment in COVID-19 positive patients. Temporary withdrawal of the immunotherapy treatment pending resolution of viral infection may be a reasonable option in long-responders patients.
COVID-19 大流行发生在癌症免疫治疗革命期间。免疫检查点抑制剂（ICI）已成为几种实体瘤的标准治疗方法，并且与特殊的毒性相关，包括肺炎，其具有与 COVID-19 肺炎相似的特征。
我们总结了 ICI 和严重急性呼吸系统综合征冠状病毒 2 引起的肺损伤的主要特征，并讨论了鉴别诊断和管理的关键方面。症状和影像学表现通常相似；相反，治疗方法却大不相同。此外，我们专注于可能产生需要验证性研究的假设的相互作用。
所有接受免疫治疗的癌症患者都应接受 SARS-CoV-2 的筛查。这将改善肺炎的诊断和治疗，并指导治疗选择。此外，临床医生可以评估 COVID-19 阳性患者继续使用 ICI 治疗的风险/获益。对于长期应答者患者，在病毒感染解决之前暂时停止免疫治疗可能是一个合理的选择。
