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2019冠状病毒病大流行期间的癌症管理:基于免疫检查点抑制剂的免疫疗法有害还是有益?

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

作者信息

Vivarelli Silvia, Falzone Luca, Grillo Caterina Maria, Scandurra Giuseppa, Torino Francesco, Libra Massimo

机构信息

Laboratory of Translational Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy.

Epidemiology Unit, IRCCS Istituto Nazionale Tumori 'Fondazione G. Pascale', I-80131 Naples, Italy.

出版信息

Cancers (Basel). 2020 Aug 10;12(8):2237. doi: 10.3390/cancers12082237.

Abstract

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

摘要

2019年冠状病毒病(COVID-19)目前对全球健康构成威胁,尤其是对癌症患者等脆弱人群。已证实,癌症患者感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)后出现更严重症状的风险增加,常导致住院和重症监护。这场大流行对肿瘤学的影响非常严重,因为整个医疗系统都进行了重组。肿瘤学家和癌症患者都在经历治疗重新安排和预约中断,同时恐惧和压力激增。在本综述中,报告了关于COVID-19与癌症之间关联的所有最新发现。一个仍有很大争议的问题是,鉴于一类新型抗癌分子——免疫检查点抑制剂(ICI)对免疫系统的调节作用,其在癌症患者中的使用情况。因此,在这场大流行期间,给癌症患者使用ICI是一个问号,因为其与COVID-19相关风险的相关性仍在研究中。基于ICI的作用机制和现有证据,我们认为ICI不仅可以安全地用于癌症患者,而且通过发挥免疫刺激作用,甚至可能对COVID-19阳性癌症患者有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80ae/7465907/fd82ed624045/cancers-12-02237-g001.jpg

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