Division of Medical Oncology for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, Milan, Italy.
Division of Medical Oncology for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, Milan, Italy.
Semin Oncol. 2020 Oct;47(5):302-304. doi: 10.1053/j.seminoncol.2020.07.010. Epub 2020 Aug 7.
Patients with cancer are presumed to have a higher risk to contract SARS-CoV-2 infection, because of their immunosuppressed status. The impact and course of COVID-19 infection in cancer patients receiving immunotherapy remains unknown.
To evaluate the safety of the management of patients with advanced melanoma treated with immunotherapy in 2 Cancer Centers located in areas of Italy with a high incidence of COVID-19 infections.
We retrospectively analyzed data from January 1 to April 30, 2020 on patients with locally advanced and metastatic melanoma receiving immunotherapy at either Istituto Europeo di Oncologia or Città della Salute e della Scienza University Hospital.
One-hundred and sixty-nine patients with stage III and IV melanoma were treated with an immunotherapy regimen at either Istituto Europeo di Oncologia or Città della Salute e della Scienza University Hospital. One-hundred and four patients continued treatment without interruption or delay, while 49 patients had a treatment delay. The main reasons for treatment delay were older age (median age of the group of patients with or without treatment-delay, respectively 60 and 69 years, P value <0.001) and/or presence of comorbidities (percentage of patients with at least one comorbidity respectively 81% and 62%, in patients with or without treatment delay, P value = 0.001). One-hundred and twelve patients had at least 1 thoracic CT scan performed and radiological findings suspicious for COVID-19 were observed in only 7 cases (4%). Fifteen patients (9%) developed symptoms potentially related to COVID-19; nasopharyngeal swabs were collected in 9 patients and only 1 was positive for SARS-CoV-2.
The incidence of symptomatic COVID-19 infection observed in our cohort of patients with advanced malignant melanoma treated with immunotherapy appears meaningfully lower as compared with that reported in the overall population in Italy as well as in patients affected by solid tumors. We conclude that in patients with locally advanced and metastatic melanoma, immunotherapy can be safely continued without delay in the majority of cases, reserving precautionary delay only for the most frail patients.
由于免疫抑制状态，癌症患者被认为感染 SARS-CoV-2 的风险更高。接受免疫治疗的癌症患者 COVID-19 感染的影响和病程尚不清楚。
评估在意大利 COVID-19 感染高发地区的 2 家癌症中心接受免疫治疗的晚期黑色素瘤患者管理的安全性。
我们回顾性分析了 2020 年 1 月 1 日至 4 月 30 日期间在欧洲肿瘤研究所或 Città della Salute e della Scienza 大学医院接受免疫治疗的局部晚期和转移性黑色素瘤患者的数据。
169 名 III 期和 IV 期黑色素瘤患者在欧洲肿瘤研究所或 Città della Salute e della Scienza 大学医院接受免疫治疗方案治疗。104 名患者继续不间断或无延迟治疗，而 49 名患者治疗延迟。治疗延迟的主要原因是年龄较大（无治疗延迟组和有治疗延迟组患者的中位年龄分别为 60 岁和 69 岁，P 值<0.001）和/或存在合并症（无治疗延迟组和有治疗延迟组患者至少有一种合并症的比例分别为 81%和 62%，P 值=0.001）。112 名患者至少进行了 1 次胸部 CT 扫描，仅在 7 例（4%）中观察到疑似 COVID-19 的放射学发现。15 名患者（9%）出现与 COVID-19 相关的症状；采集了 9 名患者的鼻咽拭子，仅 1 名患者 SARS-CoV-2 阳性。
与意大利总体人群以及实体瘤患者相比，我们接受免疫治疗的晚期恶性黑色素瘤患者队列中观察到的有症状 COVID-19 感染发生率明显较低。我们得出结论，在局部晚期和转移性黑色素瘤患者中，大多数情况下可以安全地继续进行免疫治疗而无需延迟，仅对最脆弱的患者进行预防性延迟。
