Immune-related pneumonitis with nivolumab and ipilimumab during the coronavirus disease 2019 (COVID-19) pandemic

Souza, Ive Lima; Fernandes, Ítalo Rufino de Queiroz; Taranto, Patrícia; Buzaid, Antônio C.; Schvartsman, Gustavo

doi:10.1016/j.ejca.2020.06.004

Cited by 13 publications

(10 citation statements)

References 7 publications

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“…Both patients, were successfully treated and dismissed from the hospital within a week, and still testing negative to the virus. The authors warranted caution in administering the ICIs to cancer patients (especially if administered as a combination of more than one type), although they did not develop COVID-19 [ 59 ].…”

Section: Covid-19 and Anti-cancer Therapy: Advantages And Disadvanmentioning

confidence: 99%

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

Vivarelli

Falzone

Grillo

et al. 2020

Cancers

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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.

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Section: Covid-19 and Anti-cancer Therapy: Advantages And Disadvanmentioning

confidence: 99%

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

Vivarelli

Falzone

Grillo

et al. 2020

Cancers

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“…Immunotherapy: Immune Checkpoint Inhibitor Conflicting data in published literature regarding checkpoint inhibitor immunotherapy and its effect on the severity of COVID-19, especially in the instance of treatment-related pneumonitis associated with ICI, needs to be assessed in further detail [41][42][43].…”

Section: Resumption Of Elective Surgeries?mentioning

confidence: 99%

Cancer or COVID-19? A Review of Guidelines for Safe Cancer Care in the Wake of the Pandemic

Gundavda

2020

SN Compr. Clin. Med.

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In the wake of the COVID-19 pandemic, due to reasons beyond control, health care workers have struggled to deliver treatment for the patients with cancer. The concern for otherwise healthy patients with curable cancers that require timely intervention or therapy is the risk of contracting COVID-19 may outweigh the benefits of cancer treatment. Lack of international guidelines leaves health care providers with a case-to-case approach for delivering optimal cancer care in the wake of the pandemic. Transition to telemedicine has somewhat bridged the gap for in-office visits, but there is a continuing challenge of delays in cancer screening or significant decline of new diagnoses of cancers due to the pandemic. We aim to propose a balance in risk from treatment delay versus risks from COVID-19 with emphasis on treatment modality (surgery, radiation, and systemic therapy) as well as supportive care for cancer patients, and therefore have reviewed the publications and recommendations from international societies and study groups available as of October 2020.

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“…Clinicians should always consider COVID-19 as a differential diagnosis, as few places were spared during the pandemic. In another report (35), 2 patients were initially highly suspected of COVID-19 infection based on clinical manifestations, imaging ndings, and epidemiology. Steroids were withheld in one of them, and the disease became worse until a third CT scan was obtained and a second negative RT-PCR test was released after admission.…”

Section: Ici-induced Lung Injury and Covid-19 Infectionmentioning

confidence: 99%

Immune checkpoint inhibitors use and effects on prognosis of COVID-19 infection: A systematic review and meta-analysis

Qian

Zuo

et al. 2020

Preprint

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Background: The influence of prior exposure to immune checkpoint inhibitors (ICIs) on the coronavirus disease 2019 (COVID-19) infection remains unknown. Methods: We searched the PubMed, Embase, and Web of Science databases from the inception of each database through August 8, 2020. We included studies that reported ICI use in cancer patients and their prognosis in the context of COVID-19. Raw data from the included studies were pooled to determine effect estimates. Chi-squared and I2 tests were used to calculate heterogeneity among the included studies.Results: Eighteen studies were included for the systematic review, and 8 of those were included in the meta-analysis. Patients with prior ICI treatment exhibited a higher rate of hospitalization (OR [odds ratio] 2.6, 95% CI 1.45-4.68, p=0.001; I2=0%) and severe disease (OR 1.98, 95% CI 1.14-3.43, p=0.015). However, the OR of mortality in ICI-exposed cases was similar to non-ICI exposed patients (OR 0.90, 95% CI 0.60-1.34, p= 0.60; I2=49%). No statistically significant difference in mortality was observed between patients exposed to ICI and other antitumor treatments.Conclusions: Although a higher rate of hospitalization and severe disease was observed, prior exposure to ICI did not significantly increase the rate of death in the context of COVID-19.

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Immune-related pneumonitis with nivolumab and ipilimumab during the coronavirus disease 2019 (COVID-19) pandemic

Cited by 13 publications

References 7 publications

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

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

Cancer or COVID-19? A Review of Guidelines for Safe Cancer Care in the Wake of the Pandemic

Immune checkpoint inhibitors use and effects on prognosis of COVID-19 infection: A systematic review and meta-analysis

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