Viral Infection and Lung Cancer Immunotherapy

Abstract

Immunotherapy with immune checkpoint inhibitors (mainly anti-PD1 and anti-PDL1 monoclonal antibodies) became a standard of care in non-small cell lung cancer (NSCLC) patients. Most of the clinical trials excluded patients with hepatitis B (HBV), hepatis C (HCV), and human immunodeficiency virus (HIV) active infection (1–10). Despite the progress in treatment of these infections, they remain an unresolved clinical problem when lung cancer immunotherapy should be initiated in an NSCLC patient. This manuscript summarizes the data from the literature concerning this subgroup of patients including the rationale for immunotherapy initiation depending on the HBV, HCV, or HIV infection status; the risk of adverse events; and the efficacy compared to non-infected patients. One of the crucial questions is how the candidates to immunotherapy should be screened for HBV, HCV, and HIV infections. The year 2020 brought the world a new but dynamic viral problem—severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2). The incorporation of known data in oncology guidelines became a burning need, and then, which group of the infected patients can be treated with immunotherapy despite the infection. Oncologists should also know if these patients should receive antiviral therapy and what are the safe combinations in these settings. We also indicate which of the adverse events should be monitored carefully during checkpoint inhibitor treatment.

Potential Mechanism of Colchicine against COVID-19 and Non-Small Cell Lung Cancer based on Network Pharmacology and Bioinformatics Analysis

“…Inflammation is also an important part of the tumor environment and plays an important role in the development and progression of malignant tumors [53] . Cancer patients, as one of the most susceptible populations, are facing severe disadvantages during the COVID-19 epidemic, lung cancer patients, in particular [54] , have been reported to be more susceptible to SARS-Cov-2 infection and they are at higher risk of developing pneumonia and severe complications of COVID-19 on admission [55] . ACE2 is a functional receptor for SARS-CoV-2 to enter and replicate in host cells [56] , and its expression level is thought to indicate susceptibility to COVID-19 [57] , the expression level of ACE2 in lung tissue is increased [58,59] and according to the analysis of a study, it is found that the messenger RNA (mRNA) expression of ACE2 is higher in lung and colorectal cancer than other types of cancer [60] , which may be another explanation for lung cancer patients being more susceptible to SARS-CoV-2 infection and at higher risk of severe COVID-19.…”