ABSTRACT

Introduction

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.

Areas covered

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.

Expert opinion

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.

中文翻译：

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COVID-19 肺炎和免疫相关肺炎：鉴别诊断、潜在相互作用和管理的关键问题。

摘要

介绍

COVID-19 大流行发生在癌症免疫疗法革命期间。免疫检查点抑制剂 (ICIs) 已成为多种实体癌症的治疗标准，并与特殊的毒性相关，包括与 COVID-19 肺炎具有相似特征的肺炎。

覆盖领域

我们总结了 ICI 和严重急性呼吸综合征冠状病毒 2 引起的肺损伤的主要特征，并讨论了鉴别诊断和治疗的关键方面。症状和放射学检查结果通常相似；相反，治疗方法却截然不同。此外，我们关注潜在的相互作用，产生需要验证研究的假设。

专家意见

所有接受免疫治疗的癌症患者都应接受 SARS-CoV-2 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 ICI 治疗的风险/益处。对于长反应患者来说，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。