Management of immune checkpoint therapy for patients with cancer in the face of COVID-19.
Management of immune checkpoint therapy for patients with cancer in the face of COVID-19.
复制标题
癌症患者面对 COVID-19 时的免疫检查点治疗管理
DOI：
10.1136/jitc-2020-001593
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发表时间：
2020-12
影响因子：
10.9
通讯作者：
Tao J
中科院分区：
文献类型：
--
作者：
Shen C;Li Q;Wei Y;Li Y;Li J;Tao J
由SARS-CoV-2病毒引起的新冠肺炎疫情干扰了许多慢性病患者的常规治疗，对医疗系统构成了挑战。在接受免疫检查点抑制剂(ICIS)治疗的癌症患者中，由于不完全了解他们的常规治疗与新型病毒发病机制之间的复杂相互作用，也出现了困难。通过参考以前基于ICI的研究，我们推测ICIS本身与癌症患者呼吸道疾病的高感染风险或炎症相关的不良反应无关。此外，ICI治疗甚至可能通过提高抗病毒T细胞的反应性来增强一些恶性肿瘤患者的冠状病毒清除。然而，在新冠肺炎期间，一些接受脑梗塞治疗的癌症患者出现“爆炸性”炎症，表现为强烈的免疫病理损害，甚至死亡。对于新冠肺炎的免疫发病机制，我们建议定期监测致病T细胞亚群及其耗竭标志物的表达(例如，Th17和IL-6产生的Th1亚群和表面程序性死亡1的表达)来指导ICI的使用。在这里，我们的目的是根据现有的文献和我们实践中的经验来解决这些问题，这些因素可能有助于ICI管理部门在大流行期间的决策。
The COVID-19 outbreak caused by SARS-CoV-2 challenges the medical system by interfering with routine therapies for many patients with chronic diseases. In patients with cancer receiving immune checkpoint inhibitors (ICIs), difficulties also arise from the incomplete understanding of the intricate interplay between their routine treatment and pathogenesis of the novel virus. By referring to previous ICI-based investigations, we speculate that ICIs themselves are not linked to high-infection risks of respiratory diseases or inflammation-related adverse effects in patients with cancer. Moreover, ICI treatment may even enhance coronavirus clearance in some patients with malignant tumor by boosting antiviral T-cell responsiveness. However, the ‘explosive’ inflammation during COVID-19 in some ICI-treated patients with cancer was illustrated as exuberant immunopathological damage or even death. In case of the COVID-19 immunopathogenesis fueled by ICIs, we propose a regular monitor of pathogenic T-cell subsets and their exhaustion marker expression (eg, Th17 and interleukin (IL)-6-producing Th1 subsets with surface programmed death 1 expression) to guide the usage of ICI. Here we aimed to address these considerations, based on available literature and experience from our practice, that may assist with the decision-making of ICI administration during the pandemic.
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影响因子：
82.9
作者：
Robilotti EV;Babady NE;Mead PA;Rolling T;Perez-Johnston R;Bernardes M;Bogler Y;Caldararo M;Figueroa CJ;Glickman MS;Joanow A;Kaltsas A;Lee YJ;Lucca A;Mariano A;Morjaria S;Nawar T;Papanicolaou GA;Predmore J;Redelman-Sidi G;Schmidt E;Seo SK;Sepkowitz K;Shah MK;Wolchok JD;Hohl TM;Taur Y;Kamboj M
通讯作者：
Kamboj M
DOI：
10.1183/16000617.0058-2019
发表时间：
2019-09-30
期刊：
European respiratory review : an official journal of the European Respiratory Society
影响因子：
--
作者：
通讯作者：
--
影响因子：
9
作者：
Channappanavar R;Perlman S
通讯作者：
Perlman S
影响因子：
51.1
作者：
Garassino, Marina Chiara;Whisenant, Jennifer G.;Horn, Leora
通讯作者：
Horn, Leora
影响因子：
28.2
作者：
Dai, Mengyuan;Liu, Dianbo;Cai, Hongbing
通讯作者：
Cai, Hongbing