On the use of immune checkpoint inhibitors in patients with viral infections including COVID-19

J Immunother Cancer. 2020 Jul;8(2):e001145. doi: 10.1136/jitc-2020-001145.

Abstract

The present review summarizes up-to-date evidence addressing the frequently discussed clinical controversies regarding the use of immune checkpoint inhibitors (ICIs) in cancer patients with viral infections, including AIDS, hepatitis B and C, progressive multifocal leukoencephalopathy, influenza, and COVID-19. In detail, we provide available information on (1) safety regarding the risk of new infections, (2) effects on the outcome of pre-existing infections, (3) whether immunosuppressive drugs used to treat ICI-related adverse events affect the risk of infection or virulence of pre-existing infections, (4) whether the use of vaccines in ICI-treated patients is considered safe, and (5) whether there are beneficial effects of ICIs that even qualify them as a therapeutic approach for these viral infections.

Keywords: T-lymphocytes; immune evation; review; tumor escape; vaccination.

Publication types

  • Review

MeSH terms

  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / complications
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / immunology
  • Coronavirus Infections / therapy
  • Hepatitis B / complications
  • Hepatitis B / drug therapy
  • Hepatitis B / immunology
  • Hepatitis B / therapy
  • Hepatitis C / complications
  • Hepatitis C / drug therapy
  • Hepatitis C / immunology
  • Hepatitis C / therapy
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Influenza, Human / complications
  • Influenza, Human / drug therapy
  • Influenza, Human / immunology
  • Influenza, Human / therapy
  • Neoplasms / complications*
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / therapy
  • SARS-CoV-2
  • Virus Diseases / complications
  • Virus Diseases / drug therapy
  • Virus Diseases / immunology
  • Virus Diseases / therapy*

Substances

  • Immunosuppressive Agents