The systemic pro-inflammatory response: targeting the dangerous liaison between COVID-19 and cancer

G M Dettorre; M Patel; A Gennari; G Pentheroudakis; E Romano; A Cortellini; D J Pinato

doi:10.1016/j.esmoop.2021.100123

The systemic pro-inflammatory response: targeting the dangerous liaison between COVID-19 and cancer

ESMO Open. 2021 Jun;6(3):100123. doi: 10.1016/j.esmoop.2021.100123. Epub 2021 Apr 8.

Authors

G M Dettorre¹, M Patel¹, A Gennari², G Pentheroudakis³, E Romano⁴, A Cortellini⁵, D J Pinato⁶

Affiliations

¹ Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK.
² Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy.
³ Department of Medical Oncology, University of Ioannina, Ioannina, Greece; Chief Medical Officer, European Society for Medical Oncology, Lugano, Switzerland.
⁴ Department of Medical Oncology, Center for Cancer Immunotherapy, Institut Curie, Paris, France.
⁵ Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy. Electronic address: a.cortellini@imperial.ac.uk.
⁶ Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy. Electronic address: david.pinato@imperial.ac.uk.

Abstract

Inflammation is an established driver of severe SARS-CoV-2 infection and a mechanism linked to the increased susceptibility to fatal COVID-19 demonstrated by patients with cancer. As patients with cancer exhibit a higher level of inflammation compared with the general patient population, patients with cancer and COVID-19 may uniquely benefit from strategies targeted at overcoming the unrestrained pro-inflammatory response. Targeted and non-targeted anti-inflammatory therapies may prevent end-organ damage in SARS-CoV-2-infected patients with cancer and decrease mortality. Here, we review the clinical role of selective inhibition of pro-inflammatory interleukins, tyrosine kinase modulation, anti-tumor necrosis factor agents, and other non-targeted approaches including corticosteroids in their roles as disease-modulating agents in patients with COVID-19 and cancer. Investigation of these therapeutics in this highly vulnerable patient group is posited to facilitate the development of tailored therapeutics for this patient population, aiding the transition of systemic inflammation from a prognostic domain to a source of therapeutic targets.

Keywords: COVID-19; SARS-CoV-2; cancer; immune modulation; inflammation.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Anti-Inflammatory Agents
COVID-19*
Humans
Inflammation
Neoplasms*
SARS-CoV-2

Substances

Anti-Inflammatory Agents