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1.
J Immunother Cancer ; 10(3)2022 03.
Article in English | MEDLINE | ID: covidwho-1731296

ABSTRACT

Vaccination against COVID-19 is critical for immuno-compromised individuals, including patients with cancer. Systemic reactogenicity, a manifestation of the innate immune response to vaccines, occurs in up to 69% of patients following vaccination with RNA-based COVID-19 vaccines. Tumor regression can occur following an intense immune-inflammatory response and novel strategies to treat cancer rely on manipulating the host immune system. Here, we report spontaneous regression of metastatic salivary gland myoepithelial carcinoma in a patient who experienced grade 3 systemic reactogenicity, following vaccination with the mRNA-1273 COVID-19 vaccine. Histological and immunophenotypic inspection of the postvaccination lung biopsy specimens showed a massive inflammatory infiltrate with scant embedded tumor clusters (<5%). Highly multiplexed imaging mass cytometry showed that the postvaccination lung metastasis samples had remarkable immune cell infiltration, including CD4+ T cells, CD8+ T cells, natural killer cells, B cells, and dendritic cells, which contrasted with very low levels of these cells in the prevaccination primary tumor and lung metastasis samples. CT scans obtained 3, 6, and 9 months after the second vaccine dose demonstrated persistent tumor shrinkage (50%, 67%, and 73% reduction, respectively), suggesting that vaccination stimulated anticancer immunity. Insight: This case suggests that the mRNA-1273 COVID-19 vaccine stimulated anticancer immunity and tumor regression.


Subject(s)
Immunity, Innate , Immunogenicity, Vaccine , Lung Neoplasms/immunology , Myoepithelioma/immunology , Parotid Neoplasms/surgery , B-Lymphocytes , CD4-Positive T-Lymphocytes , CD8-Positive T-Lymphocytes , Female , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/secondary , Middle Aged , Myoepithelioma/diagnostic imaging , Myoepithelioma/secondary , Parotid Neoplasms/pathology
2.
Int J Mol Sci ; 22(21)2021 Nov 08.
Article in English | MEDLINE | ID: covidwho-1512381

ABSTRACT

Tumor-associated cell-free DNAs (cfDNA) play an important role in the promotion of metastases. Previous studies proved the high antimetastatic potential of bovine pancreatic DNase I and identified short interspersed nuclear elements (SINEs) and long interspersed nuclear elements (LINEs)and fragments of oncogenes in cfDNA as the main molecular targets of enzyme in the bloodstream. Here, recombinant human DNase I (commercial name Pulmozyme®), which is used for the treatment of cystic fibrosis in humans, was repurposed for the inhibition of lung metastases in the B16 melanoma model in mice. We found that Pulmozyme® strongly reduced migration and induced apoptosis of B16 cells in vitro and effectively inhibited metastases in lungs and liver in vivo. Pulmozyme® was shown to be two times more effective when administered intranasally (i.n.) than bovine DNase I, but intramuscular (i.m.) administration forced it to exhibit as high an antimetastatic activity as bovine DNase I. Both DNases administered to mice either i.m. or i.n. enhanced the DNase activity of blood serum to the level of healthy animals, significantly decreased cfDNA concentrations, efficiently degraded SINE and LINE repeats and c-Myc fragments in the bloodstream and induced apoptosis and disintegration of neutrophil extracellular traps in metastatic foci; as a result, this manifested as the inhibition of metastases spread. Thus, Pulmozyme®, which is already an approved drug, can be recommended for use in the treatment of lung metastases.


Subject(s)
Cell-Free Nucleic Acids/blood , Deoxyribonuclease I/metabolism , Long Interspersed Nucleotide Elements/genetics , Lung Neoplasms/drug therapy , Melanoma, Experimental/drug therapy , Proto-Oncogene Proteins c-myc/antagonists & inhibitors , Short Interspersed Nucleotide Elements/genetics , Animals , Cell Line, Tumor , Deoxyribonuclease I/pharmacology , Disease Models, Animal , Drug Repositioning , Lung Neoplasms/genetics , Lung Neoplasms/metabolism , Lung Neoplasms/secondary , Male , Melanoma, Experimental/genetics , Melanoma, Experimental/metabolism , Melanoma, Experimental/pathology , Mice , Proto-Oncogene Proteins c-myc/blood , Proto-Oncogene Proteins c-myc/genetics , Recombinant Proteins/pharmacology
5.
Thorac Cancer ; 12(21): 2865-2872, 2021 11.
Article in English | MEDLINE | ID: covidwho-1494370

ABSTRACT

BACKGROUND: Lung cancer, the leading cause of cancer-related deaths worldwide, has high morbidity rates. Video-assisted thoracoscopic surgery (VATS) as day surgery makes surgical treatment ideally in time with the same quality of medical care. This study aimed to assess the safety of stage I NSCLC patients who underwent VATS at a day surgery center. METHODS: We retrospectively analyzed the clinical characteristics and tumor features of VATS patients at a single center, West China Hospital, from June 1, 2019, to December 31, 2020. Patients fulfilled all inclusion criteria, did not meet any exclusion criteria and underwent wedge resection, segmentectomy, or lobectomy with systematic lymph node dissection. RESULTS: The median patient age was 43 (range, 19-67) years. Of the 209 patients, most were women. A total of 108 (51.7%) patients underwent segmentectomy, 87 (41.6%) lobectomy, and 14 (6.7%) wedge resection with systematic lymph node dissection. According to the AJCC/UICC eighth edition of lung cancer stage grouping, stages IA, IA1, IA2, and IA3 were 195 (93.3%), 122 (58.4%), 50 (23.9%), and one (0.5%), respectively. A total of 36 (17.2%) patients were stage 0. Adenocarcinoma was predominantly the postoperative pathological diagnosis, as only 14 (6.7%) were benign. A total of 201 (96.17%) patients were discharged without a chest tube. The most common chief complaints were cough, incisional pain, and shortness of breath. No severe complications or life-threatening emergencies were observed. CONCLUSIONS: The day surgery mode of VATS for stage I NSCLC is safe and feasible, which makes surgical treatment ideally in time for stage I NSCLC patients with the same quality of medical care.


Subject(s)
Ambulatory Surgical Procedures/methods , Carcinoma, Non-Small-Cell Lung/surgery , Lung Neoplasms/secondary , Thoracic Surgery, Video-Assisted/methods , Adult , Aged , Female , Humans , Male , Middle Aged , Retrospective Studies , Young Adult
6.
Anticancer Drugs ; 32(10): 1116-1117, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1475864

ABSTRACT

During the coronavirus disease 2019 (COVID-19) pandemic, clinicians are required to manage patient care for pre-existing conditions. Currently, there are no clear indications regarding the management of lenvatinib-treated patients for radioiodine-refractory thyroid cancer and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A 74-year-old male patient was treated with lenvatinib since March 2019, with disease recurrence in the thyroid bed and bilateral multiple lung metastases. The patient partially responded to treatment, with reduction in lung metastases. In September 2019, the patient tested positive for SARS-CoV-2 and isolated at home. Initially asymptomatic, the patient developed mild symptoms. Lenvatinib treatment continued with daily monitoring of vital signs. After telemedicine consultation of patient's clinical condition, severity of symptoms was low. He tested negative for SARS-CoV-2 21 days after testing positive. The patient received the full course of lenvatinib treatment. This is the first reported case of a lenvatinib-treated patient who developed COVID-19 and could continue treatment. Despite concerns over COVID-19, clinicians should not overlook treatment of pre-existing diseases or discontinue treatment, particularly for cancer. Clinicians should evaluate a patient's history and clinical presentation, monitoring the patient to reduce the development of complications in high-risk settings, avoiding treatment discontinuation.


Subject(s)
COVID-19/complications , Lung Neoplasms/drug therapy , Phenylurea Compounds/therapeutic use , Quinolines/therapeutic use , Thyroid Neoplasms/drug therapy , Aged , Humans , Lung Neoplasms/secondary , Male , Thyroid Neoplasms/pathology
7.
J Pediatr Hematol Oncol ; 43(6): e859-e860, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1348084

ABSTRACT

The novel coronavirus, SARS-CoV-2, causes much more severe disease in adults than in children. Although it is anticipated that immune compromised children and children with cancer may be at higher risk of developing severe or fatal COVID-19, there are no currently published reports of fatal disease in a child with cancer. Because of the discrepancy in disease severity between adult and pediatric patients, we report the case of an adolescent with pulmonary metastatic osteosarcoma who died of COVID-19 early in the course of the pandemic in New York City in the hope that heightening awareness that pulmonary metastatic disease may predispose to a more severe outcome will increase surveillance in this vulnerable population.


Subject(s)
Bone Neoplasms/pathology , COVID-19/complications , Lung Neoplasms/secondary , Osteosarcoma/pathology , Respiratory Insufficiency/pathology , SARS-CoV-2/isolation & purification , Bone Neoplasms/complications , Bone Neoplasms/virology , COVID-19/virology , Child , Humans , Lung Neoplasms/complications , Lung Neoplasms/virology , Male , Osteosarcoma/complications , Osteosarcoma/virology , Respiratory Insufficiency/etiology , Severity of Illness Index
8.
FASEB J ; 35(9): e21798, 2021 09.
Article in English | MEDLINE | ID: covidwho-1334263

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic threatens human species with mortality rate of roughly 2%. We can hardly predict the time of herd immunity against and end of COVID-19 with or without success of vaccine. One way to overcome the situation is to define what delineates disease severity and serves as a molecular target. The most successful analogy is found in BCR-ABL in chronic myeloid leukemia, which is the golden biomarker, and simultaneously, the most effective molecular target. We hypothesize that S100 calcium-binding protein A8 (S100A8) is one such molecule. The underlying evidence includes accumulating clinical information that S100A8 is upregulated in severe forms of COVID-19, pathological similarities of the affected lungs between COVID-19 and S100A8-induced acute respiratory distress syndrome (ARDS) model, homeostatic inflammation theory in which S100A8 is an endogenous ligand for endotoxin sensor Toll-like receptor 4/Myeloid differentiation protein-2 (TLR4/MD-2) and mediates hyper-inflammation even after elimination of endotoxin-producing extrinsic pathogens, analogous findings between COVID-19-associated ARDS and pre-metastatic lungs such as S100A8 upregulation, pulmonary recruitment of myeloid cells, increased vascular permeability, and activation coagulation cascade. A successful treatment in an animal COVID-19 model is given with a reagent capable of abrogating interaction between S100A8/S100A9 and TLR4. In this paper, we try to verify our hypothesis that S100A8 governs COVID-19-associated ARDS.


Subject(s)
COVID-19/complications , Calgranulin A/physiology , Cytokine Release Syndrome/etiology , Inflammation/etiology , Pandemics , Respiratory Distress Syndrome/etiology , SARS-CoV-2/genetics , Angiotensin-Converting Enzyme 2/genetics , Angiotensin-Converting Enzyme 2/physiology , Animals , Antiviral Agents/pharmacology , COVID-19/genetics , COVID-19/pathology , Calgranulin A/blood , Calgranulin A/genetics , Chemokine CXCL11/blood , Cytokine Release Syndrome/genetics , Cytokine Release Syndrome/pathology , Disaccharides/pharmacology , Disaccharides/therapeutic use , Disease Models, Animal , Drug Discovery , Epithelial Cells/metabolism , Epithelial Cells/virology , Humans , Inflammation/genetics , Inflammation/pathology , Lung/metabolism , Lung/pathology , Lung/virology , Lung Neoplasms/drug therapy , Lung Neoplasms/secondary , Lymphocyte Antigen 96/physiology , Macaca mulatta , Mice , Mice, Transgenic , Models, Biological , Mutation , Respiratory Distress Syndrome/genetics , Respiratory Distress Syndrome/metabolism , Species Specificity , Sugar Phosphates/pharmacology , Sugar Phosphates/therapeutic use , Toll-Like Receptor 4/physiology , Up-Regulation , Virus Internalization
9.
Anticancer Drugs ; 32(10): 1116-1117, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1286598

ABSTRACT

During the coronavirus disease 2019 (COVID-19) pandemic, clinicians are required to manage patient care for pre-existing conditions. Currently, there are no clear indications regarding the management of lenvatinib-treated patients for radioiodine-refractory thyroid cancer and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A 74-year-old male patient was treated with lenvatinib since March 2019, with disease recurrence in the thyroid bed and bilateral multiple lung metastases. The patient partially responded to treatment, with reduction in lung metastases. In September 2019, the patient tested positive for SARS-CoV-2 and isolated at home. Initially asymptomatic, the patient developed mild symptoms. Lenvatinib treatment continued with daily monitoring of vital signs. After telemedicine consultation of patient's clinical condition, severity of symptoms was low. He tested negative for SARS-CoV-2 21 days after testing positive. The patient received the full course of lenvatinib treatment. This is the first reported case of a lenvatinib-treated patient who developed COVID-19 and could continue treatment. Despite concerns over COVID-19, clinicians should not overlook treatment of pre-existing diseases or discontinue treatment, particularly for cancer. Clinicians should evaluate a patient's history and clinical presentation, monitoring the patient to reduce the development of complications in high-risk settings, avoiding treatment discontinuation.


Subject(s)
COVID-19/complications , Lung Neoplasms/drug therapy , Phenylurea Compounds/therapeutic use , Quinolines/therapeutic use , Thyroid Neoplasms/drug therapy , Aged , Humans , Lung Neoplasms/secondary , Male , Thyroid Neoplasms/pathology
10.
Cancer Treat Res Commun ; 28: 100406, 2021.
Article in English | MEDLINE | ID: covidwho-1258358

ABSTRACT

Covid-19 Pneumonia of SARS-CoV-2 pandemic infection, persists to have high disease burden especially in cancer patients. Increased inflammation and thromboembolic processes are blamed to influence cancer patients more than the others but due to lack of knowledge regarding the pathophysiology of the both the virus itself and the response of the host, more basic and translational disease modeling research is needed to understand Cancer-Covid-19 interaction. In this study, serum samples from the patients, who were hospitalized due to Covid-19 pneumonia, applied to different cancer cells and cytotoxicity, motility, proliferation and gene expression analysis were performed. Serum samples derived from healthy volunteers and the fetal bovine serum that is used regularly in cell culture experiments used as controls. Hospitalized Covid-19 patients who had also cancer, were retrospectively screened, and their clinical course were recorded. Overall 12 Patient (PS) and 4 healthy serums (CS) were included in the experiments. PS applied cells showed increased motility in A549 cells as well as lost cell to cell connection in MCF7 and HCT116 cells, and induced expression of VIM, ZEB1 and SNAIL2 mRNA levels. Eight cancer diagnosed patients who were hospitalized due to Covid-19 between April and September 2020 were also reviewed retrospectively, which 5 of them were dead during SARS-CoV-2 infection. Thorax CT images of the 2 patients showed increased metastatic nodules in the lungs as of January 2021. The results of the study indicate that metastasis may be one of the prolonged consequences of COVID-19 pandemic in cancer sufferers.


Subject(s)
COVID-19/immunology , Epithelial-Mesenchymal Transition/physiology , Immune Sera , Neoplasms/pathology , Adult , Aged , COVID-19/complications , Cell Line, Tumor , Cell Movement , Cell Proliferation , Cytotoxicity, Immunologic , Female , Humans , Immune Sera/adverse effects , Immune Sera/toxicity , Lung Neoplasms/secondary , Lung Neoplasms/virology , Male , Middle Aged , Neoplasms/immunology
11.
J Surg Oncol ; 123(7): 1633-1639, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1122192

ABSTRACT

BACKGROUND: For patients with bilateral pulmonary metastases, staged resections have historically been the preferred surgical intervention. During the spring of 2020, the COVID-19 pandemic made patient travel to the hospital challenging and necessitated reduction in operative volume so that resources could be conserved. We report our experience with synchronous bilateral metastasectomies for the treatment of disease in both lungs. METHODS: Patients with bilateral pulmonary metastases who underwent simultaneous bilateral resections were compared with a cohort of patients who underwent staged resections. We used nearest-neighbor propensity score (1:1) matching to adjust for confounders. Perioperative outcomes were compared between groups using paired statistical analysis techniques. RESULTS: Between 1998 and 2020, 36 patients underwent bilateral simultaneous metastasectomies. We matched 31 pairs of patients. The length of stay was significantly shorter in patients undergoing simultaneous resection (median 3 vs. 8 days, p < .001) and operative time was shorter (156 vs. 235.5 min, p < .001) when compared to the sum of both procedures in the staged group. The groups did not significantly differ with regard to postoperative complications. CONCLUSION: In a carefully selected patient population, simultaneous bilateral metastasectomy is a safe option. A single procedure confers benefits for both the patient as well as the hospital resource system.


Subject(s)
Lung Neoplasms/secondary , Lung Neoplasms/surgery , Adolescent , Adult , Aged , Colorectal Neoplasms/pathology , Female , Humans , Lung Neoplasms/pathology , Male , Metastasectomy/methods , Middle Aged , Neoplasm Staging , Pneumonectomy/methods , Retrospective Studies , Thoracic Surgery, Video-Assisted/methods , Thoracotomy/methods
12.
J Immunother Cancer ; 9(2)2021 02.
Article in English | MEDLINE | ID: covidwho-1081352

ABSTRACT

By the beginning of the global pandemic, SARS-CoV-2 infection has dramatically impacted on oncology daily practice. In the current oncological landscape, where immunotherapy has revolutionized the treatment of several malignancies, distinguishing between COVID-19 and immune-mediated pneumonitis can be hard because of shared clinical, radiological and pathological features. Indeed, their common mechanism of aberrant inflammation could lead to a mutual and amplifying interaction.We describe the case of a 65-year-old patient affected by metastatic squamous head and neck cancer and candidate to an experimental therapy including an anti-PD-L1 agent. COVID-19 ground-glass opacities under resolution were an incidental finding during screening procedures and worsened after starting immunotherapy. The diagnostic work-up was consistent with ICIs-related pneumonia and it is conceivable that lung injury by SARS-CoV-2 has acted as an inflammatory primer for the development of the immune-related adverse event.Patients recovered from COVID-19 starting ICIs could be at greater risk of recall immune-mediated pneumonitis. Nasopharyngeal swab and chest CT scan are recommended before starting immunotherapy. The awareness of the phenomenon could allow an easier interpretation of radiological changes under treatment and a faster diagnostic work-up to resume ICIs. In the presence of clinical benefit, for asymptomatic ICIs-related pneumonia a watchful-waiting approach and immunotherapy prosecution are suggested.


Subject(s)
COVID-19/diagnosis , Lung Neoplasms/diagnosis , Pneumonia/diagnosis , Squamous Cell Carcinoma of Head and Neck/diagnosis , Aged , B7-H1 Antigen/antagonists & inhibitors , B7-H1 Antigen/immunology , COVID-19/drug therapy , COVID-19/immunology , COVID-19/virology , Diagnosis, Differential , Humans , Immune Checkpoint Inhibitors/administration & dosage , Immune Checkpoint Inhibitors/adverse effects , Immunotherapy/adverse effects , Lung Injury/diagnosis , Lung Injury/diagnostic imaging , Lung Injury/pathology , Lung Injury/virology , Lung Neoplasms/drug therapy , Lung Neoplasms/secondary , Lung Neoplasms/virology , Male , Nasopharynx/metabolism , Nasopharynx/pathology , Neoplasm Metastasis , Pandemics , Pneumonia/drug therapy , Pneumonia/immunology , Pneumonia/virology , SARS-CoV-2/pathogenicity , Squamous Cell Carcinoma of Head and Neck/drug therapy , Squamous Cell Carcinoma of Head and Neck/immunology , Squamous Cell Carcinoma of Head and Neck/virology
13.
BMJ Case Rep ; 13(12)2020 Dec 10.
Article in English | MEDLINE | ID: covidwho-971145

ABSTRACT

A 70-year-old man presented with gradually worsening throat discomfort. He had no prior diagnosis of cancer and no travel history of note. Examination revealed a right-sided painless neck lump. He underwent an MRI of the neck, revealing a gadolinium-enhancing tonsillar mass and two brain lesions. Biopsy of the tonsil lesion was in keeping with an epithelial neoplasm, suggesting metastatic renal cell carcinoma. This was confirmed following a staging CT, which revealed a left renal mass and lung metastases. Due to his brain metastases, the patient has been started on the tyrosine kinase inhibitor cabozantinib. A brief discussion on the diagnostic evaluation of a tonsil mass as a rare presentation of renal cell cancer follows this report.


Subject(s)
Brain Neoplasms/secondary , Carcinoma, Renal Cell/pathology , Kidney Neoplasms/secondary , Lung Neoplasms/secondary , Palatine Tonsil/pathology , Aged , Anilides/therapeutic use , Brain Neoplasms/drug therapy , Carcinoma, Renal Cell/drug therapy , Humans , Kidney Neoplasms/drug therapy , Lung Neoplasms/drug therapy , Magnetic Resonance Imaging , Male , Palatine Tonsil/drug effects , Pyridines/therapeutic use , Receptor Protein-Tyrosine Kinases/therapeutic use , Tomography, X-Ray Computed , Treatment Outcome
14.
BMJ Case Rep ; 13(10)2020 Oct 07.
Article in English | MEDLINE | ID: covidwho-840503

ABSTRACT

A 13-year-old boy presented to hospital with 3-day self-limited fever, followed by dry cough, persistent asthenia and impaired general condition of 2 weeks' duration. Blood analyses showed a severe inflammatory status and chest X-ray images were consistent with bilateral COVID-19 pneumonia. He developed an acute respiratory failure that required paediatric intensive care admission and non-invasive ventilation. A targeted COVID-19 treatment was initiated with hydroxicloroquine, corticosteroids, enoxaparine and a single dose of tocilizumab. Repeated serological tests and real-time reverse transcription PCR for SARS-CoV-2 were negative. Other infectious pathogens were also ruled out. Thoracic high resolution CT showed an intense bilateral pulmonary dissemination with lytic vertebral bone lesions. After diagnostic investigations, Ewing's sarcoma with metastatic pulmonary dissemination was diagnosed. Nowadays, in the context of SARS-CoV-2 community pandemic, we cannot forget that COVID-19 clinical presentation is not specific and other entities can mimic its clinical features.


Subject(s)
Coronavirus Infections/diagnosis , Lung Neoplasms , Multiple Pulmonary Nodules , Pneumonia, Viral/diagnosis , Sarcoma, Ewing , Tomography, X-Ray Computed/methods , Adolescent , Antineoplastic Combined Chemotherapy Protocols , Bone Marrow Examination/methods , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/methods , Coronavirus Infections/blood , Coronavirus Infections/physiopathology , Diagnosis, Differential , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/physiopathology , Lung Neoplasms/secondary , Male , Multiple Pulmonary Nodules/diagnostic imaging , Multiple Pulmonary Nodules/pathology , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/etiology , Pneumonia, Viral/physiopathology , Sarcoma, Ewing/diagnosis , Sarcoma, Ewing/physiopathology , Tomography, Emission-Computed, Single-Photon/methods
15.
Br J Cancer ; 123(4): 499-500, 2020 08.
Article in English | MEDLINE | ID: covidwho-828125

ABSTRACT

Pulmonary metastasectomy is widely and increasingly practiced in the belief that this intervention can cure patients with colorectal cancer, and that without it few survive 5 years. No good evidence exists supporting such convictions, indeed recent trial results challenge them. What evidence underpins this acceptance of illusory truths or misconceptions?


Subject(s)
Colorectal Neoplasms/surgery , Lung Neoplasms/surgery , Metastasectomy/methods , Clinical Trials, Phase II as Topic , Evidence-Based Medicine , Humans , Lung Neoplasms/secondary , Randomized Controlled Trials as Topic , Standard of Care , Survival Analysis
16.
Tumori ; 106(6): NP73-NP75, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-788438

ABSTRACT

BACKGROUND: The differential diagnosis of lung and pleural metastases and coronavirus disease 2019 (COVID-19) can be challenging. CASE: We report a case of a 41-year-old woman with FIGO (International Federation of Gynecology and Obstetrics) stage IV ovarian cancer with pleural and pulmonary spread. After primary cytoreduction was performed, she developed a high fever and worsening dyspnea with desaturation (92% in ambient air). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was suspected, but three swabs gave negative results. Computed tomographic scan showed radiologic imaging strongly suspect for COVID-19 and the patient was transferred to a COVID-19 ward. The final diagnosis was paraneoplastic fever. CONCLUSION: Lung and pleural metastases can mimic SARS-CoV-2 infection.


Subject(s)
COVID-19/diagnosis , Lung Neoplasms/diagnosis , Lung Neoplasms/secondary , Ovarian Neoplasms/pathology , Pleural Neoplasms/diagnosis , Pleural Neoplasms/secondary , Adult , COVID-19/virology , Diagnosis, Differential , Female , Humans , Neoplasm Staging , Symptom Assessment , Tomography, X-Ray Computed
18.
J Oncol Pharm Pract ; 26(5): 1289-1294, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-305896

ABSTRACT

Outbreak of the new type coronavirus infection, known as coronavirus infection 2019 (COVID-19), has begun in December 2019, in Wuhan, China. As of today, 3 April 2020, 972,640 people affected and 50,325 people died from Severe Acute Respiratory Syndrome-Coronavirus 2. There is not any standard treatment for coronavirus infection 2019; however, there are promising data for hydroxychloroquine and some anti-retroviral drugs. Programmed death-1 (PD-1)/programmed death ligand-1 (PDL-1) pathway is an important target for the cancer immunotherapy. However, there is a robust pre-clinical and clinical data regarding inhibitor effect of this pathway on the acute or chronic viral infections. Thus, blockade of this pathway may lead to an anti-viral effect and decrease viral load. Here, we report the clinical course of coronavirus infection 2019 infection of a patient in whom older aged, having multiple co-morbidities, and taking nivolumab for metastatic malignant melanoma. In contrast to her older age, comorbidities, and cancer diagnosis, she was in a good condition, and there was also no pneumonia finding. We think that this good clinical course of coronavirus infection 2019 infection may be related to blockade of PD-1/PDL-1 pathway with nivolumab. It is impossible to say that blockade of PD-1/PDL-1pathway is a treatment option for COVID-19; however, we want to share our experience.


Subject(s)
Azithromycin/administration & dosage , Betacoronavirus , Coronavirus Infections , Lung Neoplasms , Melanoma , Nivolumab/administration & dosage , Oseltamivir/administration & dosage , Pandemics , Pneumonia, Viral , Aged , Antineoplastic Agents, Immunological/administration & dosage , Antineoplastic Agents, Immunological/immunology , Antiviral Agents/administration & dosage , Betacoronavirus/drug effects , Betacoronavirus/physiology , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Coronavirus Infections/virology , Female , Humans , Hydroxychloroquine/administration & dosage , Lung Neoplasms/drug therapy , Lung Neoplasms/secondary , Melanoma/drug therapy , Melanoma/epidemiology , Melanoma/pathology , Multiple Chronic Conditions/epidemiology , Nivolumab/immunology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/virology , Programmed Cell Death 1 Receptor/antagonists & inhibitors , SARS-CoV-2 , Tomography, X-Ray Computed/methods , Treatment Outcome
20.
Diagn Interv Imaging ; 101(6): 347-353, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-108794

ABSTRACT

The COVID-19 pandemic has deeply impacted the activity of interventional oncology in hospitals and cancer centers. In this review based on official recommendations of different international societies, but also on local solutions found in different expert large-volume centers, we discuss the changes that need to be done for the organization, safety, and patient management in interventional oncology. A literature review of potential solutions in a context of scarce anesthesiologic resources, limited staff and limited access to hospital beds are proposed and discussed based on the literature data.


Subject(s)
Betacoronavirus , Cancer Care Facilities/organization & administration , Coronavirus Infections/epidemiology , Neoplasms/therapy , Pandemics , Pneumonia, Viral/epidemiology , Aerosols , Age Factors , Anesthesia, General , Anesthesiology/statistics & numerical data , Biopsy/adverse effects , Biopsy/methods , COVID-19 , COVID-19 Testing , Carcinoma, Hepatocellular/therapy , Carcinoma, Renal Cell/therapy , Chemoembolization, Therapeutic/methods , Clinical Laboratory Techniques/methods , Colonic Neoplasms/pathology , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/transmission , Databases, Factual , Health Personnel/statistics & numerical data , Health Resources/organization & administration , Health Resources/supply & distribution , Hospital Bed Capacity/statistics & numerical data , Hospitalization/statistics & numerical data , Humans , Hyperthermia, Induced/methods , Kidney Neoplasms/therapy , Liver Neoplasms/therapy , Lung Neoplasms/secondary , Lung Neoplasms/therapy , Neoplasms/complications , Palliative Care/methods , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/transmission , SARS-CoV-2 , Triage
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