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Cancer and SARS-CoV-2 Infection: Diagnostic and Therapeutic Challenges
Alessandro Allegra1,2, Giovanni Pioggia3, Alessandro Tonacci4
1Division of Haematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 98125 Messina, Italy.
Abstract:
In late December 2019, a new infectious viral disease appeared. A new betacoronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), has been recognized as the pathogen responsible for this infection. Patients affected by tumors are more vulnerable to infection owing to poor health status, concomitant chronic diseases, and immunosuppressive conditions provoked by both the cancer and antitumor therapies. In this review, we have analyzed some lesser known aspects of the relationship between neoplasms and SARS-CoV-2 infection, starting from the different expression of the ACE2 receptor of the virus in the various neoplastic pathologies, and the roles that different cytokine patterns could have in vulnerability to infection and the appearance of complications. This review also reports the rationale for a possible use of drugs commonly employed in neoplastic therapy, such as bevacizumab, ibrutinib, selinexor, thalidomide, carfilzomib, and PD-1 inhibitors, for the treatment of SARS-CoV-2 infection. Finally, we have highlighted some diagnostic challenges in the recognition of SARS-CoV-2 infection in cancer-infected patients. The combination of these two health problems-tumors and a pandemic virus-could become a catastrophe if not correctly handled. Careful and judicious management of cancer patients with SARS-Cov-2 could support a better outcome for these patients during the current pandemic.
Insights
Cancer patients are more vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to their condition and treatments. This review explores the link between neoplasms and SARS-CoV-2, including potential drug therapies and diagnostic challenges.
Area of Science:
- Oncology
- Virology
- Immunology
Background:
- The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents unique challenges for cancer patients.
- Cancer patients exhibit increased vulnerability to infections due to compromised health status, comorbidities, and immunosuppression from cancer and its treatments.
Purpose of the Study:
- To review lesser-known aspects of the relationship between neoplasms and SARS-CoV-2 infection.
- To explore the role of ACE2 receptor expression and cytokine patterns in SARS-CoV-2 vulnerability and complications in cancer patients.
- To discuss the potential repurposing of anti-cancer drugs for SARS-CoV-2 treatment and diagnostic challenges in this population.
Main Methods:
- Literature review analyzing the interplay between cancer and SARS-CoV-2.
- Examination of ACE2 receptor expression in various neoplastic pathologies.
- Analysis of cytokine profiles and their impact on infection susceptibility and outcomes.
Main Results:
- Differential expression of the ACE2 receptor in neoplastic tissues may influence SARS-CoV-2 susceptibility.
- Specific cytokine patterns may correlate with increased vulnerability and complications from SARS-CoV-2 infection in cancer patients.
- Several anti-cancer drugs (bevacizumab, ibrutinib, selinexor, thalidomide, carfilzomib, PD-1 inhibitors) show potential for SARS-CoV-2 treatment.
Conclusions:
- Managing SARS-CoV-2 in cancer patients requires careful consideration of diagnostic complexities and potential therapeutic strategies.
- Repurposing anti-cancer agents may offer novel treatment avenues for SARS-CoV-2 infection in this vulnerable group.
- Judicious management is crucial to mitigate the catastrophic potential of co-infection with SARS-CoV-2 and cancer.
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