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Case Report: Adequate T and B Cell Responses in a SARS-CoV-2 Infected Patient After Immune Checkpoint Inhibition.

K de Joode¹, A A M Oostvogels¹, C H GeurtsvanKessel²

¹Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.

Frontiers in Immunology

|February 22, 2021

Summary

Patients on immune checkpoint inhibitors for cancer showed a robust immune response to SARS-CoV-2 infection. This suggests that immunotherapy may not need to be withheld during the COVID-19 pandemic.

Keywords:

adaptive immunity cancer cellular humoral immunotherapy kidney neoplasms

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Area of Science:

Immunology
Oncology
Infectious Diseases

Background:

The COVID-19 pandemic led to non-evidence-based guidelines on adjusting cancer treatments.
Concerns exist regarding the safety of immunotherapy with immune checkpoint inhibitors (ICIs) during the pandemic due to their impact on the immune system.
Limited data are available on the immune response in cancer patients receiving immunotherapy during SARS-CoV-2 infection.

Observation:

This study details the adaptive immune response in a patient with advanced renal cell cancer treated with ICIs who contracted SARS-CoV-2.
T-cell subsets and their markers (co-signalling, maturation, chemotaxis) were analyzed at baseline, during therapy, and during SARS-CoV-2 infection.
Plasma samples were assessed for IgM and IgG antibodies and their neutralizing capacity against SARS-CoV-2.

Findings:

Despite risk factors for impaired immunity, the patient mounted both T-cell and B-cell responses to SARS-CoV-2.
Treatment with immune checkpoint inhibitors resulted in a sufficient cellular and humoral immune response in this infected patient.
The patient demonstrated effective antibody production and neutralization capabilities against SARS-CoV-2.

Implications:

These findings challenge the necessity of withholding immune checkpoint inhibitors during the COVID-19 pandemic.
The study supports the continuation of immunotherapy in cancer patients even during SARS-CoV-2 infection.
Further discussion is warranted regarding the management of cancer immunotherapy during viral pandemics.