Italian survey on managing immune checkpoint inhibitors in oncology during COVID-19 outbreak

Marco Tagliamento, Francesco Spagnolo, Francesca Poggio, Davide Soldato, Benedetta Conte, Tommaso Ruelle, Emanuela Barisione, Andrea De Maria, Lucia Del Mastro, Massimo Di Maio, Matteo Lambertini

Research output: Contribution to journalArticlepeer-review


Background: During COVID-19 outbreak, oncological care has been reorganized. Patients with cancer have been reported to experience a more severe COVID-19 syndrome; moreover, there are concerns of a potential interference between immune checkpoint inhibitors (ICIs) and SARS-CoV-2 pathogenesis. Materials and methods: Between 6 and 16 May 2020, a 22-item survey was sent to Italian physicians involved in administering ICIs. It aimed at exploring the perception about SARS-CoV-2-related risks in cancer patients receiving ICIs, and the attitudes towards their management. Results: The 104 respondents had a median age of 35.5 years, 58.7% were females and 71.2% worked in Northern Italy. 47.1% of respondents argued a synergism between ICIs and SARS-CoV-2 pathogenesis leading to worse outcomes, but 97.1% would not deny an ICI only for the risk of infection. During COVID-19 outbreak, to reduce hospital visits, 55.8% and 30.8% opted for the highest labelled dose of each ICI and/or, among different ICIs for the same indication, for the one with the longer interval between cycles, respectively. 53.8% of respondents suggested testing for SARS-CoV-2 every cancer patient candidate to ICIs. 71.2% declared to manage patients with onset of dyspnoea and cough as infected by SARS-CoV-2 until otherwise proven; however, 96.2% did not reduce the use of steroids to manage immune-related toxicities. The administration of ICIs in specific situations for different cancer types has not been drastically conditioned. Conclusions: These results highlight the uncertainties around the perception of a potential interference between ICIs and COVID-19, supporting the need of focused studies on this topic.

Original languageEnglish
Article numbere13315
JournalEuropean Journal of Clinical Investigation
Issue number9
Publication statusPublished - Sep 1 2020


  • cancer
  • COVID-19
  • immune checkpoint inhibitors
  • immunotherapy
  • SARS-CoV-2

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry


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