新型冠状病毒肺炎与抗肿瘤药物治疗

doi:10.19401/j.cnki.1007-3639.2022.06.004

中国癌症杂志 ›› 2022, Vol. 32 ›› Issue (6): 499-511.doi: 10.19401/j.cnki.1007-3639.2022.06.004

新型冠状病毒肺炎与抗肿瘤药物治疗

胡夕春¹^,^#()(), 胡志皇²^,^#()(), 王碧芸³, 王佳蕾², 陶荣⁴, 张剑⁵, 郭伟剑⁶, 陈洁⁷, 罗志国¹, 李婷³, 黄明主⁶, 邱立新⁶, 桑友洲⁷

1.复旦大学附属肿瘤医院大内科,复旦大学上海医学院肿瘤学系,上海 200032
2.复旦大学附属肿瘤医院胸部肿瘤内科,复旦大学上海医学院肿瘤学系,上海 200032
3.复旦大学附属肿瘤医院乳腺及泌尿肿瘤内科,复旦大学上海医学院肿瘤学系,上海 200032
4.复旦大学附属肿瘤医院淋巴瘤科,复旦大学上海医学院肿瘤学系,上海 200032
5.复旦大学附属肿瘤医院Ⅰ期临床试验病房,复旦大学上海医学院肿瘤学系,上海 200032
6.复旦大学附属肿瘤医院消化肿瘤内科,复旦大学上海医学院肿瘤学系,上海 200032
7.复旦大学附属肿瘤医院头颈及神经内分泌肿瘤内科,复旦大学上海医学院肿瘤学系,上海 200032

收稿日期:2022-05-08 修回日期:2022-05-20 出版日期:2022-06-30 发布日期:2022-07-21
通信作者: 胡夕春 E-mail:xchu2009@hotmail.com;ZhihuangHu@hotmail.com
作者简介:胡夕春,主任医师,教授,博士研究生导师,复旦大学附属肿瘤医院肿瘤内科主任。现为欧洲肿瘤内科学会（European Society for Medical Oncology,ESMO）乳腺癌Faculty Member、ABC5 Panelist、中国抗癌协会多原发和不明原发肿瘤专业委员会主任委员、中华医学会肿瘤分会肿瘤内科专家委员会副主任委员、中国研究型医院学会乳腺专业委员会副主任委员、中国抗癌协会乳腺癌专业委员会常委兼秘书长、国家药品监督管理局审评中心审评专家等。目前担任International Journal of Biological Markers、Journal of Bone Oncology、《中华乳腺病杂志》、《中国癌症杂志》、《临床肿瘤学杂志》编委。已在The Lancet Oncology、Annals of Oncology、Journal of Clinical Oncology等杂志发表论文200多篇。主编《肿瘤内科方案的药物不良反应及对策》、《肿瘤科常见诊疗问题问答-胡夕春医生查房实录》等专著。主持十三五计划“重大新药创制”科技重大专项、国家自然科学基金面上项目和上海市科委项目等,获中国抗癌协会科技奖一等奖、全国妇幼健康科学技术奖一等奖和上海市医学科技进步奖一等奖等。
胡志皇（ORCID: 0000-0002-6547-3832）,博士,副主任医师,E-mail: ZhihuangHu@hotmail.com
第一联系人：^#共同第一作者

COVID-19 and systemic anti-cancer therapy

HU Xichun¹^,^#()(), HU Zhihuang²^,^#()(), WANG Biyun³, WANG Jialei², TAO Rong⁴, ZHANG Jian⁵, GUO Weijian⁶, CHEN Jie⁷, LUO Zhiguo¹, LI Ting³, HUANG Mingzhu⁶, QIU Lixin⁶, SANG Youzhou⁷

1. Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
2. Department of Thoracic Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
3. Department of Breast and Urinary Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
4. Department of Lymphoma, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
5. Department of Phase Ⅰ Clinical Trial Ward, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
6. Department of Gastroenterological Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
7. Department of Head, Neck and Neuroendocrine Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China

Received:2022-05-08 Revised:2022-05-20 Published:2022-06-30 Online:2022-07-21
Contact: HU Xichun E-mail:xchu2009@hotmail.com;ZhihuangHu@hotmail.com

摘要/Abstract

摘要：

新型冠状病毒感染的肺炎（corona virus disease 2019,COVID-19）疫情仍严重影响着世界各国的医疗卫生体系,而恶性肿瘤患者由于较低的免疫功能状态及更多的风险暴露,影响更甚。本文通过检索PubMed数据库中与本研究目的直接相关的国内外相关文献,并参考相关诊治指南,总结了国内外关于恶性肿瘤与COVID-19相关的研究数据,以论述该人群的个体防护、抗肿瘤治疗、合并感染的转归以及患者的临床管理策略。我们发现恶性肿瘤患者感染COVID-19的概率更高,临床预后更差,尤其是肺癌和血液系统肿瘤。全身化疗可能延缓人体对严重急性呼吸综合征冠状病毒2型（severe acute respiratory syndrome corona virus 2,SARS-CoV-2）的清除时间,进而对COVID-19的临床结局产生负面影响,部分内分泌治疗药物、靶向药物对其影响较小,而免疫检查点抑制剂治疗方面的证据尚不够充分。临床工作中,加强肿瘤患者的个体防护、合理调整抗肿瘤治疗方案、优化临床诊治流程具有重要价值。

关键词: 新冠肺炎, 恶性肿瘤, 化疗, 抗肿瘤治疗, 临床结局

Abstract:

The corona virus disease 2019 (COVID-19) pandemic continues to severely impact healthcare systems around the world, and patients with cancer are even worse affected owing to compromised immune status and greater exposure risk. In the present review, we retrieved the relevant literature including guidelines and consensuses directly related to the purpose of this study from the PubMed database, and then summarized the research data on cancer and COVID-19, aiming to discuss the personal protection, systemic anti-cancer therapy, outcome of co-infection, and the clinical management strategy in this population. We found that patients with malignant tumors had a higher chance of suffering COVID-19, co-infection of whom had an even worse clinical prognosis, especially for those with lung cancer or hematologic cancers. Systemic chemotherapy may delay the clearance of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) virus of human body, and thus have a negative impact on the clinical outcomes of COVID-19, while certain endocrine therapy and targeted drugs having limited or no impact. There has been no sufficient evidence for the impact of immune checkpoint therapy on the outcomes of COVID-19 till now. It is of great value to strengthen the personal protection of patients, adjust the anti-tumor treatments rationally and optimize the clinical management processes.

Key words: COVID-19, Malignant tumors, Chemotherapy, Anti-tumor therapy, Clinical outcome

中图分类号:

R730.53

胡夕春, 胡志皇, 王碧芸, 王佳蕾, 陶荣, 张剑, 郭伟剑, 陈洁, 罗志国, 李婷, 黄明主, 邱立新, 桑友洲. 新型冠状病毒肺炎与抗肿瘤药物治疗[J]. 中国癌症杂志, 2022, 32(6): 499-511.

HU Xichun, HU Zhihuang, WANG Biyun, WANG Jialei, TAO Rong, ZHANG Jian, GUO Weijian, CHEN Jie, LUO Zhiguo, LI Ting, HUANG Mingzhu, QIU Lixin, SANG Youzhou. COVID-19 and systemic anti-cancer therapy[J]. China Oncology, 2022, 32(6): 499-511.

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新型冠状病毒肺炎与抗肿瘤药物治疗

COVID-19 and systemic anti-cancer therapy

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