SARS-CoV-2-related pneumonia can be successfully managed in patients with metastatic neuroendocrine tumors: a critical p
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SARS-CoV-2-related pneumonia can be successfully managed in patients with metastatic neuroendocrine tumors: a critical point of view F. Spada1 S. Pellicori1 G. Zampino1 L. Funicelli2 L. Gervaso1 A. Laffi1 M. Rubino1 R. Garcia-Carbonero3 N. Fazio 1 ●
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Received: 30 April 2020 / Accepted: 6 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Primary neuroendocrine tumors of the thymus are extremely rare. In patients with advanced disease, tumor growth control, and sometimes also syndrome control are the main goals of systemic therapy. Unfortunately, no standard therapies are available in clinical practice; therefore, clinical studies are strongly recommended. Axitinib (AXI) is a tyrosine kinase inhibitor, currently under investigation in an international phase II/III trial including thymic neuroendocrine tumors. Over the past 5 months, the entire world has been facing a devastating medical emergency brought about by a pandemic due to a novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in Wuhan, China, in late 2019. Since then, health professionals have been expending all their efforts on trying to provide the best available treatments for patients involved. Patients with cancer, especially those with thoracic involvement, are at higher risk of coronavirus disease 19 (COVID-19) and its complications because of their immunosuppressive status caused by the cancer and the anticancer therapies. As it remains unclear how to optimally manage such patients, we wished to report our experience with a patient with a metastatic neuroendocrine tumor of the thymus infected with SARS-CoV-2 in the hope that it may provide some insights and reflections on the management of cancer patients during this challenging time in our history. Keywords COVID-19 NET Thymus Neuroendocrine tumors ●
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Introduction Thymic (Thy) neuroendocrine tumors (NETs) represent a heterogeneous and rare group of neoplasms including less than 5% of primary epithelial tumors in the thymus [1]. They can be discovered incidentally or due to symptoms related to tumor mass effect or hormone secretion. In
* N. Fazio [email protected] 1
Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy
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Division of Radiology, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy
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Medical Oncology Department, Hospital Universitario Doce de Octubre, Imas12, UCM, Madrid, Spain
advanced low/intermediate-grade Thy-NETs [2], prognosis is relatively poor and systemic therapy is usually proposed. Unfortunately, no therapy has been validated so far in clinical practice; thus, treatment within a clinical trial is strongly encouraged. Axitinib (AXI) is an oral tyrosine kinase inhibitor (TKI) that binds to the kinase domain of receptors 1, 2, and 3 of VEGF, inhibiting intracellular signaling mediated
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