Abstract
The COVID-19 pandemic has changed the therapeutic algorithm for many dermatological diseases, particularly those where drugs are influencing the immune system. Patients with advanced melanoma are treated with immunotherapy or targeted therapy in an adjuvant or palliative regimen.
There are only a few guidelines suggesting the approach to these patients, many are being treated on an individual basis. According to the National Comprehensive Cancer Network guidelines, initiation of immunotherapy/targeted therapy for metastatic disease or in an adjuvant setting is still recommended during the COVID-19 pandemic.
Immune checkpoint blockade activates the immune system by enhancing T-cell proliferation and cytokine production. The extent to which an activated immune response may influence the clinical course of COVID-19 or whether it induces or enhances a hyperinflammatory reaction, is currently unknown.
We evaluated 104 patients currently being treated with immunotherapy for advanced melanoma. In 76 patients the therapy was ongoing, while in 28 patients the treatment was initiated during the pandemic.
Individuals were treated in an adjuvant or palliative setting with anti-PD-1 monotherapy (nivolumab/pembrolizumab), combo treatment (ipilimumab + nivolumab) or triplet treatment (spartalizumab + dabrafenib + trametinib).