• Marco Russano, Fabrizio Citarella, Andrea Napolitano, Emanuela Dell'Aquila, Alessio Cortellini, Francesco Pantano, Bruno Vincenzi, Giuseppe Tonini, and Daniele Santini.
• Department of Medical Oncology, University Campus Bio-Medico , Rome, Italy.
• Expert Opin Biol Ther. 2020 Sep 1; 20 (9): 959-964.

IntroductionThe COVID-19 pandemic occurred amid the cancer immunotherapy revolution. Immune checkpoint inhibitors (ICIs) have become the standard of care for several solid cancers and are associated with peculiar toxicities, including pneumonitis which has similar features to COVID-19 pneumonia.Areas CoveredWe summarize the main hallmarks of lung injury induced by ICIs and severe acute respiratory syndrome coronavirus 2 and discuss the critical aspects for differential diagnosis and management. Symptoms and radiological findings are often similar; conversely, treatments are quite different. Furthermore, we focus on potential interactions generating hypotheses that need confirmatory studies.Expert OpinionAll cancer patients treated with immunotherapy should receive screening for SARS-CoV-2. This would improve the diagnosis and management of pneumonia and guide therapeutic choices. Furthermore, clinicians could estimate the risk/benefit of continuing ICI treatment in COVID-19 positive patients. Temporary withdrawal of the immunotherapy treatment pending resolution of viral infection may be a reasonable option in long-responders patients.

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