{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T02:01:12Z","timestamp":1769306472894,"version":"3.49.0"},"reference-count":27,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T00:00:00Z","timestamp":1613001600000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2020,12,20]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>By the beginning of the global pandemic, SARS-CoV-2 infection has dramatically impacted on oncology daily practice. In the current oncological landscape, where immunotherapy has revolutionized the treatment of several malignancies, distinguishing between COVID-19 and immune-mediated pneumonitis can be hard because of shared clinical, radiological and pathological features. Indeed, their common mechanism of aberrant inflammation could lead to a mutual and amplifying interaction.<\/jats:p>\n               <jats:p>We describe the case of a 65\u2013year-old patient affected by metastatic squamous head and neck cancer and candidate to an experimental therapy including an anti-PD-L1 agent. COVID-19 ground-glass opacities under resolution were an incidental finding during screening procedures and worsened after starting immunotherapy. The diagnostic work-up was consistent with ICIs-related pneumonia and it is conceivable that lung injury by SARS-CoV-2 has acted as an inflammatory primer for the development of the immune-related adverse event.<\/jats:p>\n               <jats:p>Patients recovered from COVID-19 starting ICIs could be at greater risk of recall immune-mediated pneumonitis. Nasopharyngeal swab and chest CT scan are recommended before starting immunotherapy. The awareness of the phenomenon could allow an easier interpretation of radiological changes under treatment and a faster diagnostic work-up to resume ICIs. In the presence of clinical benefit, for asymptomatic ICIs-related pneumonia a watchful-waiting approach and immunotherapy prosecution are suggested.<\/jats:p>","DOI":"10.1136\/jitc-2020-001870","type":"journal-article","created":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T11:33:38Z","timestamp":1613043218000},"page":"e001870","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["COVID-19 lung injury as a primer for immune checkpoint inhibitors (ICIs)-related pneumonia in a patient affected by squamous head and neck carcinoma treated with PD-L1 blockade: a case report"],"prefix":"10.1136","volume":"9","author":[{"given":"Angelo","family":"Dipasquale","sequence":"first","affiliation":[{"name":"Department of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pasquale","family":"Persico","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Lorenzi","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daoud","family":"Rahal","sequence":"additional","affiliation":[{"name":"Department of Pathology, IRCCS Humanitas Research Hospital, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armando","family":"Santoro","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Simonelli","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,2,11]]},"reference":[{"key":"2025100305285632000_9.2.e001870.1","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.CD-20-0422"},{"key":"2025100305285632000_9.2.e001870.2","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1038\/s41591-020-0979-0","article-title":"Determinants of COVID-19 disease severity in patients with cancer","volume":"26","author":"Robilotti","year":"2020","journal-title":"Nat Med"},{"key":"2025100305285632000_9.2.e001870.3","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-17670-y"},{"key":"2025100305285632000_9.2.e001870.4","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1001\/jamaoncol.2016.2453","article-title":"Incidence of programmed cell death 1 inhibitor-related pneumonitis in patients with advanced cancer: a systematic review and meta-analysis","volume":"2","author":"Nishino","year":"2016","journal-title":"JAMA Oncol"},{"key":"2025100305285632000_9.2.e001870.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2018.08.2035"},{"key":"2025100305285632000_9.2.e001870.6","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1002\/cncr.31043","article-title":"Comparison of the toxicity profile of PD-1 versus PD-L1 inhibitors in non-small cell lung cancer: a systematic analysis of the literature","volume":"124","author":"Pillai","year":"2018","journal-title":"Cancer"},{"key":"2025100305285632000_9.2.e001870.7","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-019-0218-0"},{"key":"2025100305285632000_9.2.e001870.8","doi-asserted-by":"crossref","unstructured":"Zhu Y , Liu Y-L , Li Z-P , et al . 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