{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:55:14Z","timestamp":1760147714114,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>We present the case of a 76-year-old male patient persistently infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the setting of a stage IIIC cutaneous melanoma and non-Hodgkin\u2019s lymphoma (NHL). Due to the persistent coronavirus disease 19 (COVID-19), all cancer treatments were discontinued. Because of the worsening of his clinical state and the persistence of SARS-CoV-2 positivity for more than six months, the patient was treated with sotrovimab, which was ineffective due to resistance mutations acquired during that time. In order to resume cancer treatment and make the patient free from SARS-CoV-2, an in vitro screening of Evusheld monoclonal antibodies (tixagevumab\u2013cilgavimab) against the viral strains isolated from the subject was performed. The promising results obtained during in vitro testing led to the authorization of the off-label use of Evusheld, which made the patient negative for SARS-CoV-2, thus, allowing him to resume his cancer treatment. This study highlights the Evusheld monoclonal antibodies\u2019 efficacy, not only in prevention but also in successful therapy against prolonged COVID-19. Therefore, testing neutralizing monoclonal antibodies in vitro against SARS-CoV-2 mutants directly isolated from patients could provide useful information for the treatment of people affected by long COVID.<\/jats:p>","DOI":"10.3390\/v15030614","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T03:01:01Z","timestamp":1677207661000},"page":"614","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rational Use of Monoclonal Antibodies as Therapeutic Treatment in an Oncologic Patient with Long COVID"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8869-8164","authenticated-orcid":false,"given":"Maria Grazia","family":"Cusi","sequence":"first","affiliation":[{"name":"Virology Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy"},{"name":"Virology Unit, Department of Medical Biotechnolopgies, Santa Maria Alle Scotte University Hospital, V.le Bracci 16, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Maria","family":"Di Giacomo","sequence":"additional","affiliation":[{"name":"Center for Immuno-Oncology, Medical Oncology and Immunotherapy, Department of Medical Sciences, Surgical and Neuroscience, 53100 Siena, Italy"},{"name":"Italian Network for Tumor Bio-Immunotherapy Foundation Onlus, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Anichini","sequence":"additional","affiliation":[{"name":"Virology Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2287-9258","authenticated-orcid":false,"given":"Gianni","family":"Gori Savellini","sequence":"additional","affiliation":[{"name":"Virology Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Terrosi","sequence":"additional","affiliation":[{"name":"Virology Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2174-0713","authenticated-orcid":false,"given":"Claudia","family":"Gandolfo","sequence":"additional","affiliation":[{"name":"Virology Unit, Department of Medical Biotechnolopgies, Santa Maria Alle Scotte University Hospital, V.le Bracci 16, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Maio","sequence":"additional","affiliation":[{"name":"Center for Immuno-Oncology, Medical Oncology and Immunotherapy, Department of Medical Sciences, Surgical and Neuroscience, 53100 Siena, Italy"},{"name":"Italian Network for Tumor Bio-Immunotherapy Foundation Onlus, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"key":"ref_1","first-page":"2273","article-title":"Role of COVID-19 Vaccines in SARS-CoV-2 Variants","volume":"13","author":"Zhou","year":"2022","journal-title":"Front. Immunol."},{"key":"ref_2","first-page":"e068632","article-title":"Efficacy of COVID-19 vaccines in immunocompromised patients: Systematic review and meta-analysis","volume":"376","author":"Wong","year":"2022","journal-title":"BMJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2436","DOI":"10.1056\/NEJMc2202861","article-title":"SARS-CoV-2 Evolution and Immune Escape in Immunocompromised Patients","volume":"386","author":"Scherer","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2560","DOI":"10.1038\/s41467-022-30163-4","article-title":"Cumulative SARS-CoV-2 mutations and corresponding changes in immunity in an immunocompromised patient indicate viral evolution within the host","volume":"13","author":"Sonnleitner","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1056\/NEJMsb2104756","article-title":"SARS-CoV-2 Variants in Patients with Immunosuppression","volume":"385","author":"Corey","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_6","unstructured":"(2022, October 19). Centers for Disease Control and Prevention, Pre-Exposure Prophylaxis with EVUSHELD, Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/clinical-care\/pre-exposure-prophylaxis.html."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1093\/oxfordjournals.aje.a118408","article-title":"A simple method of estimating fifty per cent endpoints","volume":"27","author":"Reed","year":"1938","journal-title":"Am. J. Epidemiol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Anichini, G., Terrosi, C., Gandolfo, C., GoriSavellini, G., Fabrizi, S., Miceli, G.B., Franchi, F., and Cusi, M.G. (2022). Omicron Infection Evokes Cross-Protection against SARS-CoV-2 Variants in Vaccinees. Vaccines, 10.","DOI":"10.3390\/vaccines10050808"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1056\/NEJMc2103825","article-title":"SARS-CoV-2 Antibody Response in Persons with Past Natural Infection","volume":"385","author":"Anichini","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1038\/s41586-020-2349-y","article-title":"Cross-neutralization of SARS-CoV-2 by a human monoclonal SARS-CoV antibody","volume":"583","author":"Pinto","year":"2020","journal-title":"Nature"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e559","DOI":"10.1016\/S2666-5247(22)00120-3","article-title":"Sotrovimab drives SARS-CoV-2 omicron variant evolution in immunocompromised patients","volume":"3","author":"Destras","year":"2022","journal-title":"Lancet Microbe."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1056\/NEJMc2120219","article-title":"Resistance Mutations in SARS-CoV-2 Delta Variant after Sotrovimab Use","volume":"386","author":"Rockett","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e202201415","DOI":"10.26508\/lsa.202201415","article-title":"SARS-CoV-2 spike E156G\/\u0394157-158 mutations contribute to increased infectivity and immune escape","volume":"5","author":"Mishra","year":"2022","journal-title":"Life Sci. Alliance"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1126\/science.abf6950","article-title":"Recurrent deletions in the SARS-CoV-2 spike glycoprotein drive antibody escape","volume":"371","author":"McCarthy","year":"2021","journal-title":"Science"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"201","DOI":"10.3390\/jmp3040018","article-title":"The Comparison of Mutational Progression in SARS-CoV-2: A Short Updated Overview","volume":"3","author":"Abeer","year":"2022","journal-title":"J. Mol. Pathol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"4683","DOI":"10.1038\/s41598-022-08559-5","article-title":"In vitro evaluation of therapeutic antibodies against a SARS-CoV-2 Omicron B.1.1.529 isolate","volume":"12","author":"Touret","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2188","DOI":"10.1056\/NEJMoa2116620","article-title":"Intramuscular AZD7442 (Tixagevimab-Cilgavimab) for Prevention of COVID-19","volume":"386","author":"Levin","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/j.dsx.2021.04.007","article-title":"Long COVID: An overview","volume":"15","author":"Raveendran","year":"2021","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1002\/ijc.33213","article-title":"Cancer associates with risk and severe events of COVID-19: A systematic review and meta-analysis","volume":"148","author":"Tian","year":"2021","journal-title":"Int. J. Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and Efficacy of the BNT162b2 mRNA COVID-19 Vaccine","volume":"383","author":"Polack","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1056\/NEJMoa2035389","article-title":"Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine","volume":"384","author":"Baden","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.ejca.2021.10.013","article-title":"Evaluation of COVID-19 vaccine response in patients with cancer: An interim analysis","volume":"159","author":"Tran","year":"2021","journal-title":"Eur. J. Cancer"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1038\/s41571-022-00610-8","article-title":"COVID-19 vaccines in patients with cancer: Immunogenicity, efficacy and safety","volume":"19","author":"Fendler","year":"2022","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4860","DOI":"10.1002\/jmv.27956","article-title":"Impaired serological response to COVID-19 vaccination following anticancer therapy: A systematic review and meta-analysis","volume":"94","author":"Tang","year":"2022","journal-title":"J. Med. Virol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1080\/07853890.2022.2034936","article-title":"Efficacy and safety of three new oral antiviral treatment (molnupiravir, fluvoxamine and Paxlovid) for COVID-19: A meta-analysis","volume":"54","author":"Wen","year":"2022","journal-title":"Ann. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e2220957","DOI":"10.1001\/jamanetworkopen.2022.20957","article-title":"Effectiveness of Casirivimab-Imdevimab and Sotrovimab During a SARS-CoV-2 Delta Variant Surge: A Cohort Study and Randomized Comparative Effectiveness Trial","volume":"5","author":"Huang","year":"2022","journal-title":"JAMA Netw. Open."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e2402","DOI":"10.1002\/rmv.2402","article-title":"Efficacy and safety of sotrovimab in patients with COVID-19: A rapid review and meta-analysis","volume":"32","author":"Amani","year":"2022","journal-title":"Rev. Med. Virol."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/15\/3\/614\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:40:31Z","timestamp":1760121631000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/15\/3\/614"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,23]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["v15030614"],"URL":"https:\/\/doi.org\/10.3390\/v15030614","relation":{},"ISSN":["1999-4915"],"issn-type":[{"type":"electronic","value":"1999-4915"}],"subject":[],"published":{"date-parts":[[2023,2,23]]}}}