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Clinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition #MMPMID33468556
Rogiers A; Pires da Silva I; Tentori C; Tondini CA; Grimes JM; Trager MH; Nahm S; Zubiri L; Manos M; Bowling P; Elkrief A; Papneja N; Vitale MG; Rose AAN; Borgers JSW; Roy S; Mangana J; Pimentel Muniz T; Cooksley T; Lupu J; Vaisman A; Saibil SD; Butler MO; Menzies AM; Carlino MS; Erdmann M; Berking C; Zimmer L; Schadendorf D; Pala L; Queirolo P; Posch C; Hauschild A; Dummer R; Haanen J; Blank CU; Robert C; Sullivan RJ; Ascierto PA; Miller WH Jr; Stephen Hodi F; Suijkerbuijk KPM; Reynolds KL; Rahma OE; Lorigan PC; Carvajal RD; Lo S; Mandala M; Long GV
J Immunother Cancer 2021[Jan]; 9 (1): ? PMID33468556show ga
BACKGROUND: Patients with cancer who are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to develop severe illness and die compared with those without cancer. The impact of immune checkpoint inhibition (ICI) on the severity of COVID-19 illness is unknown. The aim of this study was to investigate whether ICI confers an additional risk for severe COVID-19 in patients with cancer. METHODS: We analyzed data from 110 patients with laboratory-confirmed SARS-CoV-2 while on treatment with ICI without chemotherapy in 19 hospitals in North America, Europe and Australia. The primary objective was to describe the clinical course and to identify factors associated with hospital and intensive care (ICU) admission and mortality. FINDINGS: Thirty-five (32%) patients were admitted to hospital and 18 (16%) died. All patients who died had advanced cancer, and only four were admitted to ICU. COVID-19 was the primary cause of death in 8 (7%) patients. Factors independently associated with an increased risk for hospital admission were ECOG >/=2 (OR 39.25, 95% CI 4.17 to 369.2, p=0.0013), treatment with combination ICI (OR 5.68, 95% CI 1.58 to 20.36, p=0.0273) and presence of COVID-19 symptoms (OR 5.30, 95% CI 1.57 to 17.89, p=0.0073). Seventy-six (73%) patients interrupted ICI due to SARS-CoV-2 infection, 43 (57%) of whom had resumed at data cut-off. INTERPRETATION: COVID-19-related mortality in the ICI-treated population does not appear to be higher than previously published mortality rates for patients with cancer. Inpatient mortality of patients with cancer treated with ICI was high in comparison with previously reported rates for hospitalized patients with cancer and was due to COVID-19 in almost half of the cases. We identified factors associated with adverse outcomes in ICI-treated patients with COVID-19.
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J+Immunother+Cancer 2021 ; 9 (1): ?
