COVID-19 Should Not Delay Cancer Treatment in Patients With Thoracic Cancer, Data Suggest

Recent exposure to systemic treatment does not increase the risk of 30-day mortality in patients with thoracic cancers and COVID-19, according to new data from the COVID-19 and Cancer Consortium (CCC19) registry.

The data did show a high 30-day mortality rate in this patient group, but none of the cancer treatments patients received were associated with an increased risk of 30-day mortality.  

“The study provides reassuring data for not withholding or delaying systemic cancer treatment in the context of recent COVID-19,” said Amit Kulkarni, MBBS, of the University of Minnesota in Minneapolis.

Dr Kulkarni presented these data at the IASLC 2022 World Conference on Lung Cancer.

The study included 903 adults with thoracic cancer and confirmed SARS-CoV-2 infection. The median age at baseline was 70 years (interquartile range, 62-77), 53% of patients were women, 59% were non-Hispanic White, 79% were former or current smokers, and 56% had an ECOG performance status of 0 or 1.

Thirty-four percent of patients had active cancer that was stable or responding to treatment, 24% had active cancer that was progressing, 29% were in remission, and 14% had missing data or the status of their cancer was unknown.

Within the 3 months prior to COVID-19 diagnosis, the types of treatment patients received included chemotherapy with or without immunotherapy (27%), targeted therapy (13%), immunotherapy alone (10%), and chemotherapy and radiation (7%). The remaining 47% of patients had received no recent cancer treatment.

The median follow-up was 70 days, and the primary outcome was 30-day mortality rate. Secondary outcomes included ICU admission, supplemental oxygen use, and mechanical ventilation use.

Rates of the primary and secondary outcomes were highest among patients who received chemotherapy with radiation and generally lowest among patients who received immunotherapy alone.

Primary and Secondary Outcomes by Treatment
Outcome Measure	Entire Cohort	Chemo ± Immunotherapy	Immunotherapy Alone	Chemo and Radiation	Targeted Therapy	No Treatment
30-Day Mortality	22%	26%	15%	33%	18%	22%
ICU Admission	19%	23%	18%	27%	18%	17%
Supplemental Oxygen Use	53%	54%	44%	58%	49%	53%
Mechanical Ventilation	11%	12%	9%	17%	12%	8%

In a multivariable analysis, none of the systemic treatments were associated with 30-day mortality or COVID-19 severity.

Factors that were significantly associated with an increased risk of 30-day mortality and severe COVID-19 were age older than 40 years, male sex, pulmonary comorbidities, ECOG performance status of 2 or higher, active and progressing cancer, and baseline steroid use greater than 10 mg of prednisone daily equivalent.

Disclosures: Dr Kulkarni disclosed affiliations with AstraZeneca, Genentech, Fate Therapeutics, Merck, Exact Sciences, Gilead Sciences, Mirati Therapeutics, and Novavax.

Reference

Kulkarni A, Hennessy C, Wislon G, et al. Impact of systemic anti-cancer treatments on outcomes of COVID-19 in patients with thoracic cancers: CCC19 registry analysis. Presented at WCLC 2022. August 6-9, 2022. Presentation number OA06.06.

This article originally appeared on Cancer Therapy Advisor