Published by:
Warner JL, et al. Abstract LBA110. Presented at: ASCO20 Virtual Scientific Program; May 29-31, 2020.
Progressing malignancy linked to higher mortality among patients with cancer and COVID-19
Published by:
Warner JL, et al. Abstract LBA110. Presented at: ASCO20 Virtual Scientific Program; May 29-31, 2020.
Click Here to Manage Email Alerts
Progressing cancer appeared independently associated with increased risk for death among a cohort of patients with malignancies and COVID-19, according to study results presented during the ASCO20 Virtual Scientific Program.
Other factors linked to higher 30-day mortality among this cohort included age, male sex, ECOG performance status.
Receipt of a combination of hydroxychloroquine and azithromycin also appeared associated with higher mortality risk; however, researchers emphasized no conclusions can be drawn about the impact of this combination because several factors — including disease severity — may have influenced which patients received it, therefore confounding the results.
“The effects of COVID-19 on patients with cancer remain poorly understood,” Jeremy Lyle Warner, MD, MS, medical director of the Vanderbilt Cancer Registry and associate professor of medicine and biomedical informatics at Vanderbilt-Ingram Cancer Center, said during a presentation. “There are some published reports, but they tend to be on the smaller size or are focused on a specific geographic region. We wanted to collect a larger and more representative cohort to learn more about COVID-19 and cancer.”
Warner presented results based on cases reported by academic and community hospitals in the COVID-19 and Cancer Consortium, which is collecting data on patients with active or previous hematologic or invasive solid malignancies.
Warner and colleagues analyzed 928 patients (median age, 66 years; range, 18-90) with cancer and COVID-19 to determine who may be most at risk for mortality and to identify potential prognostic factors.
The most common malignancies in the cohort included breast cancer (20%) and prostate cancer (16%), and 43% of the total population remained on active anticancer treatment.
About 20% of patients received the combination of hydroxychloroquine and azithromycin, and about 10% received hydroxychloroquine alone, Warner said.
At the time of data analysis, 106 patients had died and 26% met the composite outcome of death, severe illness requiring hospitalization or mechanical ventilation.
Within 30 days of COVID-19 diagnosis, 121 patients (13%) had died.
Multivariable logistic regression analysis identified several independent factors associated with higher 30-day mortality. These included age, male sex, former smoking, ECOG performance status (ECOG 2 vs. 0 or 1: partially adjusted OR [paOR] = 2.74; 95% CI, 1.31-5.7; ECOG 3 or 4 vs. ECOG 0 or 1: paOR = 5.34; 95% CI, 2.44-11.69), active malignancy status (stable/responding: paOR = 1.93; 95% CI, 1.06-3.5; progressing: paOR = 3.79; 95% CI, 1.78-8.08), and receipt of azithromycin in combination with hydroxychloroquine.
Tumor type, race, ethnicity, obesity, number of comorbidities, recent surgery and type of cancer therapy did not appear to be significant predictors of mortality.
“The patients who were hospitalized were much more likely to receive hydroxychloroquine or the combination of [hydroxychloroquine and azithromycin,” Warner said. “Our data are limited about when exactly these patients received the drugs and require follow-up. It’s too early to make any major conclusions on these data regarding the combination of these drugs.” – by John DeRosier
References:
Warner JL, et al. Abstract LBA110. Presented at: ASCO20 Virtual Scientific Program; May 29-31, 2020.
Disclosures: Warner reports consultant/advisory roles with and/or travel expenses from IBM and Westat and stock ownership in HemOnc.org. Please see the abstract for all other researchers’ relevant financial disclosures.