Systemic cancer treatment not linked to mortality among patients with COVID-19
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Active systemic cancer treatment did not appear associated with increased mortality among patients with cancer and COVID-19, according to study results published in JAMA Network Open.
Rationale and methods
Csilla Várnai, PhD, research fellow in the department of bioinformatics at University of Birmingham in the U.K., and colleagues conducted the prospective cohort study to assess potential associations of systemic cancer treatments, tumor subtypes, patient demographic characteristics and comorbidities with COVID-19-associated mortality.
The U.K. Coronavirus Cancer Monitoring Project study included 2,515 patients (median age, 72 years; 58% men) with active cancer and a clinical diagnosis of COVID-19 who received treatment across 69 U.K. cancer centers between March 18 and Aug. 1, 2020. All-cause mortality within the primary hospitalization served as the primary endpoint.
Key findings
Results showed an association of hematologic malignant neoplasms with higher mortality irrespective of active systemic cancer therapy, especially among those with acute leukemias or myelodysplastic syndrome (OR = 2.16; 95% CI, 1.3-3.6) and myeloma or plasmacytoma (OR = 1.53; 95% CI, 1.04-2.26). Researchers also observed a significant association of lung cancer with higher COVID-19-associated mortality (OR = 1.58; 95% CI, 1.11-2.25).
Although researchers did not observe an association between higher mortality and receipt of chemotherapy within 4 weeks before a COVID-19 diagnosis after adjusting for age, sex and comorbidities, they did find an association between lower mortality and receipt of immunotherapy within 4 weeks before COVID-19 diagnosis vs. no cancer therapy (OR = 0.52; 95% CI, 0.31-0.86).
Implications
“This [study] has relevance for the care of patients with cancer requiring treatment, particularly in countries experiencing an increase in COVID-19 case numbers,” the researchers wrote. “Important differences in outcomes among patients with hematological and lung cancers were observed.”
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