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    Clinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition

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    Authors
    Rogiers, A.
    Pires da Silva, I.
    Tentori, C.
    Tondini, C. A.
    Grimes, J. M.
    Trager, M. H.
    Nahm, Sharon
    Zubiri, L.
    Manos, M.
    Bowling, P.
    Elkrief, A.
    Papneja, N.
    Vitale, M. G.
    Rose, A. A. N.
    Borgers, J. S. W.
    Roy, S.
    Mangana, J.
    Pimentel Muniz, T.
    Cooksley, T.
    Lupu, J.
    Vaisman, A.
    Saibil, S. D.
    Butler, M. O.
    Menzies, A. M.
    Carlino, M. S.
    Erdmann, M.
    Berking, C.
    Zimmer, L.
    Schadendorf, D.
    Pala, L.
    Queirolo, P.
    Posch, C.
    Hauschild, A.
    Dummer, R.
    Haanen, J.
    Blank, C. U.
    Robert, C.
    Sullivan, R. J.
    Ascierto, P. A.
    Miller, W. H., Jr.
    Stephen Hodi, F.
    Suijkerbuijk, K. P. M.
    Reynolds, K. L.
    Rahma, O. E.
    Lorigan, Paul C
    Carvajal, R. D.
    Lo, S.
    Mandala, M.
    Long, G. V.
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    Affiliation
    Melanoma Institute Australia and University of Sydney, Sydney, New South Wales, Australia.
    Issue Date
    2021
    
    Metadata
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    Abstract
    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 decribe 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.
    Citation
    Rogiers A, Pires da Silva I, Tentori C, Tondini CA, Grimes JM, Trager MH, et al. Clinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition. J Immunother Cancer. 2021;9(1).
    Journal
    Journal for immunotherapy of cancer
    URI
    http://hdl.handle.net/10541/623792
    DOI
    10.1136/jitc-2020-001931
    PubMed ID
    33468556
    Additional Links
    https://dx.doi.org/10.1136/jitc-2020-001931
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1136/jitc-2020-001931
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