SARS-CoV-2 infection and adverse events in patients with cancer receiving immune checkpoint inhibitors: an observational prospective study
Lorigan, Paul C
De Luca, M.
Bettini, A. C.
Vitale, M. G.
Di Croce, A.
Ascierto, P. A.
Tondini, C. A.
AffiliationUnit of Medical Oncology, University of Perugia, Perugia, Italy
MetadataShow full item record
AbstractBackground: In ambulatory patients with cancer with asymptomatic or pauci-symptomatic SARS-CoV-2 infection, the safety of targeted therapies (TTs), chemotherapy (CT) or immune checkpoint inhibitors (ICIs) therapy is still unknown. Material and methods: From the start of the first epidemic wave of SARS-CoV-2 in Bergamo, Italy, we have prospectively screened all consecutive outpatients who presented for treatment to the Oncology Division of the Papa Giovanni XXIII Hospital, Bergamo for SARS-CoV-2 antigen expression. We identified patients treated with ICIs and compared these to patients with the same cancer subtypes treated with TTs or CT. Results: Between March 5 and May 18, 293 consecutive patients (49% melanoma, 34% non-small cell lung cancer, 9% renal cell carcinoma, 8% other) were included in this study: 159 (54%), 50 (17%) and 84 (29%) received ICIs, CT or TTs, respectively. Overall 89 patients (30.0%) were SARS-CoV-2 positive. Mortality of SARS-CoV-2-positive patients was statistically significantly higher compared with SARS-CoV-2 negative patients (8/89 vs 3/204, respectively, Fisher's exact test p=0.004). All deaths were due to COVID-19. Serious adverse events (SAEs) were more frequent in SARS-CoV-2-positive patients compared with SARS-CoV-2-negative cases (Cochran-Mantel-Haenszel (CMH) test p=0.0008). The incidence of SAEs in SARS-CoV-2 positive compared with SARS-CoV-2 negative patients was similar in ICI and CT patients (17.3% and 3.7% for positive and negative patients in ICIs and 15.4% and 2.7% in CT, Breslow-Day test p=0.891). No COVID-19-related SAEs were observed in the TTs patients. Conclusions: The incidence of SAEs was higher for SARS-CoV-2-positive patients treated with ICIs and CT, mostly in advanced disease. No SAEs were observed in patients treated with TTs. SAEs were COVID-19 related rather than treatment related. Treatment with ICIs does not appear to significantly increase risk of SAEs compared with CT. This information should be considered when determining treatment options for patients.
CitationMandala M, Lorigan P, De Luca M, Bianchetti A, Merelli B, Bettini AC, et al. SARS-CoV-2 infection and adverse events in patients with cancer receiving immune checkpoint inhibitors: an observational prospective study. J Immunother Cancer. 2021;9(2).
JournalJournal for Immunotherapy of Cancer
- Influenza vaccination in cancer patients receiving immune checkpoint inhibitors: A systematic review.
- Authors: Spagnolo F, Boutros A, Croce E, Cecchi F, Arecco L, Tanda E, Pronzato P, Lambertini M
- Issue date: 2021 Jul
- Immunotherapy may protect cancer patients from SARS-CoV-2 infection: a single-center retrospective analysis.
- Authors: Isgrò MA, Vitale MG, Celentano E, Nocerino F, Porciello G, Curvietto M, Mallardo D, Montagnese C, Russo L, Zanaletti N, Avallone A, Pensabene M, De Laurentiis M, Centonze S, Pignata S, Cannella L, Morabito A, Caponigro F, Botti G, Masucci GV, Giannarelli D, Cavalcanti E, Ascierto PA
- Issue date: 2021 Mar 31
- Impact of COVID-19 outbreak on cancer immunotherapy in Italy: a survey of young oncologists.
- Authors: Ottaviano M, Curvietto M, Rescigno P, Tortora M, Palmieri G, Giannarelli D, Aieta M, Assalone P, Attademo L, Avallone A, Bloise F, Bosso D, Borzillo V, Buono G, Calderoni G, Caputo F, Cartenì G, Cavallero D, Cavo A, Ciardiello F, Conca R, Conteduca V, De Falco S, De Felice M, De Laurentiis M, De Placido P, De Placido S, De Santo I, De Stefano A, Della Corte CM, Di Franco R, Di Lauro V, Fabbrocini A, Federico P, Festino L, Giordano P, Giuliano M, Gridelli C, Grimaldi AM, Lia M, Marretta AL, Massa V, Mennitto A, Merler S, Merz V, Messina C, Messina M, Milano M, Minisini AM, Montesarchio V, Morabito A, Morgillo F, Mucci B, Nappi L, Napolitano F, Paciolla I, Pagliuca M, Palmieri G, Parola S, Pepe S, Petrillo A, Piantedosi F, Piccin L, Picozzi F, Pietroluongo E, Pignata S, Prati V, Riccio V, Rosanova M, Rossi A, Russo A, Salati M, Santabarbara G, Sbrana A, Simeone E, Silvestri A, Spada M, Tarantino P, Taveggia P, Tomei F, Vincenzo T, Trapani D, Trojanello C, Vanella V, Vari S, Ventriglia J, Vitale MG, Vitiello F, Vivaldi C, von Arx C, Zacchi F, Zampiva I, Zivi A, Daniele B, Ascierto PA, SCITO (Società Campana di ImmunoTerapia Oncologica).
- Issue date: 2020 Oct
- Clinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition.
- Authors: 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
- Issue date: 2021 Jan
- Prevalence and Clinical Impact of SARS-CoV-2 Silent Carriers Among Actively Treated Patients with Cancer During the COVID-19 Pandemic.
- Authors: Zambelli A, Chiudinelli L, Fotia V, Negrini G, Bosetti T, Callegaro A, Di Croce A, Caremoli ER, Moro C, Milesi L, Poletti P, Tasca C, Mandalà M, Merelli B, Mosconi S, Arnoldi E, Bettini A, Bonomi L, Messina C, Ghilardi L, Chirco A, Maracino M, Tondini C
- Issue date: 2021 Apr