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1.
J Immunother Cancer ; 10(11), 2022.
Article in English | PubMed | ID: covidwho-2137949

ABSTRACT

BACKGROUND: As management and prevention strategies against COVID-19 evolve, it is still uncertain whether prior exposure to immune checkpoint inhibitors (ICIs) affects COVID-19 severity in patients with cancer. METHODS: In a joint analysis of ICI recipients from OnCovid (NCT04393974) and European Society for Medical Oncology (ESMO) CoCARE registries, we assessed severity and mortality from SARS-CoV-2 in vaccinated and unvaccinated patients with cancer and explored whether prior immune-related adverse events (irAEs) influenced outcome from COVID-19. FINDINGS: The study population consisted of 240 patients diagnosed with COVID-19 between January 2020 and February 2022 exposed to ICI within 3 months prior to COVID-19 diagnosis, with a 30-day case fatality rate (CFR(30)) of 23.6% (95% CI 17.8 to 30.7%). Overall, 42 (17.5%) were fully vaccinated prior to COVID-19 and experienced decreased CFR(30) (4.8% vs 28.1%, p=0.0009), hospitalization rate (27.5% vs 63.2%, p<0.0001), requirement of oxygen therapy (15.8% vs 41.5%, p=0.0030), COVID-19 complication rate (11.9% vs 34.6%, p=0.0040), with a reduced need for COVID-19-specific therapy (26.3% vs 57.9%, p=0.0004) compared with unvaccinated patients. Inverse probability of treatment weighting (IPTW)-fitted multivariable analysis, following a clustered-robust correction for the data source (OnCovid vs ESMO CoCARE), confirmed that vaccinated patients experienced a decreased risk of death at 30 days (adjusted OR, aOR 0.08, 95% CI 0.01 to 0.69).Overall, 38 patients (15.8%) experienced at least one irAE of any grade at any time prior to COVID-19, at a median time of 3.2 months (range 0.13-48.7) from COVID-19 diagnosis. IrAEs occurred independently of baseline characteristics except for primary tumor (p=0.0373) and were associated with a significantly decreased CFR(30) (10.8% vs 26.0%, p=0.0462) additionally confirmed by the IPTW-fitted multivariable analysis (aOR 0.47, 95% CI 0.33 to 0.67). Patients who experienced irAEs also presented a higher median absolute lymphocyte count at COVID-19 (1.4 vs 0.8 10(9) cells/L, p=0.0098). CONCLUSION: Anti-SARS-CoV-2 vaccination reduces morbidity and mortality from COVID-19 in ICI recipients. History of irAEs might identify patients with pre-existing protection from COVID-19, warranting further investigation of adaptive immune determinants of protection from SARS-CoV-2.

2.
ESMO Open ; 7(3): 100499, 2022 06.
Article in English | MEDLINE | ID: covidwho-1821235

ABSTRACT

BACKGROUND: ESMO COVID-19 and CAncer REgistry (ESMO-CoCARE) is an international collaborative registry-based, cohort study gathering real-world data from Europe, Asia/Oceania and Africa on the natural history, management and outcomes of patients with cancer infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). PATIENTS AND METHODS: ESMO-CoCARE captures information on patients with solid/haematological malignancies, diagnosed with coronavirus disease 2019 (COVID-19). Data collected since June 2020 include demographics, comorbidities, laboratory measurements, cancer characteristics, COVID-19 clinical features, management and outcome. Parameters influencing COVID-19 severity/recovery were investigated as well as factors associated with overall survival (OS) upon SARS-CoV-2 infection. RESULTS: This analysis includes 1626 patients from 20 countries (87% from 24 European, 7% from 5 North African, 6% from 8 Asian/Oceanian centres), with COVID-19 diagnosis from January 2020 to May 2021. Median age was 64 years, with 52% of female, 57% of cancer stage III/IV and 65% receiving active cancer treatment. Nearly 64% patients required hospitalization due to COVID-19 diagnosis, with 11% receiving intensive care. In multivariable analysis, male sex, older age, Eastern Cooperative Oncology Group (ECOG) performance status ≥2, body mass index (BMI) <25 kg/m2, presence of comorbidities, symptomatic disease, as well as haematological malignancies, active/progressive cancer, neutrophil-to-lymphocyte ratio (NLR) ≥6 and OnCovid Inflammatory Score ≤40 were associated with COVID-19 severity (i.e. severe/moderate disease requiring hospitalization). About 98% of patients with mild COVID-19 recovered, as opposed to 71% with severe/moderate disease. Advanced cancer stage was an additional adverse prognostic factor for recovery. At data cut-off, and with median follow-up of 3 months, the COVID-19-related death rate was 24.5% (297/1212), with 380 deaths recorded in total. Almost all factors associated with COVID-19 severity, except for BMI and NLR, were also predictive of inferior OS, along with smoking and non-Asian ethnicity. CONCLUSIONS: Selected patient and cancer characteristics related to sex, ethnicity, poor fitness, comorbidities, inflammation and active malignancy predict for severe/moderate disease and adverse outcomes from COVID-19 in patients with cancer.


Subject(s)
COVID-19 , Hematologic Neoplasms , Neoplasms , COVID-19 Testing , Cohort Studies , Female , Humans , Male , Middle Aged , Neoplasms/epidemiology , Neoplasms/therapy , Registries , SARS-CoV-2
3.
Annals of Oncology ; 32:S1133, 2021.
Article in English | EMBASE | ID: covidwho-1432861

ABSTRACT

Background: At the height of the first wave of the SARS-COV-2 pandemic, ESMO mobilized to accelerate research for the understanding of COVID-19 in cancer patients (pts). ESMO CoCARE is an international collaborative registry-based, cohort study, gathering real-world data and information from healthcare professionals about the natural history, treatment and outcomes of COVID-19 in cancer pts. Methods: ESMO CoCARE captures information on pts with any solid or hematologic malignancy (including cancer survivors free of disease for ≥5 years) presenting with a COVID-19 diagnosis in any of the participating centers. Data collected since 06/2020 include demographics, cancer characteristics and status, co-morbidities, COVID-19 clinical features, course, management and outcome. Factors influencing COVID-19 severity (hospitalization +/- ICU support needed) and recovery are investigated using multivariable logistic regression with backward elimination method. The study is ongoing. Results: The current analysis includes 1551 registered pts (19 countries;87% pts from 23 European centers, 7% and 6% pts from 5 Northern African and 7 Asian centers), with COVID-19 diagnosis as of 11/03/2021. Median age was 64 years, with the majority female (52%), cancer stage III/IV (58%), and on active cancer treatment (60%). 65% had severe COVID-19 requiring hospitalization, with 11% receiving intensive care. In multivariable analysis, in addition to demographics (male gender, older age, other ethnicity than Caucasian, lower BMI), co-morbidities and symptomatic COVID-19, severe disease was associated to higher ECOG PS (Odds Ratio (OR)2 vs 0=5.9, OR1 vs 0=2.1), hematological malignancies (OR hemvs solid =2.0), and active/progressive cancer status (OR progressivevs no evidence of disease =1.6). 98% of pts with mild disease recovered, as opposed to only 70% of those with severe disease. Cancer stage was an additional prognostic factor for recovery (ORI/II vs IV =3.4). Conclusions: Demographic characteristics, type and status of cancer, and symptomatology of COVID-19 increase the probability of severe disease, while advanced cancer stage is also associated with the risk of death. Legal entity responsible for the study: Institut Curie, Paris, France. Funding: ESMO - European Society for Medical Oncology. Disclosure: E. Romano: Financial Interests, Institutional, Funding, Investigator-initiated trial: AstraZeneca;Financial Interests, Institutional, Funding, Investigator-initiated trial: BMS;Financial Interests, Personal, Advisory Board: AstraZeneca;Financial Interests, Personal, Advisory Board: Merck;Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Invited Speaker: Pierre Fabre. R. Lee: Financial Interests, Personal, Invited Speaker: AstraZeneca;Financial Interests, Institutional, Funding: BMS. A. Croitoru: Financial Interests, Personal, Advisory Role: Ipsen;Financial Interests, Personal, Advisory Role: Astellas;Financial Interests, Personal and Institutional, Funding: Bristol-Myers Squibb;Financial Interests, Personal and Institutional, Funding: Merck;Financial Interests, Personal and Institutional, Funding: Astellas;Financial Interests, Personal and Institutional, Funding: Servier;Financial Interests, Personal and Institutional, Funding: Five Prime Therapeutics;Financial Interests, Personal and Institutional, Funding: Amgen;Financial Interests, Personal, Other, Travel funding: Merck;Financial Interests, Personal, Other, travel funding: Servier;Financial Interests, Personal, Other, travel funding: Roche. S. Susnjar: Financial Interests, Personal, Other, Honoraria and/or advisory fees: Roche;Financial Interests, Personal, Other, Honoraria and/or advisory fees: Pfizer;Financial Interests, Personal, Other, Honoraria and/or advisory fees: Novartis;Financial Interests, Personal, Other, Honoraria and/or advisory fees: AstraZeneca;Financial Interests, Personal, Other, Honoraria and/or advisory fees: Amicus. M. Rossi: Financial Interests, Personal, Other, travel and personal fees: Novartis;Financial terests, Personal, Other, travel and personal fees: Ipsen. O.A. Michielin: Financial Interests, Personal, Other, personal fees: Bristol-Myers Squibb;Financial Interests, Personal, Other, personal fees: MSD;Financial Interests, Personal, Other, personal fees: Novartis;Financial Interests, Personal, Other, personal fees: Roche;Financial Interests, Personal, Other, personal fees: Amgen;Financial Interests, Personal, Other, personal fees: NeraCare GmbH. G. Pentheroudakis: Financial Interests, Personal, Advisory Board: Amgen;Financial Interests, Personal, Advisory Board: AstraZeneca;Financial Interests, Personal, Advisory Board: Bristol Myers Squibb;Financial Interests, Personal, Advisory Board: Lilly;Financial Interests, Personal, Advisory Board: Merck;Financial Interests, Personal, Advisory Board: MSD;Financial Interests, Personal, Advisory Board: Roche;Financial Interests, Institutional, Principal Investigator: AbbVie;Financial Interests, Institutional, Research Grant: Amgen;Financial Interests, Institutional, Principal Investigator, Coordinating PI: Amgen;Financial Interests, Institutional, Research Grant: AstraZeneca;Financial Interests, Institutional, Principal Investigator: AstraZeneca;Financial Interests, Institutional, Research Grant: Boehringer Ingelheim;Financial Interests, Institutional, Funding: Boehringer Ingelheim;Financial Interests, Institutional, Funding: Bristol Myers Squibb;Financial Interests, Institutional, Principal Investigator: Bristol Myers Squibb;Financial Interests, Institutional, Principal Investigator: Debbiopharm;Financial Interests, Institutional, Funding: Enorasis;Financial Interests, Institutional, Funding: Genekor;Financial Interests, Institutional, Funding: Ipsen;Financial Interests, Institutional, Principal Investigator: Ipsen;Financial Interests, Institutional, Funding: Janssen;Financial Interests, Institutional, Principal Investigator: Lilly;Financial Interests, Institutional, Funding: Merck;Financial Interests, Institutional, Principal Investigator: Merck;Financial Interests, Institutional, Funding: MSD;Financial Interests, Institutional, Principal Investigator: MSD;Financial Interests, Institutional, Funding: Pfizer;Financial Interests, Institutional, Principal Investigator: Roche;Financial Interests, Institutional, Research Grant: Roche;Financial Interests, Institutional, Funding: Sanofi;Financial Interests, Institutional, Principal Investigator, Coodinating Pi: Servier;Financial Interests, Institutional, Funding: Servier. S. Peters: Consultation / Advisory role: AbbVie, Amgen, AstraZeneca, Bayer, Beigene, Biocartis, Bio Invent, Blueprint Medicines, Boehringer Ingelheim, Bristol-Myers Squibb, Clovis, Daiichi Sankyo, Debiopharm, Eli Lilly, Elsevier, F. Hoffmann-La Roche/Genentech, Foundation Medicine, Illumina, Incyte, IQVIA, Janssen, Medscape, Merck Sharp and Dohme, Merck Serono, Merrimack, Mirati, Novartis, PharmaMar, Phosplatin Therapeutics, Pfizer, Regeneron, Sanofi, Seattle Genetics, Takeda, Vaccibody. Talk in a company’s organized public event: AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, e-cancer, Eli Lilly, F. Hoffmann-La Roche/Genentech, Illumina, Medscape, Merck Sharp and Dohme, Novartis, PER, Pfizer, Prime, RTP, Sanofi, Takeda. Receipt of grants/research supports: (Sub)investigator in trials (institutional financial support for clinical trials) sponsored by Amgen, AstraZeneca, Biodesix, Boehringer Ingelheim, Bristol-Myers Squibb, Clovis, F. Hoffmann-La Roche/Genentech, GSK, Illumina, Lilly, Merck Sharp and Dohme, Merck Serono, Mirati, Novartis, and Pfizer, Phosplatin Therapeutics. All other authors have declared no conflicts of interest.

4.
Journal for Immunotherapy of Cancer ; 8:A298-A299, 2020.
Article in English | Web of Science | ID: covidwho-1105522
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