Breast cancer and COVID-19: Impact ofactive treatment on severe outcomes

ABSTRACT

Background: Several reports have observed that cancer patients who recently underwent chemotherapy or surgeryhad a higher risk of severe events compared with patients without cancer. Limited data is available on outcomes inspecific cancer types, as well as the impact of non-cytotoxic systemic treatment, such as targeted therapy andhormonal therapy on severe outcomes. We aim to identify whether active treatment impacts severe outcomes (rateof hospitalization, ICU admission, intubation, and death) in breast cancer patients. Methods: We conducted amulticenter study in the state of Louisiana, throughout the Ochsner Health System, in both tertiary and non-tertiarycenters. Patients must carry a diagnosis of breast cancer, and have a completed SARS-CoV-2 test between March1st and April 30th, 2020. Chi-squared and Fisher's exact tests were performed to compare the proportion of patientsexperiencing severe outcomes between treatment groups. Results: As of April 30, 2020, a total of 70 patients withbreast cancer who had a positive SARS-COV-2 test were identified. Median age 64.5, median BMI 30.8, 62.9%(n=44) black, 27.1% (n=19) current/former smokers, HTN (n=52) and DM2 (n=22) were the most commoncomorbidities, and 12.9% (n=9) of patients had stage IV disease. Of these patients, 58.6% (n=41) were on hormonaltreatment, and another 12.9% (n=9) were receiving other forms of systemic therapy (cytotoxic chemotherapy ortargeted therapy). In terms of severe outcomes, 32.9% (n=23) of patients required hospitalization, 8.6% (n=6)required ICU admission with 7.1% (n=5) patients requiring intubation, 11.4% (n=8) of patients died. There was not astatistical difference in rate of severe outcomes (rate of hospitalization, ICU admission, intubation, and death)among breast cancer patients receiving active treatment (chemotherapy, targeted therapy, or hormonal therapy) vs those receiving no active treatment. There was also no difference in terms of severe outcomes by race. Conclusion:With an ongoing global COVID-19 pandemic, it is important to identify how the treatment and management ofcancer impacts COVID-19 outcomes. This small cohort does not identify active treatment as a risk factor forincreased rate of severe outcomes in patients with breast cancer. Further analyses describing impact of specifichormonal and chemotherapy regimens on risk of hospitalization and death will be completed by time of presentation.