Dutch oncology COVID-19 Consortium (DOCC): Outcome of COVID-19 in patients with cancer in a nationwide cohort study

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) pandemic is having significant impact on oncological care (Joode et al, Eur J Cancer 2020;136132-139) and patients with cancer might have an increased risk for severe outcome of COVID-19. In order to identify risk factors associated with a worse outcome of COVID-19, a nationwide registry was developed for patients with cancer and COVID-19. Methods: This ongoing multicentre nationwide observational cohort study was designed as a quality of care registry and is executed by the Dutch Oncology COVID-19 Consortium (DOCC), a collaboration of oncology physicians in the Netherlands. A questionnaire was developed to collect pseudonymised patient data on patients’ characteristics, cancer diagnosis, cancer treatment, and outcome of COVID-19. All patients with COVID-19 and a cancer diagnosis or cancer treatment in the past 5 years were eligible for inclusion. Results: To date, > 600 cancer patients diagnosed with COVID-19 have been registered by 45 Dutch hospitals. Data of 442 registered patients with at least 4 weeks follow-up were cleaned and 351 patients could be included for the first analyses. The main cancer diagnoses were non-small cell lung cancer (13.4%), breast cancer (13.4%), and chronic lymphocytic leukaemia (8.8%). Overall, 114 (32.3%) out of 351 patients with cancer died from COVID-19. In multivariate analyses, age ≥ 65 years (p < 0.001), male gender (p = 0.035), prior or other malignancy (p = 0.045), and active diagnosis of haematological malignancy (p = 0.046) or lung cancer (p = 0.003) were independent risk factors for a fatal outcome of COVID-19. In a subgroup analysis of patients with active malignancy, the risk for a fatal outcome was mainly determined by tumour type (haematological malignancy or lung cancer) and age (≥ 65 years). Conclusions: The findings in this registry indicate that patients with a haematological malignancy or lung cancer have an increased risk of a worse outcome of COVID-19. During the ongoing COVID-19 pandemic, these vulnerable patients should avoid exposure to SARS-CoV-2, whereas treatment adjustments and prioritizing vaccination, when available, should also be considered. Legal entity responsible for the study Erasmus Medical Center. Funding: Dutch Cancer Society. Disclosure D.W. Dumoulin Honoraria (self), Speakers fee MSD;Honoraria (self), Speakers fee Roche;Honoraria (self), Speakers fee Astazeneca;Honoraria (self), Speakers fee BMS;Honoraria (self), Speakers fee Novartis;Honoraria (self), Speakers fee Pfizer. H.M. Westgeest Honoraria (self) Astellas;Honoraria (self) Roche;Travel/Accommodation/Expenses Ipsen. L.E.L. Hendriks Advisory/Consultancy, Mentorship program with key opinion leaders funded by AstraZeneca AstraZeneca;Honoraria (self), Educational webinars Quadia;Research grant/Funding (institution) AstraZeneca;Advisory/Consultancy, Paid to institution Eli Lilly;Advisory/Consultancy, Paid to institution Roche Genentech;Advisory/Consultancy, Paid to institution Pfizer;Advisory/Consultancy, Advisory board and speakers fee all paid to institution MSD;Advisory/Consultancy, Paid to institution Takeda;Leadership role, Local PI of pharma initiated research AstraZeneca;Leadership role, Local PI of pharma initiated research Novartis;Leadership role, Local PI of pharma initiated research BMS;Leadership role, Local PI of pharma initiated research MSD / Merck;Leadership role, Local PI of pharma initiated research GSK;Leadership role, Local PI of pharma initiated research Takeda;Leadership role, Local PI of pharma initiated research Blueprint Medicines;Leadership role, Local PI of pharma initiated research Roche Genentech;Advisory/Consultancy, Paid to institution Amgen;Advisory/Consultancy, Paid to institution Boehringer Ingelheim;Advisory/Consultancy, Paid to institution BMS;Advisory/Consultancy, Travel/Accommodation/Expenses, Advisory board paid to institution Roche Genentech;Travel/Accommodation/Expenses BMS;Research grant/Funding (institution) Roche Genentech;R search grant/Funding (institution) Boehringer Ingelheim. A-M.C. Dingemans Honoraria (self) Roche;Honoraria (self) Eli Lilly;Honoraria (self) Boehringer Ingelheim;Honoraria (self) Pfizer;Honoraria (self) BMS;Honoraria (self) Novartis;Honoraria (self) Takeda;Honoraria (self) PharmaMar;Advisory/Consultancy, non financial support AbbVie;Research grant/Funding (institution) BMS;Research grant/Funding (institution) Amgen. A.A.M. Van der Veldt Honoraria (institution), Advisory/Consultancy BMS;Honoraria (institution), Advisory/Consultancy MSD;Honoraria (institution), Advisory/Consultancy Pfizer;Honoraria (institution), Advisory/Consultancy Sanofi;Honoraria (institution), Advisory/Consultancy Eisai;Honoraria (institution), Advisory/Consultancy Ipsen;Honoraria (institution), Advisory/Consultancy Roche;Honoraria (institution), Advisory/Consultancy Novartis;Honoraria (institution), Advisory/Consultancy Merck;Honoraria (institution), Advisory/Consultancy Pierre Fabre. All other authors have declared no conflicts of interest.