Incidence of asymptomatic COVID-19 positivity in cancer patients and effects on therapy.

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic is posing unprecedented challenges for patient care, especially for cancer patients. This study looks at asymptomatic (AS) COVID-19 positivity in cancer patients and its effects on their care. METHODS: We conducted a retrospective chart review of AS patients testing positive for COVID-19 upon screening at Fox Chase Cancer Center between January 2020 and September 2020. Relationships between positive tests and demographics, clinical characteristics, and treatment delays were investigated using conditional logistic regression or Mantel-Haenszel tests. RESULTS: Among 4143 AS patients who underwent COVID-19 testing, 25 (0.6%) were COVID-19 positive (cases) and these were matched to 50 controls. The median age was lower in the cases compared to that of the controls (64 vs 70 years old, p = 0.04). Of the cases, 10 patients (40%) never underwent their planned oncologic intervention [6/10 (60%) did not require the planned intervention once deemed okay to proceed]. Of the controls, only 1 patient (2%) did not undergo the planned intervention. Of these 15 COVID-19 positive patients who underwent the planned intervention, 11 (73.3%) had a delay related to COVID-19, with a mean delay duration of 18 days (range: 0-49, SD: 16.72). CONCLUSION: Cancer patients had lower incidence of AS COVID-19 than general population. Delays that occur due to AS COVID screening are not very long and serve as a tool to limit spread of virus. Further studies will be important in addressing delays in cancer care and concerns of patient safety as the pandemic continues.

Incidence of asymptomatic COVID-19 positivity in cancer patients and effects on therapy.

Purpose The coronavirus disease 2019 (COVID-19) pandemic is posing unprecedented challenges for patient care, especially for cancer patients. This study looks at asymptomatic (AS) COVID-19 positivity in cancer patients and its effects on their care. Methods We conducted a retrospective chart review of AS patients testing positive for COVID-19 upon screening at Fox Chase Cancer Center between January 2020 and September 2020. Relationships between positive tests and demographics, clinical characteristics, and treatment delays were investigated using conditional logistic regression or Mantel-Haenszel tests. Results Among 4143 AS patients who underwent COVID-19 testing, 25 (0.6%) were COVID-19 positive (cases) and these were matched to 50 controls. The median age was lower in the cases compared to that of the controls (64 vs 70 years old, p = 0.04). Of the cases, 10 patients (40%) never underwent their planned oncologic intervention [6/10 (60%) did not require the planned intervention once deemed okay to proceed]. Of the controls, only 1 patient (2%) did not undergo the planned intervention. Of these 15 COVID-19 positive patients who underwent the planned intervention, 11 (73.3%) had a delay related to COVID-19, with a mean delay duration of 18 days (range: 0-49, SD: 16.72). Conclusion Cancer patients had lower incidence of AS COVID-19 than general population. Delays that occur due to AS COVID screening are not very long and serve as a tool to limit spread of virus. Further studies will be important in addressing delays in cancer care and concerns of patient safety as the pandemic continues.

Pembrolizumab monotherapy in patients with previously treated metastatic high-grade neuroendocrine neoplasms: joint analysis of two prospective, non-randomised trials.

BACKGROUND: Metastatic high-grade neuroendocrine neoplasms (G3NENs) have limited treatment options after progression on platinum-based therapy. We addressed the role of Pembrolizumab in patients with previously treated metastatic G3NENs. METHODS: Two open-label, phase 2 studies enrolled patients with G3NEN (Ki-67 > 20%) to receive Pembrolizumab at 200 mg I.V. every 3 weeks. Radiographic evaluation was conducted every 9 weeks with overall response rate as the primary endpoint. RESULTS: Between November 2016 and May 2018, 29 patients (13 males/16 females) with G3NENs were enrolled. One patient (3.4%) had an objective response and an additional six patients (20.7%) had stable disease, resulting in a disease control rate of 24.1%. Disease control rate (DCR) at 18 weeks was 10.3% (3/29). There was no difference in the DCR, PFS or OS between the PD-L1-negative and -positive groups (p 0.56, 0.88 and 0.55, respectively). Pembrolizumab was well tolerated with only 9 grade 3, and no grade 4 events considered drug-related. CONCLUSIONS: Pembrolizumab can be safely administered to patients with G3NENs but has limited activity as a single agent. Successful completion of our trials suggest studies in G3NENs are feasible and present an unmet need. Further research to identify active combination therapies should be considered. CLINICAL TRIAL REGISTRATION NUMBER: NCT02939651 (10/20/2016).