Clinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition

Background Patients with cancer who are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to develop severe illness and die compared with those without cancer. The impact of immune checkpoint inhibition (ICI) on the severity of COVID-19 illness is unknown. Th...

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Autores principales:	Dirk Schadendorf, Lisa Zimmer, Serigne Lo, Caroline Robert, John Haanen, Ines Pires da Silva, Paolo Antonio Ascierto, Reinhard Dummer, Michael Manos, Joanna Mangana, Richard D Carvajal, Georgina V Long, Alon Vaisman, Christian Posch, Paola Queirolo, Axel Hauschild, Christian U Blank, Maria Grazia Vitale, Carlo Alberto Tondini, Arielle Elkrief, Karijn P M Suijkerbuijk, Mario Mandala, Alexander M Menzies, Aljosja Rogiers, Chiara Tentori, Joseph M Grimes, Megan H Trager, Sharon Nahm, Peter Bowling, Neha Papneja, April A N Rose, Jessica S W Borgers, Severine Roy, Thiago Pimentel Muniz, Tim Cooksley, Jeremy Lupu, Samuel D Saibil, Matteo S Carlino, Michael Erdmann, Laura Pala, Wilson H Miller Jr, Osama E Rahma, Paul C Lorigan
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2021
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/0880e80bb8394806afbc90b0e9140059
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spelling	oai:doaj.org-article:0880e80bb8394806afbc90b0e91400592021-11-16T07:30:04ZClinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition10.1136/jitc-2020-0019312051-1426https://doaj.org/article/0880e80bb8394806afbc90b0e91400592021-01-01T00:00:00Zhttps://jitc.bmj.com/content/9/1/e001931.fullhttps://doaj.org/toc/2051-1426Background Patients with cancer who are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to develop severe illness and die compared with those without cancer. The impact of immune checkpoint inhibition (ICI) on the severity of COVID-19 illness is unknown. The aim of this study was to investigate whether ICI confers an additional risk for severe COVID-19 in patients with cancer.Methods We analyzed data from 110 patients with laboratory-confirmed SARS-CoV-2 while on treatment with ICI without chemotherapy in 19 hospitals in North America, Europe and Australia. The primary objective was to describe the clinical course and to identify factors associated with hospital and intensive care (ICU) admission and mortality.Findings Thirty-five (32%) patients were admitted to hospital and 18 (16%) died. All patients who died had advanced cancer, and only four were admitted to ICU. COVID-19 was the primary cause of death in 8 (7%) patients. Factors independently associated with an increased risk for hospital admission were ECOG ≥2 (OR 39.25, 95% CI 4.17 to 369.2, p=0.0013), treatment with combination ICI (OR 5.68, 95% CI 1.58 to 20.36, p=0.0273) and presence of COVID-19 symptoms (OR 5.30, 95% CI 1.57 to 17.89, p=0.0073). Seventy-six (73%) patients interrupted ICI due to SARS-CoV-2 infection, 43 (57%) of whom had resumed at data cut-off.Interpretation COVID-19–related mortality in the ICI-treated population does not appear to be higher than previously published mortality rates for patients with cancer. Inpatient mortality of patients with cancer treated with ICI was high in comparison with previously reported rates for hospitalized patients with cancer and was due to COVID-19 in almost half of the cases. We identified factors associated with adverse outcomes in ICI-treated patients with COVID-19.Dirk SchadendorfLisa ZimmerSerigne LoCaroline RobertJohn HaanenInes Pires da SilvaPaolo Antonio AsciertoReinhard DummerMichael ManosJoanna ManganaRichard D CarvajalGeorgina V LongAlon VaismanChristian PoschPaola QueiroloAxel HauschildChristian U BlankMaria Grazia VitaleCarlo Alberto TondiniArielle ElkriefKarijn P M SuijkerbuijkMario MandalaAlexander M MenziesAljosja RogiersChiara TentoriJoseph M GrimesMegan H TragerSharon NahmPeter BowlingNeha PapnejaApril A N RoseJessica S W BorgersSeverine RoyThiago Pimentel MunizTim CooksleyJeremy LupuSamuel D SaibilMatteo S CarlinoMichael ErdmannLaura PalaWilson H Miller JrOsama E RahmaPaul C LoriganBMJ Publishing GrouparticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENJournal for ImmunoTherapy of Cancer, Vol 9, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Dirk Schadendorf Lisa Zimmer Serigne Lo Caroline Robert John Haanen Ines Pires da Silva Paolo Antonio Ascierto Reinhard Dummer Michael Manos Joanna Mangana Richard D Carvajal Georgina V Long Alon Vaisman Christian Posch Paola Queirolo Axel Hauschild Christian U Blank Maria Grazia Vitale Carlo Alberto Tondini Arielle Elkrief Karijn P M Suijkerbuijk Mario Mandala Alexander M Menzies Aljosja Rogiers Chiara Tentori Joseph M Grimes Megan H Trager Sharon Nahm Peter Bowling Neha Papneja April A N Rose Jessica S W Borgers Severine Roy Thiago Pimentel Muniz Tim Cooksley Jeremy Lupu Samuel D Saibil Matteo S Carlino Michael Erdmann Laura Pala Wilson H Miller Jr Osama E Rahma Paul C Lorigan Clinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition
description	Background Patients with cancer who are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to develop severe illness and die compared with those without cancer. The impact of immune checkpoint inhibition (ICI) on the severity of COVID-19 illness is unknown. The aim of this study was to investigate whether ICI confers an additional risk for severe COVID-19 in patients with cancer.Methods We analyzed data from 110 patients with laboratory-confirmed SARS-CoV-2 while on treatment with ICI without chemotherapy in 19 hospitals in North America, Europe and Australia. The primary objective was to describe the clinical course and to identify factors associated with hospital and intensive care (ICU) admission and mortality.Findings Thirty-five (32%) patients were admitted to hospital and 18 (16%) died. All patients who died had advanced cancer, and only four were admitted to ICU. COVID-19 was the primary cause of death in 8 (7%) patients. Factors independently associated with an increased risk for hospital admission were ECOG ≥2 (OR 39.25, 95% CI 4.17 to 369.2, p=0.0013), treatment with combination ICI (OR 5.68, 95% CI 1.58 to 20.36, p=0.0273) and presence of COVID-19 symptoms (OR 5.30, 95% CI 1.57 to 17.89, p=0.0073). Seventy-six (73%) patients interrupted ICI due to SARS-CoV-2 infection, 43 (57%) of whom had resumed at data cut-off.Interpretation COVID-19–related mortality in the ICI-treated population does not appear to be higher than previously published mortality rates for patients with cancer. Inpatient mortality of patients with cancer treated with ICI was high in comparison with previously reported rates for hospitalized patients with cancer and was due to COVID-19 in almost half of the cases. We identified factors associated with adverse outcomes in ICI-treated patients with COVID-19.
format	article
author	Dirk Schadendorf Lisa Zimmer Serigne Lo Caroline Robert John Haanen Ines Pires da Silva Paolo Antonio Ascierto Reinhard Dummer Michael Manos Joanna Mangana Richard D Carvajal Georgina V Long Alon Vaisman Christian Posch Paola Queirolo Axel Hauschild Christian U Blank Maria Grazia Vitale Carlo Alberto Tondini Arielle Elkrief Karijn P M Suijkerbuijk Mario Mandala Alexander M Menzies Aljosja Rogiers Chiara Tentori Joseph M Grimes Megan H Trager Sharon Nahm Peter Bowling Neha Papneja April A N Rose Jessica S W Borgers Severine Roy Thiago Pimentel Muniz Tim Cooksley Jeremy Lupu Samuel D Saibil Matteo S Carlino Michael Erdmann Laura Pala Wilson H Miller Jr Osama E Rahma Paul C Lorigan
author_facet	Dirk Schadendorf Lisa Zimmer Serigne Lo Caroline Robert John Haanen Ines Pires da Silva Paolo Antonio Ascierto Reinhard Dummer Michael Manos Joanna Mangana Richard D Carvajal Georgina V Long Alon Vaisman Christian Posch Paola Queirolo Axel Hauschild Christian U Blank Maria Grazia Vitale Carlo Alberto Tondini Arielle Elkrief Karijn P M Suijkerbuijk Mario Mandala Alexander M Menzies Aljosja Rogiers Chiara Tentori Joseph M Grimes Megan H Trager Sharon Nahm Peter Bowling Neha Papneja April A N Rose Jessica S W Borgers Severine Roy Thiago Pimentel Muniz Tim Cooksley Jeremy Lupu Samuel D Saibil Matteo S Carlino Michael Erdmann Laura Pala Wilson H Miller Jr Osama E Rahma Paul C Lorigan
author_sort	Dirk Schadendorf
title	Clinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition
title_short	Clinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition
title_full	Clinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition
title_fullStr	Clinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition
title_full_unstemmed	Clinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition
title_sort	clinical impact of covid-19 on patients with cancer treated with immune checkpoint inhibition
publisher	BMJ Publishing Group
publishDate	2021
url	https://doaj.org/article/0880e80bb8394806afbc90b0e9140059
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Clinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition

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