Oncologic immunomodulatory agents in patients with cancer and COVID-19

Abstract Corticosteroids, anti-CD20 agents, immunotherapies, and cytotoxic chemotherapy are commonly used in the treatment of patients with cancer. It is unclear how these agents affect patients with cancer who are infected with SARS-CoV-2. We retrospectively investigated associations between SARS-C...

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Autores principales:	Justin Jee, Aaron J. Stonestrom, Sean Devlin, Teresa Nguyentran, Beatriz Wills, Varun Narendra, Michael B. Foote, Melissa Lumish, Santosha A. Vardhana, Stephen M. Pastores, Neha Korde, Dhwani Patel, Steven Horwitz, Michael Scordo, Anthony F. Daniyan
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ac5a7ce592fd4888901daa72413e1e59
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spelling	oai:doaj.org-article:ac5a7ce592fd4888901daa72413e1e592021-12-02T13:20:03ZOncologic immunomodulatory agents in patients with cancer and COVID-1910.1038/s41598-021-84137-52045-2322https://doaj.org/article/ac5a7ce592fd4888901daa72413e1e592021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-84137-5https://doaj.org/toc/2045-2322Abstract Corticosteroids, anti-CD20 agents, immunotherapies, and cytotoxic chemotherapy are commonly used in the treatment of patients with cancer. It is unclear how these agents affect patients with cancer who are infected with SARS-CoV-2. We retrospectively investigated associations between SARS-CoV-2-associated respiratory failure or death with receipt of the aforementioned medications and with pre-COVID-19 neutropenia. The study included all cancer patients diagnosed with SARS-CoV-2 at Memorial Sloan Kettering Cancer Center until June 2, 2020 (N = 820). We controlled for cancer-related characteristics known to predispose to worse COVID-19 as well as level of respiratory support during corticosteroid administration. Corticosteroid administration was associated with worse outcomes prior to use of supplemental oxygen; no statistically significant difference was observed in sicker cohorts. In patients with metastatic thoracic cancer, 9 of 25 (36%) and 10 of 31 (32%) had respiratory failure or death among those who did and did not receive immunotherapy, respectively. Seven of 23 (30%) and 52 of 187 (28%) patients with hematologic cancer had respiratory failure or death among those who did and did not receive anti-CD20 therapy, respectively. Chemotherapy itself was not associated with worse outcomes, but pre-COVID-19 neutropenia was associated with worse COVID-19 course. Relative prevalence of chemotherapy-associated neutropenia in previous studies may account for different conclusions regarding the risks of chemotherapy in patients with COVID-19. In the absence of prospective studies and evidence-based guidelines, our data may aid providers looking to assess the risks and benefits of these agents in caring for cancer patients in the COVID-19 era.Justin JeeAaron J. StonestromSean DevlinTeresa NguyentranBeatriz WillsVarun NarendraMichael B. FooteMelissa LumishSantosha A. VardhanaStephen M. PastoresNeha KordeDhwani PatelSteven HorwitzMichael ScordoAnthony F. DaniyanNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Justin Jee Aaron J. Stonestrom Sean Devlin Teresa Nguyentran Beatriz Wills Varun Narendra Michael B. Foote Melissa Lumish Santosha A. Vardhana Stephen M. Pastores Neha Korde Dhwani Patel Steven Horwitz Michael Scordo Anthony F. Daniyan Oncologic immunomodulatory agents in patients with cancer and COVID-19
description	Abstract Corticosteroids, anti-CD20 agents, immunotherapies, and cytotoxic chemotherapy are commonly used in the treatment of patients with cancer. It is unclear how these agents affect patients with cancer who are infected with SARS-CoV-2. We retrospectively investigated associations between SARS-CoV-2-associated respiratory failure or death with receipt of the aforementioned medications and with pre-COVID-19 neutropenia. The study included all cancer patients diagnosed with SARS-CoV-2 at Memorial Sloan Kettering Cancer Center until June 2, 2020 (N = 820). We controlled for cancer-related characteristics known to predispose to worse COVID-19 as well as level of respiratory support during corticosteroid administration. Corticosteroid administration was associated with worse outcomes prior to use of supplemental oxygen; no statistically significant difference was observed in sicker cohorts. In patients with metastatic thoracic cancer, 9 of 25 (36%) and 10 of 31 (32%) had respiratory failure or death among those who did and did not receive immunotherapy, respectively. Seven of 23 (30%) and 52 of 187 (28%) patients with hematologic cancer had respiratory failure or death among those who did and did not receive anti-CD20 therapy, respectively. Chemotherapy itself was not associated with worse outcomes, but pre-COVID-19 neutropenia was associated with worse COVID-19 course. Relative prevalence of chemotherapy-associated neutropenia in previous studies may account for different conclusions regarding the risks of chemotherapy in patients with COVID-19. In the absence of prospective studies and evidence-based guidelines, our data may aid providers looking to assess the risks and benefits of these agents in caring for cancer patients in the COVID-19 era.
format	article
author	Justin Jee Aaron J. Stonestrom Sean Devlin Teresa Nguyentran Beatriz Wills Varun Narendra Michael B. Foote Melissa Lumish Santosha A. Vardhana Stephen M. Pastores Neha Korde Dhwani Patel Steven Horwitz Michael Scordo Anthony F. Daniyan
author_facet	Justin Jee Aaron J. Stonestrom Sean Devlin Teresa Nguyentran Beatriz Wills Varun Narendra Michael B. Foote Melissa Lumish Santosha A. Vardhana Stephen M. Pastores Neha Korde Dhwani Patel Steven Horwitz Michael Scordo Anthony F. Daniyan
author_sort	Justin Jee
title	Oncologic immunomodulatory agents in patients with cancer and COVID-19
title_short	Oncologic immunomodulatory agents in patients with cancer and COVID-19
title_full	Oncologic immunomodulatory agents in patients with cancer and COVID-19
title_fullStr	Oncologic immunomodulatory agents in patients with cancer and COVID-19
title_full_unstemmed	Oncologic immunomodulatory agents in patients with cancer and COVID-19
title_sort	oncologic immunomodulatory agents in patients with cancer and covid-19
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ac5a7ce592fd4888901daa72413e1e59
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Oncologic immunomodulatory agents in patients with cancer and COVID-19

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