The following article features coverage from the American Society of Clinical Oncology 2020 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

Treatment with chemotherapy within 3 months prior to the diagnosis of COVID-19 was associated with an increased risk of death from the virus among patients with thoracic cancers, according to an analysis of the TERAVOLT registry presented at ASCO20 Virtual Scientific Program.1

TERAVOLT is a global registry founded in mid-March 2020 for patients with thoracic cancers and COVID-19 from more than 59 centers and 9 countries.  

“Patients with thoracic malignancies are thought to be at particularly high risk due to their older age, smoking-related comorbidities, and decreased lung function,” Leora Horn, MD, MSc, of the Vanderbilt-Ingram Cancer Center in Nashville, Tennessee, and lead author and presenter of the study, said.

The study is an update of the analysis originally presented at the 2020 AACR Annual Meeting Part I.2 The original analysis had a median follow-up of 15 days, whereas the current analysis had a median follow-up of 33 days from COVID-19 diagnosis, and enrolled 400 patients enrolled.


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In this analysis of patients with laboratory-confirmed COVID-19, the median patient age was 68 years, 34% of patients were female, and 23.4% to 65.2% of patients were current or former smokers. The most common cancer type was non-small cell lung cancer (NSCLC; 78%), followed by small cell lung cancer (13%), and other thoracic cancers. Stage IV disease was present in 71% of patients, with the majority receiving chemotherapy or a chemotherapy combination regimen.

Hospitalization for COVID-19 was required in 78.3% of patients and intensive care unit admission was required for 8.3%, with mechanical ventilation administered to 5%. The median length of hospital stay was 10 days.

The mortality rate was 35.5%, with 10.6% of deaths that were attributable to cancer and 79.4% that were attributable to COVID-19. Another 8.5% of deaths was due to both.  

The types of therapies administered to treat COVID-19 were similar among patients who recovered, died, or had ongoing infection. “No particular therapy was associated with an increased chance of recovery from COVID-19,” Dr Horn said.

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A multivariate analysis found that increased risk of death was significantly associated with an age of 65 years or older (hazard ratio [HR], 1.70; 95% CI, 1.09-2.63; P =.108), Eastern Cooperative Oncology Group performance status of 1 (HR, 2.14; 95% CI, 1.11-4.11; P <.001), and use of steroids of higher than 10 mg/day (HR, 1.49; 95% CI, 1.00-2.23; P =.052).

Chemotherapy alone or in combination with other treatments was significantly associated with an increased risk of death (HR, 1.71; 95% CI, 1.12-2.63; P =.025). Patients on steroids or anticoagulation prior to a COVID-19 diagnosis were determined to be at increased risk of mortality as well.

The data from this analysis suggest that “prior administration of chemotherapy, as [a] unique modality or in combination with ICI [an immune checkpoint inhibitor], is associated with increased risk of death, while immunotherapy and TKI [tyrosine kinase inhibition] are not,” Dr Horn said.

Read more of Cancer Therapy Advisor‘s coverage of the ASCO 2020 meeting by visiting the conference page.

References

  1. Horn L, Shisenant JG, Torri V, et al. Thoracic Cancers International COVID-19 Collaboration (TERAVOLT): Impact of type of cancer therapy and COVID therapy on survival. Presented at: ASCO20 Virtual Scientific Program. J Clin Oncol. 2020;38(suppl):abstr LBA111. 
  2. Garassino MC. TERAVOLT (Thoracic cancERs international coVid 19 cOLlaboraTion): First results of a global collaboration to address the impact of COVID-19 in patients with thoracic malignancies. Presented at: American Association for Cancer Research (AACR) Virtual Annual Meeting I 2020; April 27-28, 2020.