Article ; Online: Oncologic immunomodulatory agents in patients with cancer and COVID-19.
2021 Volume 11, Issue 1, Page(s) 4814
Abstract: ... the risks and benefits of these agents in caring for cancer patients in the COVID-19 era. ... may account for different conclusions regarding the risks of chemotherapy in patients with COVID-19 ... in the treatment of patients with cancer. It is unclear how these agents affect patients with cancer who are ...
| 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. |
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| MeSH term(s) | Adrenal Cortex Hormones/administration & dosage ; Aged ; Antineoplastic Agents, Immunological/administration & dosage ; COVID-19/mortality ; Female ; Hematologic Neoplasms/drug therapy ; Hematologic Neoplasms/mortality ; Humans ; Immunologic Factors/administration & dosage ; Male ; Middle Aged ; Neutropenia/drug therapy ; Neutropenia/mortality ; Respiratory Insufficiency ; Retrospective Studies ; SARS-CoV-2 ; COVID-19 Drug Treatment |
| Chemical Substances | Adrenal Cortex Hormones ; Antineoplastic Agents, Immunological ; Immunologic Factors |
| Language | English |
| Publishing date | 2021-03-01 |
| Publishing country | England |
| Document type | Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 2615211-3 |
| ISSN | 2045-2322 ; 2045-2322 |
| ISSN (online) | 2045-2322 |
| ISSN | 2045-2322 |
| DOI | 10.1038/s41598-021-84137-5 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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