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  1. AU="Olsson-Brown, Anna C."
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  1. Article: Oestrogen Receptor Positive Metastatic Eccrine Porocarcinoma: A Case Report and Review of Anti-Oestrogen Therapy in Rare Cancers.

    Kalakonda, Anita J M / Mahajan, Abhishek / Chow, Shien / Olsson-Brown, Anna C / Sacco, Joseph J

    Case reports in oncology

    2024  Volume 17, Issue 1, Page(s) 497–503

    Abstract: Introduction: Rare cancers, in aggregate, represent a significant burden of disease in oncology and remain therapeutically challenging to manage due to a lack of clinical trials. Eccrine porocarcinoma is a rare cutaneous sweat-gland malignancy for which ...

    Abstract Introduction: Rare cancers, in aggregate, represent a significant burden of disease in oncology and remain therapeutically challenging to manage due to a lack of clinical trials. Eccrine porocarcinoma is a rare cutaneous sweat-gland malignancy for which there remains no standard approach to metastatic disease.
    Case presentation: We describe a patient diagnosed with metastatic disease, confirmed on bone biopsy; pathological analysis further revealed this was oestrogen receptor positive. She was commenced on the aromatase inhibitor letrozole, and denosumab, and showed a significant clinical and radiological response on bone scan within 7 months. At the time of report, over 2 years since commencing letrozole, she remains well with no evidence of progression.
    Conclusion: Our experience adds to the literature suggesting anti-oestrogen therapy can have significant benefit in patients with ER-positive non-breast cancer and is in keeping with increasing interest in therapies agnostic to site of origin but guided by expression/mutation of oncogenic drivers.
    Language English
    Publishing date 2024-03-27
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2458961-5
    ISSN 1662-6575
    ISSN 1662-6575
    DOI 10.1159/000535328
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  2. Article ; Online: Observational study investigating Tolerance Of Anticancer Systemic Therapy In the Elderly (TOASTIE): a protocol.

    Dearden, Helen / Baxter, Mark A / Martin, Sally / Rowe, Michael / Zucker, Kieran / Jones, Christopher Mark / Olsson-Brown, Anna C / Petty, R D / Swinson, Daniel

    BMJ open

    2021  Volume 11, Issue 9, Page(s) e051104

    Abstract: Introduction: The number of older adults diagnosed with cancer is increasing. Older adults are more likely to have pre-existing frailty, which is associated with greater chemotherapy-related toxicity. Early identification of those at risk of toxicity is ...

    Abstract Introduction: The number of older adults diagnosed with cancer is increasing. Older adults are more likely to have pre-existing frailty, which is associated with greater chemotherapy-related toxicity. Early identification of those at risk of toxicity is important to reduce patient morbidity and mortality. Current chemotherapy toxicity prediction tools including the Cancer and Ageing Research Group (CARG) tool exist but are not in routine clinical use and have not been prospectively validated in a UK population. This study is the first prospective study to investigate the CARG tool in a UK population with cancer.
    Methods and analysis: Tolerance Of Anticancer Systemic Therapy In the Elderly is a prospective observational study of patients, aged ≥65 years, commencing first-line (any indication) chemotherapy for a solid-organ malignancy. Patients receiving other systemic anticancer agents or radiotherapy will be excluded. The primary objective will be to validate the ability of the CARG score to predict grade 3+ toxicity in this population. Secondary objectives include describing the feasibility of screening for frailty, as well as the prevalance of frailty in this population and assessing patient and clinician perception of chemotherapy toxicity risk. 500 patients will be recruited over a two year period. Baseline assessments will be recorded. At the end of the 6-month follow-up period, toxicity data will be retrospectively collected. A descriptive analysis of the recruited population will be performed. The validity of the CARG model will be analysed using receiver-operating characteristic curves and calculation of the area under the curve (c-statistic).
    Ethics and dissemination: The study has received ethical approval from the East of Scotland Research Ethics Service 20/ES/0114. Results will be reported in peer-reviewed scientific journals and disseminated to patient organisations and media.
    MeSH term(s) Aged ; Antineoplastic Agents/adverse effects ; Frailty/epidemiology ; Humans ; Neoplasms/drug therapy ; Observational Studies as Topic ; Prospective Studies ; Retrospective Studies
    Chemical Substances Antineoplastic Agents
    Language English
    Publishing date 2021-09-28
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2021-051104
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  3. Article ; Online: Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19.

    Várnai, Csilla / Palles, Claire / Arnold, Roland / Curley, Helen M / Purshouse, Karin / Cheng, Vinton W T / Booth, Stephen / Campton, Naomi A / Collins, Graham P / Hughes, Daniel J / Kulasekararaj, Austin G / Lee, Alvin J X / Olsson-Brown, Anna C / Sharma-Oates, Archana / Van Hemelrijck, Mieke / Lee, Lennard Y W / Kerr, Rachel / Middleton, Gary / Cazier, Jean-Baptiste

    JAMA network open

    2022  Volume 5, Issue 2, Page(s) e220130

    Abstract: Importance: Large cohorts of patients with active cancers and COVID-19 infection are needed to provide evidence of the association of recent cancer treatment and cancer type with COVID-19 mortality.: Objective: To evaluate whether systemic anticancer ...

    Abstract Importance: Large cohorts of patients with active cancers and COVID-19 infection are needed to provide evidence of the association of recent cancer treatment and cancer type with COVID-19 mortality.
    Objective: To evaluate whether systemic anticancer treatments (SACTs), tumor subtypes, patient demographic characteristics (age and sex), and comorbidities are associated with COVID-19 mortality.
    Design, setting, and participants: The UK Coronavirus Cancer Monitoring Project (UKCCMP) is a prospective cohort study conducted at 69 UK cancer hospitals among adult patients (≥18 years) with an active cancer and a clinical diagnosis of COVID-19. Patients registered from March 18 to August 1, 2020, were included in this analysis.
    Exposures: SACT, tumor subtype, patient demographic characteristics (eg, age, sex, body mass index, race and ethnicity, smoking history), and comorbidities were investigated.
    Main outcomes and measures: The primary end point was all-cause mortality within the primary hospitalization.
    Results: Overall, 2515 of 2786 patients registered during the study period were included; 1464 (58%) were men; and the median (IQR) age was 72 (62-80) years. The mortality rate was 38% (966 patients). The data suggest an association between higher mortality in patients with hematological malignant neoplasms irrespective of recent SACT, particularly in those with acute leukemias or myelodysplastic syndrome (OR, 2.16; 95% CI, 1.30-3.60) and myeloma or plasmacytoma (OR, 1.53; 95% CI, 1.04-2.26). Lung cancer was also significantly associated with higher COVID-19-related mortality (OR, 1.58; 95% CI, 1.11-2.25). No association between higher mortality and receiving chemotherapy in the 4 weeks before COVID-19 diagnosis was observed after correcting for the crucial confounders of age, sex, and comorbidities. An association between lower mortality and receiving immunotherapy in the 4 weeks before COVID-19 diagnosis was observed (immunotherapy vs no cancer therapy: OR, 0.52; 95% CI, 0.31-0.86).
    Conclusions and relevance: The findings of this study of patients with active cancer suggest that recent SACT is not associated with inferior outcomes from COVID-19 infection. This has relevance for the care of patients with cancer requiring treatment, particularly in countries experiencing an increase in COVID-19 case numbers. Important differences in outcomes among patients with hematological and lung cancers were observed.
    MeSH term(s) Aged ; Aged, 80 and over ; COVID-19/complications ; Cohort Studies ; Drug Therapy ; Female ; Hematologic Neoplasms/complications ; Hematologic Neoplasms/mortality ; Hematologic Neoplasms/therapy ; Humans ; Immunotherapy ; Lung Neoplasms/complications ; Lung Neoplasms/mortality ; Lung Neoplasms/therapy ; Male ; Middle Aged ; Prospective Studies ; Registries ; SARS-CoV-2 ; United Kingdom
    Language English
    Publishing date 2022-02-01
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2022.0130
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  4. Article ; Online: Su1185 IMMUNE CHECKPOINT INHIBITOR-RELATED COLITIS ASSESSMENT AND PROGNOSIS: CAN UCEIS, MAYO AND NANCY INDEX SCORING POINT THE WAY?

    Cheung, Vincent T. / Gupta, Tarun / Olsson-Brown, Anna C. / Subramanian, Sreedhar / Sasson, Sarah C. / Heseltine, Jonathan / Fryer, Eve / Collantes-Bellido, Elena / Sacco, Joseph J. / Pirmohamed, Munir / Simmons, Alison / Klenerman, Paul / Fairfax, Benjamin P. / Payne, Miranda J. / Middleton, Mark R. / Brain, Oliver

    Gastroenterology

    Keywords covid19
    Publisher PMC
    Document type Article ; Online
    DOI 10.1016/s0016-5085(20)32033-3
    Database COVID19

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  5. Article ; Online: COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study.

    Lee, Lennard Yw / Cazier, Jean-Baptiste / Angelis, Vasileios / Arnold, Roland / Bisht, Vartika / Campton, Naomi A / Chackathayil, Julia / Cheng, Vinton Wt / Curley, Helen M / Fittall, Matthew W / Freeman-Mills, Luke / Gennatas, Spyridon / Goel, Anshita / Hartley, Simon / Hughes, Daniel J / Kerr, David / Lee, Alvin Jx / Lee, Rebecca J / McGrath, Sophie E /
    Middleton, Christopher P / Murugaesu, Nirupa / Newsom-Davis, Thomas / Okines, Alicia Fc / Olsson-Brown, Anna C / Palles, Claire / Pan, Yi / Pettengell, Ruth / Powles, Thomas / Protheroe, Emily A / Purshouse, Karin / Sharma-Oates, Archana / Sivakumar, Shivan / Smith, Ashley J / Starkey, Thomas / Turnbull, Chris D / Várnai, Csilla / Yousaf, Nadia / Kerr, Rachel / Middleton, Gary

    Lancet (London, England)

    2020  Volume 395, Issue 10241, Page(s) 1919–1926

    Abstract: Background: Individuals with cancer, particularly those who are receiving systemic anticancer treatments, have been postulated to be at increased risk of mortality from COVID-19. This conjecture has considerable effect on the treatment of patients with ... ...

    Abstract Background: Individuals with cancer, particularly those who are receiving systemic anticancer treatments, have been postulated to be at increased risk of mortality from COVID-19. This conjecture has considerable effect on the treatment of patients with cancer and data from large, multicentre studies to support this assumption are scarce because of the contingencies of the pandemic. We aimed to describe the clinical and demographic characteristics and COVID-19 outcomes in patients with cancer.
    Methods: In this prospective observational study, all patients with active cancer and presenting to our network of cancer centres were eligible for enrolment into the UK Coronavirus Cancer Monitoring Project (UKCCMP). The UKCCMP is the first COVID-19 clinical registry that enables near real-time reports to frontline doctors about the effects of COVID-19 on patients with cancer. Eligible patients tested positive for severe acute respiratory syndrome coronavirus 2 on RT-PCR assay from a nose or throat swab. We excluded patients with a radiological or clinical diagnosis of COVID-19, without a positive RT-PCR test. The primary endpoint was all-cause mortality, or discharge from hospital, as assessed by the reporting sites during the patient hospital admission.
    Findings: From March 18, to April 26, 2020, we analysed 800 patients with a diagnosis of cancer and symptomatic COVID-19. 412 (52%) patients had a mild COVID-19 disease course. 226 (28%) patients died and risk of death was significantly associated with advancing patient age (odds ratio 9·42 [95% CI 6·56-10·02]; p<0·0001), being male (1·67 [1·19-2·34]; p=0·003), and the presence of other comorbidities such as hypertension (1·95 [1·36-2·80]; p<0·001) and cardiovascular disease (2·32 [1·47-3·64]). 281 (35%) patients had received cytotoxic chemotherapy within 4 weeks before testing positive for COVID-19. After adjusting for age, gender, and comorbidities, chemotherapy in the past 4 weeks had no significant effect on mortality from COVID-19 disease, when compared with patients with cancer who had not received recent chemotherapy (1·18 [0·81-1·72]; p=0·380). We found no significant effect on mortality for patients with immunotherapy, hormonal therapy, targeted therapy, radiotherapy use within the past 4 weeks.
    Interpretation: Mortality from COVID-19 in cancer patients appears to be principally driven by age, gender, and comorbidities. We are not able to identify evidence that cancer patients on cytotoxic chemotherapy or other anticancer treatment are at an increased risk of mortality from COVID-19 disease compared with those not on active treatment.
    Funding: University of Birmingham, University of Oxford.
    MeSH term(s) Age Factors ; Aged ; Antineoplastic Agents/therapeutic use ; Betacoronavirus ; COVID-19 ; Cause of Death ; Comorbidity ; Coronavirus Infections/complications ; Coronavirus Infections/mortality ; Female ; Humans ; Male ; Middle Aged ; Neoplasms/complications ; Neoplasms/drug therapy ; Neoplasms/mortality ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/mortality ; Prospective Studies ; Risk Factors ; SARS-CoV-2 ; Sex Factors
    Chemical Substances Antineoplastic Agents
    Keywords covid19
    Language English
    Publishing date 2020-05-28
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(20)31173-9
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  6. Article ; Online: COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study.

    Lee, Lennard Y W / Cazier, Jean-Baptiste / Starkey, Thomas / Briggs, Sarah E W / Arnold, Roland / Bisht, Vartika / Booth, Stephen / Campton, Naomi A / Cheng, Vinton W T / Collins, Graham / Curley, Helen M / Earwaker, Philip / Fittall, Matthew W / Gennatas, Spyridon / Goel, Anshita / Hartley, Simon / Hughes, Daniel J / Kerr, David / Lee, Alvin J X /
    Lee, Rebecca J / Lee, Siow Ming / Mckenzie, Hayley / Middleton, Chris P / Murugaesu, Nirupa / Newsom-Davis, Tom / Olsson-Brown, Anna C / Palles, Claire / Powles, Thomas / Protheroe, Emily A / Purshouse, Karin / Sharma-Oates, Archana / Sivakumar, Shivan / Smith, Ashley J / Topping, Oliver / Turnbull, Chris D / Várnai, Csilla / Briggs, Adam D M / Middleton, Gary / Kerr, Rachel

    The Lancet. Oncology

    2020  Volume 21, Issue 10, Page(s) 1309–1316

    Abstract: Background: Patients with cancer are purported to have poor COVID-19 outcomes. However, cancer is a heterogeneous group of diseases, encompassing a spectrum of tumour subtypes. The aim of this study was to investigate COVID-19 risk according to tumour ... ...

    Abstract Background: Patients with cancer are purported to have poor COVID-19 outcomes. However, cancer is a heterogeneous group of diseases, encompassing a spectrum of tumour subtypes. The aim of this study was to investigate COVID-19 risk according to tumour subtype and patient demographics in patients with cancer in the UK.
    Methods: We compared adult patients with cancer enrolled in the UK Coronavirus Cancer Monitoring Project (UKCCMP) cohort between March 18 and May 8, 2020, with a parallel non-COVID-19 UK cancer control population from the UK Office for National Statistics (2017 data). The primary outcome of the study was the effect of primary tumour subtype, age, and sex and on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence and the case-fatality rate during hospital admission. We analysed the effect of tumour subtype and patient demographics (age and sex) on prevalence and mortality from COVID-19 using univariable and multivariable models.
    Findings: 319 (30·6%) of 1044 patients in the UKCCMP cohort died, 295 (92·5%) of whom had a cause of death recorded as due to COVID-19. The all-cause case-fatality rate in patients with cancer after SARS-CoV-2 infection was significantly associated with increasing age, rising from 0·10 in patients aged 40-49 years to 0·48 in those aged 80 years and older. Patients with haematological malignancies (leukaemia, lymphoma, and myeloma) had a more severe COVID-19 trajectory compared with patients with solid organ tumours (odds ratio [OR] 1·57, 95% CI 1·15-2·15; p<0·0043). Compared with the rest of the UKCCMP cohort, patients with leukaemia showed a significantly increased case-fatality rate (2·25, 1·13-4·57; p=0·023). After correction for age and sex, patients with haematological malignancies who had recent chemotherapy had an increased risk of death during COVID-19-associated hospital admission (OR 2·09, 95% CI 1·09-4·08; p=0·028).
    Interpretation: Patients with cancer with different tumour types have differing susceptibility to SARS-CoV-2 infection and COVID-19 phenotypes. We generated individualised risk tables for patients with cancer, considering age, sex, and tumour subtype. Our results could be useful to assist physicians in informed risk-benefit discussions to explain COVID-19 risk and enable an evidenced-based approach to national social isolation policies.
    Funding: University of Birmingham and University of Oxford.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Betacoronavirus/pathogenicity ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/mortality ; Coronavirus Infections/pathology ; Coronavirus Infections/virology ; Female ; Hospitalization ; Humans ; Male ; Middle Aged ; Neoplasms/mortality ; Neoplasms/pathology ; Neoplasms/virology ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/mortality ; Pneumonia, Viral/pathology ; Pneumonia, Viral/virology ; Prospective Studies ; Risk Assessment ; Risk Factors ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-08-24
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2049730-1
    ISSN 1474-5488 ; 1470-2045
    ISSN (online) 1474-5488
    ISSN 1470-2045
    DOI 10.1016/S1470-2045(20)30442-3
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  7. Article: COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study

    Lee, Lennard Y W / Cazier, Jean-Baptiste / Starkey, Thomas / Briggs, Sarah E W / Arnold, Roland / Bisht, Vartika / Booth, Stephen / Campton, Naomi A / Cheng, Vinton W T / Collins, Graham / Curley, Helen M / Earwaker, Philip / Fittall, Matthew W / Gennatas, Spyridon / Goel, Anshita / Hartley, Simon / Hughes, Daniel J / Kerr, David / Lee, Alvin J X /
    Lee, Rebecca J / Lee, Siow Ming / Mckenzie, Hayley / Middleton, Chris P / Murugaesu, Nirupa / Newsom-Davis, Tom / Olsson-Brown, Anna C / Palles, Claire / Powles, Thomas / Protheroe, Emily A / Purshouse, Karin / Sharma-Oates, Archana / Sivakumar, Shivan / Smith, Ashley J / Topping, Oliver / Turnbull, Chris D / Várnai, Csilla / Briggs, Adam D M / Middleton, Gary / Kerr, Rachel

    Lancet Oncol

    Abstract: BACKGROUND: Patients with cancer are purported to have poor COVID-19 outcomes. However, cancer is a heterogeneous group of diseases, encompassing a spectrum of tumour subtypes. The aim of this study was to investigate COVID-19 risk according to tumour ... ...

    Abstract BACKGROUND: Patients with cancer are purported to have poor COVID-19 outcomes. However, cancer is a heterogeneous group of diseases, encompassing a spectrum of tumour subtypes. The aim of this study was to investigate COVID-19 risk according to tumour subtype and patient demographics in patients with cancer in the UK. METHODS: We compared adult patients with cancer enrolled in the UK Coronavirus Cancer Monitoring Project (UKCCMP) cohort between March 18 and May 8, 2020, with a parallel non-COVID-19 UK cancer control population from the UK Office for National Statistics (2017 data). The primary outcome of the study was the effect of primary tumour subtype, age, and sex and on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence and the case-fatality rate during hospital admission. We analysed the effect of tumour subtype and patient demographics (age and sex) on prevalence and mortality from COVID-19 using univariable and multivariable models. FINDINGS: 319 (30·6%) of 1044 patients in the UKCCMP cohort died, 295 (92·5%) of whom had a cause of death recorded as due to COVID-19. The all-cause case-fatality rate in patients with cancer after SARS-CoV-2 infection was significantly associated with increasing age, rising from 0·10 in patients aged 40-49 years to 0·48 in those aged 80 years and older. Patients with haematological malignancies (leukaemia, lymphoma, and myeloma) had a more severe COVID-19 trajectory compared with patients with solid organ tumours (odds ratio [OR] 1·57, 95% CI 1·15-2·15; p<0·0043). Compared with the rest of the UKCCMP cohort, patients with leukaemia showed a significantly increased case-fatality rate (2·25, 1·13-4·57; p=0·023). After correction for age and sex, patients with haematological malignancies who had recent chemotherapy had an increased risk of death during COVID-19-associated hospital admission (OR 2·09, 95% CI 1·09-4·08; p=0·028). INTERPRETATION: Patients with cancer with different tumour types have differing susceptibility to SARS-CoV-2 infection and COVID-19 phenotypes. We generated individualised risk tables for patients with cancer, considering age, sex, and tumour subtype. Our results could be useful to assist physicians in informed risk-benefit discussions to explain COVID-19 risk and enable an evidenced-based approach to national social isolation policies. FUNDING: University of Birmingham and University of Oxford.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #726907
    Database COVID19

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  8. Article: COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study

    Lee, Lennard Yw / Cazier, Jean-Baptiste / Angelis, Vasileios / Arnold, Roland / Bisht, Vartika / Campton, Naomi A / Chackathayil, Julia / Cheng, Vinton Wt / Curley, Helen M / Fittall, Matthew W / Freeman-Mills, Luke / Gennatas, Spyridon / Goel, Anshita / Hartley, Simon / Hughes, Daniel J / Kerr, David / Lee, Alvin Jx / Lee, Rebecca J / McGrath, Sophie E /
    Middleton, Christopher P / Murugaesu, Nirupa / Newsom-Davis, Thomas / Okines, Alicia Fc / Olsson-Brown, Anna C / Palles, Claire / Pan, Yi / Pettengell, Ruth / Powles, Thomas / Protheroe, Emily A / Purshouse, Karin / Sharma-Oates, Archana / Sivakumar, Shivan / Smith, Ashley J / Starkey, Thomas / Turnbull, Chris D / Várnai, Csilla / Yousaf, Nadia / Kerr, Rachel / Middleton, Gary

    Lancet

    Abstract: BACKGROUND: Individuals with cancer, particularly those who are receiving systemic anticancer treatments, have been postulated to be at increased risk of mortality from COVID-19. This conjecture has considerable effect on the treatment of patients with ... ...

    Abstract BACKGROUND: Individuals with cancer, particularly those who are receiving systemic anticancer treatments, have been postulated to be at increased risk of mortality from COVID-19. This conjecture has considerable effect on the treatment of patients with cancer and data from large, multicentre studies to support this assumption are scarce because of the contingencies of the pandemic. We aimed to describe the clinical and demographic characteristics and COVID-19 outcomes in patients with cancer. METHODS: In this prospective observational study, all patients with active cancer and presenting to our network of cancer centres were eligible for enrolment into the UK Coronavirus Cancer Monitoring Project (UKCCMP). The UKCCMP is the first COVID-19 clinical registry that enables near real-time reports to frontline doctors about the effects of COVID-19 on patients with cancer. Eligible patients tested positive for severe acute respiratory syndrome coronavirus 2 on RT-PCR assay from a nose or throat swab. We excluded patients with a radiological or clinical diagnosis of COVID-19, without a positive RT-PCR test. The primary endpoint was all-cause mortality, or discharge from hospital, as assessed by the reporting sites during the patient hospital admission. FINDINGS: From March 18, to April 26, 2020, we analysed 800 patients with a diagnosis of cancer and symptomatic COVID-19. 412 (52%) patients had a mild COVID-19 disease course. 226 (28%) patients died and risk of death was significantly associated with advancing patient age (odds ratio 9·42 [95% CI 6·56-10·02]; p<0·0001), being male (1·67 [1·19-2·34]; p=0·003), and the presence of other comorbidities such as hypertension (1·95 [1·36-2·80]; p<0·001) and cardiovascular disease (2·32 [1·47-3·64]). 281 (35%) patients had received cytotoxic chemotherapy within 4 weeks before testing positive for COVID-19. After adjusting for age, gender, and comorbidities, chemotherapy in the past 4 weeks had no significant effect on mortality from COVID-19 disease, when compared with patients with cancer who had not received recent chemotherapy (1·18 [0·81-1·72]; p=0·380). We found no significant effect on mortality for patients with immunotherapy, hormonal therapy, targeted therapy, radiotherapy use within the past 4 weeks. INTERPRETATION: Mortality from COVID-19 in cancer patients appears to be principally driven by age, gender, and comorbidities. We are not able to identify evidence that cancer patients on cytotoxic chemotherapy or other anticancer treatment are at an increased risk of mortality from COVID-19 disease compared with those not on active treatment. FUNDING: University of Birmingham, University of Oxford.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #401263
    Database COVID19

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  9. Article ; Online: COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics

    Lee, Lennard Y W / Cazier, Jean-Baptiste / Starkey, Thomas / Briggs, Sarah E W / Arnold, Roland / Bisht, Vartika / Booth, Stephen / Campton, Naomi A / Cheng, Vinton W T / Collins, Graham / Curley, Helen M / Earwaker, Philip / Fittall, Matthew W / Gennatas, Spyridon / Goel, Anshita / Hartley, Simon / Hughes, Daniel J / Kerr, David / Lee, Alvin J X /
    Lee, Rebecca J / Lee, Siow Ming / Mckenzie, Hayley / Middleton, Chris P / Murugaesu, Nirupa / Newsom-Davis, Tom / Olsson-Brown, Anna C / Palles, Claire / Powles, Thomas / Protheroe, Emily A / Purshouse, Karin / Sharma-Oates, Archana / Sivakumar, Shivan / Smith, Ashley J / Topping, Oliver / Turnbull, Chris D / Várnai, Csilla / Briggs, Adam D M / Middleton, Gary / Kerr, Rachel

    a prospective cohort study.

    2020  

    Abstract: BACKGROUND Patients with cancer are purported to have poor COVID-19 outcomes. However, cancer is a heterogeneous group of diseases, encompassing a spectrum of tumour subtypes. The aim of this study was to investigate COVID-19 risk according to tumour ... ...

    Abstract BACKGROUND Patients with cancer are purported to have poor COVID-19 outcomes. However, cancer is a heterogeneous group of diseases, encompassing a spectrum of tumour subtypes. The aim of this study was to investigate COVID-19 risk according to tumour subtype and patient demographics in patients with cancer in the UK. METHODS We compared adult patients with cancer enrolled in the UK Coronavirus Cancer Monitoring Project (UKCCMP) cohort between March 18 and May 8, 2020, with a parallel non-COVID-19 UK cancer control population from the UK Office for National Statistics (2017 data). The primary outcome of the study was the effect of primary tumour subtype, age, and sex and on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence and the case-fatality rate during hospital admission. We analysed the effect of tumour subtype and patient demographics (age and sex) on prevalence and mortality from COVID-19 using univariable and multivariable models. FINDINGS 319 (30·6%) of 1044 patients in the UKCCMP cohort died, 295 (92·5%) of whom had a cause of death recorded as due to COVID-19. The all-cause case-fatality rate in patients with cancer after SARS-CoV-2 infection was significantly associated with increasing age, rising from 0·10 in patients aged 40-49 years to 0·48 in those aged 80 years and older. Patients with haematological malignancies (leukaemia, lymphoma, and myeloma) had a more severe COVID-19 trajectory compared with patients with solid organ tumours (odds ratio [OR] 1·57, 95% CI 1·15-2·15; p<0·0043). Compared with the rest of the UKCCMP cohort, patients with leukaemia showed a significantly increased case-fatality rate (2·25, 1·13-4·57; p=0·023). After correction for age and sex, patients with haematological malignancies who had recent chemotherapy had an increased risk of death during COVID-19-associated hospital admission (OR 2·09, 95% CI 1·09-4·08; p=0·028). INTERPRETATION Patients with cancer with different tumour types have differing susceptibility to SARS-CoV-2 infection and COVID-19 phenotypes. We generated individualised risk tables for patients with cancer, considering age, sex, and tumour subtype. Our results could be useful to assist physicians in informed risk-benefit discussions to explain COVID-19 risk and enable an evidenced-based approach to national social isolation policies. FUNDING University of Birmingham and University of Oxford.
    Keywords QW Microbiology. Immunology ; QZ Pathology. Oncology ; WC Communicabable diseases ; WH Haemic and lymphatic systems. Haematology ; WN Medical imaging. Radiology ; covid19
    Subject code 610 ; 616
    Publishing date 2020-08-24
    Publisher Elsevier
    Publishing country uk
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments

    Lee, Lennard YW / Cazier, Jean-Baptiste / Angelis, Vasileios / Arnold, Roland / Bisht, Vartika / Campton, Naomi A / Chackathayil, Julia / Cheng, Vinton WT / Curley, Helen M / Fittall, Matthew W / Freeman-Mills, Luke / Gennatas, Spyridon / Goel, Anshita / Hartley, Simon / Hughes, Daniel J / Kerr, David / Lee, Alvin JX / Lee, Rebecca J / McGrath, Sophie E /
    Middleton, Christopher P / Murugaesu, Nirupa / Newsom-Davis, Thomas / Okines, Alicia FC / Olsson-Brown, Anna C / Palles, Claire / Pan, Yi / Pettengell, Ruth / Powles, Thomas / Protheroe, Emily A / Purshouse, Karin / Sharma-Oates, Archana / Sivakumar, Shivan / Smith, Ashley J / Starkey, Thomas / Turnbull, Chris D / Várnai, Csilla / Yousaf, Nadia / Kerr, Rachel / Middleton, Gary

    The Lancet

    a prospective cohort study

    2020  Volume 395, Issue 10241, Page(s) 1919–1926

    Keywords General Medicine ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/s0140-6736(20)31173-9
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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