Abstract 1574P
Background
We assessed mortality risk by COVID-19 (C19) infection among treated cancer patients (pts) and the impact of anti-cancer treatment (tx) on mortality.
Methods
Optum de-identified Electronic Health Record dataset (2021-01-07 release) were used to find cancer pts with a C19 positive (ICD-9/10-CM codes U071/U072 or positive test result) or negative (negative test and no positive test at any time after the first negative result) status on the first test/diagnosis date (ie the “index date”). Pts with <1 year database history, with no tx 0-90 days before index, <18 years old, with implausible death dates, and with index dates outside of 02/2020 - 11/2020 were excluded. C19 positive and negative pts were exact-matched on cancer type, then 1:1 nearest-neighbor matched on propensity scores (variables in table). Missing values were imputed (n = 5), and outcomes were evaluated by multivariable logistic regression, including interaction terms between tx and C19 positivity.
Results
We identified 21,060 pts, of whom 1,636 (7.8%) were positive for C19 and 19,424 (92.2%) negative. Among 1,636 matched pairs of positive/negative C19 pts, the odds ratio (OR) of 30-day mortality comparing C19 positive vs negative patients was 2.14 (95% CI: 0.71 – 6.52). Among the strongest predictors of 30-day mortality were age 75+ (OR = 5.42, 95% CI: 2.21 – 13.28), inpatient C19 testing/diagnosis (OR = 4.78, 95% CI: 3.04, 7.53), CCI of 3+ (OR = 2.24, 95% CI: 1.30 – 3.89), and metastatic disease (OR = 1.80, 95% CI 1.21 – 2.68). Anti-cancer therapies do not appear to modulate risk of death due to C19. Beyond 30-day mortality, matched mortality rate ratios (MRRs) suggested increased risk for C19 positive patients (MRR = 1.85, 95% CI: 1.26 – 2.44). Table: 1574P
Selectˆ OR and 95% CIs for 30-day mortality
| OR | 95% CI, lower | 95% CI, upper | p | |
| Anti-cancer tx | ||||
| Chemotherapy | 2.10 | 0.98 | 4.52 | 0.06 |
| Hormone | 0.75 | 0.27 | 2.09 | 0.57 |
| Immunotherapy | 1.56 | 0.56 | 4.39 | 0.39 |
| Targeted biologic | 1.58 | 0.49 | 5.07 | 0.41 |
| Targeted small molecule | 2.00 | 0.74 | 5.44 | 0.16 |
| C19 positive | 2.14 | 0.71 | 6.52 | 0.18 |
| Interactions with C19 | ||||
| Chemotherapy | 0.81 | 0.31 | 2.15 | 0.67 |
| Immunotherapy | 0.45 | 0.14 | 1.52 | 0.20 |
| Hormone therapy | 1.58 | 0.46 | 5.36 | 0.46 |
| Targeted biologic | 0.49 | 0.13 | 1.77 | 0.26 |
| Targeted nonbiologic | 1.42 | 0.46 | 4.39 | 0.54 |
ˆ Not shown (statistical significance*): (intercept)*, age*, CCI*, index month*, insurance, metastasis*, obesity, region, setting*, sex, smoking status, years since first cancer diagnosis
Conclusions
C19 showed a trend towards increased 30-day mortality risk (not statistically significant), and increased overall mortality risk. Specific tx did not appear to modulate 30-day mortality due to C19.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Genentech, Inc.
Funding
Roche/Genentech.
Disclosure
P.A. Ascierto: Financial Interests, Personal, Advisory Board: Bristol Myers Squibb, Roche-Genentech, Merck Sharp & Dohme, Novartis, Array, Merck Serono, Pierre-Fabre, Incyte, Medimmune, AstraZeneca, Syndax, Sun Pharma, Sanofi, Idera, Ultimovacs, Sandoz, Immunocore, 4SC, Alkermes, Italfarmaco, Nektar, Boehringer Ingelheim; Financial Interests, Personal, Research Grant: Bristol Myers Squibb, Roche-Genentech, Array, Sanofi; Financial Interests, Personal, Other: MSD; Non-Financial Interests, Personal, Advisory Board: TAKIS. M.H. Secrest: Financial Interests, Personal, Full or part-time Employment: Roche/Genentech; Financial Interests, Personal, Stocks/Shares: Roche. P. Lambert: Financial Interests, Personal, Full or part-time Employment: Genentech/Roche; Financial Interests, Personal, Stocks/Shares: Roche. K. Sarsour: Financial Interests, Personal, Full or part-time Employment: Roche/Genentech; Financial Interests, Personal, Stocks/Shares: Roche. A. Tan: Financial Interests, Personal, Full or part-time Employment: Roche/Genentech; Financial Interests, Personal, Stocks/Shares: Roche. R. Walls: Financial Interests, Personal, Full or part-time Employment: Hoffmann-La Roche; Financial Interests, Personal, Stocks/Shares: Hoffmann-La Roche. J. Reddy: Financial Interests, Personal, Full or part-time Employment: Roche/Genentech; Financial Interests, Personal, Stocks/Shares: Roche. A. Seetasith: Financial Interests, Personal, Full or part-time Employment: Genentech, Inc.; Financial Interests, Personal, Stocks/Shares: Roche. D. Shenison: Financial Interests, Personal, Full or part-time Employment: Roche/Genentech; Financial Interests, Personal, Stocks/Shares: Roche, Cigna . I. Ngwa: Financial Interests, Personal, Full or part-time Employment: F. Hoffmann - La Roche Ltd; Financial Interests, Personal, Stocks/Shares: F. Hoffmann - La Roche Ltd. C. Yun: Financial Interests, Personal, Full or part-time Employment: Genentech, Inc.; Financial Interests, Personal, Stocks/Shares: Roche. Q. Zhang: Financial Interests, Personal, Full or part-time Employment: Roche/Genentech; Financial Interests, Personal, Stocks/Shares: Roche, Regeneron, BMS, AbbVie, AC Immune.