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Proffered Paper session - SARS-CoV-2 and cancer

1560O_PR - Prevalence and impact of COVID-19 sequelae on treatment pathways and survival of cancer patients who recovered from SARS-CoV-2 infection

Date

21 Sep 2021

Session

Proffered Paper session - SARS-CoV-2 and cancer

Presenters

Alessio Cortellini

Citation

Annals of Oncology (2021) 32 (suppl_5): S1129-S1163. 10.1016/annonc/annonc713

Authors

A. Cortellini1, E. Roldán2, M.C. Carmona Garcia3, R. Berardi4, A. Sánchez5, C. Martinez6, A. Parisi7, E. Jones8, R.M. Bertulli9, G. Rizzo10, A. Guida11, C. Chung12, M.D. Bower13, M. Betti14, B. Vincenzi15, O. Mirallas16, F. Biello17, P. Queirolo18, A. Gennari19, D.J. Pinato20

Author affiliations

  • 1 Department Of Biotechnology And Applied Clinical Sciences, University of L'Aquila, 67100 - L'Aquila/IT
  • 2 Hematology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona/ES
  • 3 Medical Oncology Dept., Catalan Institute of Oncology, University Hospital Josep Trueta, Girona/ES
  • 4 Clinical Oncology, Dept. Of Internal Medicine, AOU - Ospedali Riuniti Umberto I - G.M. Lancisi - G. Salesi, 60126 - Torrette di Ancona/IT
  • 5 Medical Oncology, Hospital Universitario XII de Octubre, Madrid/ES
  • 6 Medical Oncology, Fundació Althaia Manresa, Manresa/ES
  • 7 Department Of Life, Health And Environmental Sciences, University of L'Aquila, L'Aquila/IT
  • 8 Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London/GB
  • 9 Medical Oncology, Istituto Nazionale dei Tumori di Milano - Fondazione IRCCS, 20133 - Milan/IT
  • 10 Oncology Dept., Fondazione IRCCS Policlinico San Matteo, 27100 - Pavia/IT
  • 11 Medical Oncology, Azienda Ospedaliera Santa Maria, Terni/IT
  • 12 Surgery And Cancer, Imperial College London, London/GB
  • 13 Medical Oncology, Chelsea and Westminster Hospital - NHS Trust, SW10 9NH - London/GB
  • 14 14. infrastruttura Ricerca Formazione Innovazione, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria/IT
  • 15 Medical Oncology, Policlinico Universitario Campus Bio-Medico, 00128 - Rome/IT
  • 16 Medical Oncology Department, Vall d'Hebron University Hospital, 8035 - Barcelona/ES
  • 17 Medical Oncology, Azienda Ospedaliera Universitaria Maggiore della Carità, 28100 - Novara/IT
  • 18 Melanoma And Sarcoma Medical Treatment Unit, IEO - Istituto Europeo di Oncologia, 20141 - Milan/IT
  • 19 Medical Oncology Department, Università Degli Studi Del Piemonte Orientale - Scuola di Medicina, 28100 - Novara/IT
  • 20 Surgery And Cancer, Imperial College London - Hammersmith Hospital, W12 0HS - London/GB
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Resources

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Abstract 1560O_PR

Background

The long-term impact of COVID-19 in cancer patients (pts) is undefined.

Methods

Among 2795 consecutive pts with COVID-19 and cancer registered to OnCovid between 01/2020 and 02/2021, we examined clinical outcomes of pts reassessed post COVID-19 recovery.

Results

Among 1557 COVID-19 survivors, 234 (15%) reported sequelae including respiratory symptoms (49.6%), fatigue (41%) and cognitive/psychological dysfunction (4.3%). Persisting COVID-19 sequelae were more likely found in males (p=0.0407) aged ≥65 years (p=0.0489) with ≥2 comorbidities (p=0.0006) and positive smoking history (p=0.0004). Sequelae were associated with history of prior hospitalisation (p<0.0001), complicated disease (p<0.0001) and COVID-19 therapy (p=0.0002). With a median post-COVID-19 follow up of 128 days (95%CI 113-148), multivariable analysis of survival revealed COVID-19 sequelae to be associated with an increased risk of death (HR 1.76, 95%CI 1.16-2.66) after adjusting for sex, age, comorbidities, tumour characteristics, anticancer therapy and COVID-19 severity. Out of 473 patients who were on systemic anticancer therapy (SACT) at COVID-19 diagnosis; 62 (13.1%) permanently discontinued therapy and 75 (15.8%) received SACT adjustments, respectively. Discontinuations were due to worsening performance status (45.1%), disease progression (16.1%) and residual organ disfunction (6.3%). SACT adjustments were pursued to avoid hospital attendance (40%), prevent immunosuppression (57.3%) or adverse events (20.3%). Multivariable analyses showed permanent discontinuation to be associated with an increased risk of death (HR 4.2, 95%CI: 1.62-10.7), whereas SACT adjustments did not adversely affect survival.

Conclusions

Sequelae post-COVID-19 affect up to 15% of patients with cancer and adversely influence survival and oncological outcomes after recovery. SACT adjustments can be safely pursued to preserve oncological outcomes in patients who remain eligible to treatment.

Clinical trial identification

NCT04393974.

Editorial acknowledgement

Legal entity responsible for the study

Imperial College London.

Funding

Has not received any funding.

Disclosure

A. Cortellini: Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: BMS; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Invited Speaker: Novartis; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Invited Speaker: Astellas; Financial Interests, Personal, Advisory Board: Sun Pharma. D.J. Pinato: Financial Interests, Personal, Advisory Board: ViiV Healthcare; Financial Interests, Personal, Invited Speaker: Bayer; Financial Interests, Personal, Advisory Board: Eisai; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Invited Speaker: AstraZeneca. All other authors have declared no conflicts of interest.

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