Abstract 509P
Background
KBP-2020-CPHG is a prospective cohort study that included all consecutive patients diagnosed with lung cancer (LC) admitted in 2020, in nonacademic public hospital pulmonology or oncology units. This study provides a unique opportunity to prospectively study the incidence rate of COVID and associated factors in LC patients.
Methods
All new LC diagnosed between 01/01 and 12/31/2020 in non-academic public hospital pulmonology or oncology units were included. Data on COVID diagnosis (PCR test, serology, CT-scan) were collected. Only COVID diagnosed in 2020 after LC diagnosis were considered in this analysis. Incidence rate ratios were measured in different subgroups of patients (multivariate Poisson regression including age, sex, smoking status, histological type, PS, tumour grade and chemotherapy before COVID) and a survival analysis was performed (Cox regression with COVID as a time-dependent covariate).
Results
A total of 8,999 patients were included by 82 centers. Data on COVID were completed for 8,474: 308 patients had COVID after LC diagnosis, in 2020. COVID incidence measured by number of case / 100py from LC diagnosis was 7.5 [6.6-8.5]. Incidence rate ratio (IRR) was statistically larger in patients with small cell LC (IRR 2.01[1.37:2.91] P<0.001) or with squamous LC (IRR 1.42 [1.03:1.94] P=0.028) (Table). PS 2 or 3, and stage III or IV, and the absence of chemotherapy were associated with increased incidence. Age and smoking status had no significant effect on IRR. COVID was significantly associated with shorter survival time (HR 3,24; [ 2.69:3.90] P<0.001). Table: 509P
| Incidence rate per 100 patients-years (95% CI) | Multivariate | |||
| IRR1 | 95% CI1 | p-value | ||
| Gender | ||||
| F | 6.2 (4.9 ; 7.7) | — | — | |
| M | 8.3 (5.0 ; 13.6) | 1.30 | 0.99, 1.74 | 0.068 |
| Histology | ||||
| Adenocarcinoma & others | 6.3 (5.3 ; 7.4) | — | — | |
| Small cells | 11.4 (6.8 ; 18.6) | 2.01 | 1.37, 2.91 | <0.001 |
| Squamous LC | 9.2 (5.8 ; 14.4) | 1.42 | 1.03, 1.94 | 0.028 |
| Stage at diagnosis | ||||
| I | 4.2 (2.4 ; 6.5) | — | — | |
| II | 5.3 (1.6 ; 16.3) | 1.41 | 0.73, 2.77 | 0.3 |
| III | 7.6 (2.6 ; 21.5) | 2.20 | 1.24, 4.10 | 0.009 |
| IV | 8.6 (3.1 ; 23,5) | 2.18 | 1.29, 3.94 | 0.006 |
| Chemotherapy before COVID | ||||
| Yes | 6.4 (5.4 ; 7.6) | — | — | |
| No | 9.5 (6.2 ; 14.3) | 2.04 | 1.51, 2.76 | <0.001 |
1IRR = Incidence Rate Ratio, CI = Confidence Interval.
Conclusions
COVID incidence in lung cancer was associated with histology type, stage and PS. COVID is a strong risk factor of mortality.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
French College of General Hospital Pulmonologists (CPHG).
Funding
The study was promoted by the French College of General Hospital Pulmonologists (CPHG) with the endowment funds of Fondation du Souffle, Le Nouveau Souffle, Couleur espoir, the labeling of InCa (Institut national du Cancer) and FHF-CNCR (Fédération Hospitalière de France-Comité National de Coordination de la Recherche), and financial support of following laboratories: AstraZeneca, Bayer, Boehringer Ingelheim, BMS, Chugai, Janssen, MSD, Lilly, Pfizer, Roche, Sanofi and Takeda.
Disclosure
O. Molinier: Financial Interests, Personal, Invited Speaker: AstraZeneca. S. Couraud: Financial Interests, Personal, Advisory Role: Amgen, AstraZeneca, BMS, Boehringer Ingelheim, MSD, Roche, Sanofi, Takeda, BMS; Financial Interests, Personal, Invited Speaker: AstraZeneca, Roche, Takeda, Boehringer Ingelheim. A. Cortot: Financial Interests, Personal, Advisory Role: AstraZeneca, Novartis, Roche; Financial Interests, Personal, Invited Speaker: AstraZeneca, BMS, MSD, Pfizer, Novartis, Takeda, Janssen, Roche. D. Debieuvre: Financial Interests, Personal, Advisory Role: AstraZeneca, Roche, Pfizer, BMS, MSD, Novartis, GSK, Janssen, Amgen, OSE Immunotherapeutics, Sanofi Aventis; Financial Interests, Personal, Invited Speaker: Takeda, AstraZeneca, BMS, Pfizer, MSD, Novartis. All other authors have declared no conflicts of interest.