LBA70 - COVID-19 in cancer patients: Update from the joint analysis of ESMO-CoCARE, BSMO, PSMO international databases

Background

COVID-19 (C19) has significantly affected patients (pts) with cancer and exposed unanticipated challenges in securing optimal cancer care across disciplines. ESMO-CoCARE is an international, real-world database, collecting data on the natural history, management and outcomes of pts with cancer and SARS-CoV-2.

Methods

This is the 2^nd CoCARE analysis, jointly with Belgian (BSMO) and Portuguese (PSMO) registries, from Jan 2020 to Dec 2021. The aim is to identify significant prognostic factors for the primary C19 outcomes of hospitalization and mortality, and the secondary outcomes of Intensive Care Unit admission (ICU-adm) and overall survival (OS). Subgroup analysis by pandemic phase and vaccination status is performed.

Results

The analysis cohort includes 3294 pts (CoCARE: 2049; BSMO: 928, all hospitalised by eligibility criteria; PSMO: 317), diagnosed in 4 distinct pandemic phases (Jan-May/20: 36%; Jun-Sep/20: 9%; Oct/20-Feb/21: 41%; Mar-Dec/21: 12%). The C19 hospitalization rate is 54% (CoCARE and- PSMO data), ICU-adm 14% and C19 mortality 22% (all data). At a 6-month median follow-up, 1013 deaths were recorded, with 73% 3-mo OS rate. No significant change was observed in C19 mortality among hospitalized pts across the 4 pandemic phases (30-33%). Hospitalizations and ICU-adm decreased significantly (from 78% to 34% and 16% to 10%). Among 1522 pts, 70% were non-vaccinated, 24% had incomplete and 7% complete vaccination at C19 diagnosis. Complete vaccination had a protective effect on hospitalization (OR: 0.24; 95%CI [0.14 - 0.38]), ICU-adm (OR: 0.29 [0.09 - 0.94]) and OS (HR: 0.39 [0.20 - 0.76]). In multivariable analyses, C19 hospitalization was associated with pt/cancer characteristics, the 1^st pandemic phase, the presence of C19-related symptoms or inflammatory biomarkers, while C19 mortality was significantly higher in symptomatic pts, male gender, older age, ethnicity other than Asian/Caucasian, ECOG PS≥2, BMI<25, haematological malignancy, PD vs NED and advanced cancer stage.

Conclusions

The updated CoCARE analysis, jointly with BSMO and PSMO, highlights factors that significantly affect C19 outcomes, providing actionable clues for further reducing mortality.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

ESMO and Institut Curie.

Funding

ESMO.

Disclosure

E. Romano: Financial Interests, Institutional, Research Grant, Research fundings: BMS, AstraZeneca, Amgen, Janssen; Financial Interests, Invited Speaker: Light Chain Biosciences. E. de Azambuja: Financial Interests, Personal, Advisory Board: Roche/GNE, Novartis; Financial Interests, Personal, Invited Speaker: Seattle Genetic, Zodiac, Libbs, Pierre Fabre; Financial Interests, Institutional, Research Grant: Roche/GNE, AstraZeneca, GSK/Novartis, Servier; Financial Interests, Institutional, Other, Travel Grant: Roche/GNE. J. Oliveira: Financial Interests, Personal and Institutional, Research Grant: AstraZeneca; Financial Interests, Personal, Invited Speaker: GSK, Janssen, Novartis, Roche, Bayer, MSD, Eisai, AstraZeneca, Pierre Fabre, BMS. S. Susnjar: Financial Interests, Personal, Advisory Board: Roche, Pfizer, Novartis, AstraZeneca, Amicus. D. Vinal Lozano: Financial Interests, Personal, Sponsor/Funding: MSD; Financial Interests, Personal, Invited Speaker: Servier. R. Lee: Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal and Institutional, Funding: BMS. D. Arnold: Financial Interests, Personal, Advisory Board: AstraZeneca, Bristol Myers Squibb, Merck Sharp & Dohme, Sanofi (Genzyme), Terumo, Samsung Bioepis, Pierre Fabre Pharma, Boston Scientific; Financial Interests, Personal, Invited Speaker: AstraZeneca, Bristol Myers Squibb, Merck Sharp & Dohme, Sanofi (Genzyme), Terumo, Boston Scientific, Amgen, Roche, Merck (Serono), Samsung Bioepis, Pierre Fabre Pharma, Servier, Ipsen; Financial Interests, Personal, Invited Speaker, CME Provider: PRMA Consulting, Tactics MD LLC, WebMD Health Corp, From Research to Practice, Aptitude Health, art tempi media, ACE Oncology, Imedex, streamitup Germany, MedAhead (Austria), Clinical Care Options (CCO); Financial Interests, Personal, Advisory Board, Consulting Agency: CRA International, Ketchum; Financial Interests, Personal, Advisory Board, CME Provider, App Producer: onkowissen; Financial Interests, Personal, Other, Roles as Assoc. Editor for ESMO Open and Ann Oncol: Elsevier; Financial Interests, Personal, Other, Role as Associate Editor Ann Oncol: Oxford University Press; Financial Interests, Personal, Other, Role as Associate Editor Clin Colorect Cancer: Elsevier; Financial Interests, Institutional, Other, DSMB chair: Sanofi (Genzyme); Financial Interests, Institutional, Invited Speaker: Bristol Myers Squibb, Pierre Fabre Pharma, Roche, OncoLytics; Financial Interests, Institutional, Funding, Educational Grant: AbbVie; Non-Financial Interests, Project Lead: OncoLytics; Non-Financial Interests, Leadership Role, GI Group Steering Committee: EORTC; Non-Financial Interests, Leadership Role, Steering Committee Member: AIO (German Cancer Society); Non-Financial Interests, Member: ASCO, ESO, DGHO. K.J. Harrington: Financial Interests, Institutional, Advisory Board: Amgen, AstraZeneca, BMS, Boehringer Ingelheim, Merck, MSD, Pfizer, Replimune, Oncolys, Vyriad, Idera; Financial Interests, Institutional, Other, Honoraria for lectures: Amgen, AstraZeneca, BMS, Boehringer Ingelheim; Financial Interests, Institutional, Advisory Board, Advisory board for CD47 assets: Arch Oncology; Financial Interests, Institutional, Advisory Board, Development of DDR assets: ARTIOS; Financial Interests, Institutional, Advisory Board, Development of exosomal STING agonist: Codiak; Financial Interests, Institutional, Advisory Board, Development of oncolytic adenovirus: PsiVac; Financial Interests, Institutional, Funding, Research: AstraZeneca, Boehringer Ingelheim, MSD; Financial Interests, Institutional, Funding, Development of oncolytic HSV platform.: Replimune; Non-Financial Interests, Leadership Role, Chair of Steering Committee: ART NET; Non-Financial Interests, Other, Member of Global Steering Committee: MR - Linac. O.A. Michielin: Financial Interests, Institutional, Invited Speaker: BMS, Amgen, Pierre Fabre, Roche, BMS; Financial Interests, Institutional, Advisory Board: BMS, Amgen, Roche, Novartis, Pierre Fabre, MSD; Financial Interests, Personal, Other, Advisory Role: BMS, MSD, Roche, Novartis, Pierre Fabre, Amgen, GSL; Financial Interests, Institutional, Research Grant: BMS, MSD, Pierre Fabre, Amgen, Merck; Financial Interests, Institutional, Funding: BMS, MSD, Pierre Fabre, Amgen, MSD; Non-Financial Interests, Principal Investigator: BMS, MSD, Amgen, Roche, Pierre Fabre, Novartis. U. Dafni: Financial Interests, Personal, Other, Member of the Tumor Agnostic Evidence Generation working Group: ROCHE. G. Pentheroudakis: Financial Interests, Personal, Full or part-time Employment, Chief Medical Officer: ESMO; Non-Financial Interests, Member: ASCO, Hellenic Cooperative Oncology Group (HeCOG), Hellenic Society of Medical Oncology. S. Peters: Financial Interests, Institutional, Advisory Board: Vaccibody, Takeda, Seattle Genetics, Sanofi, Roche/Genentech, Regeneron, Phosplatin Therapeutics, PharmaMar, Pfizer, Novartis, Mirati, Merck Serono, MSD, Janssen, Incyte, Illumina, IQVIA, GlaxoSmithKline, Gilhead, Genzyme, Foundation Medicine, F-Star, Eli Lilly, Debiopharm, Daiichi Sankyo, Boehringer Ingelheim, Blueprint Medicines, Biocartis, Bio Invent, BeiGene, Bayer, BMS, AstraZeneca, Arcus, Amgen, AbbVie, iTheos, Novocure; Financial Interests, Institutional, Invited Speaker: Takeda, Sanofi, Roche/Genentech, RTP, Pfizer, PRIME, PER, Novartis, Medscape, MSD, Imedex, Illumina, Fishawack, Eli Lilly, Ecancer, Boehringer Ingelheim, BMS, AstraZeneca, OncologyEducation, RMEI, Mirati; Financial Interests, Personal, Other, Associate Editor Annals of Oncology: Elsevier; Financial Interests, Institutional, Invited Speaker, MERMAID-1: AstraZeneca; Financial Interests, Institutional, Invited Speaker, MERMAID-2, POSEIDON, MYSTIC: AstraZeneca; Financial Interests, Institutional, Invited Speaker, Clinical Trial Steering committee CheckMate 743, CheckMate 73L, CheckMate 331 and 451: BMS; Financial Interests, Institutional, Invited Speaker, RELATIVITY 095: BMS; Financial Interests, Institutional, Invited Speaker, BGB-A317-A1217-301/AdvanTIG-301: Beigene; Financial Interests, Institutional, Invited Speaker, Clinical Trial Chair ZEAL-1: GSK; Financial Interests, Institutional, Invited Speaker, Clinical Trial steering Committee PEARLS, MK-7684A: MSD; Financial Interests, Institutional, Invited Speaker, Clinical Trial Steering Committee SAPPHIRE: Mirati; Financial Interests, Institutional, Invited Speaker, LAGOON: Pharma Mar; Financial Interests, Institutional, Invited Speaker, phase 1/2 trials: Phosplatin Therapeutics; Financial Interests, Institutional, Invited Speaker, Clinical Trial Chair Skyscraper-01; chair ALEX; steering committee BFAST; steering committee BEAT-Meso; steering committee ImPower-030, IMforte: Roche/Genentech; Financial Interests, Institutional, Invited Speaker, Phase 2 Inupadenant with chemo: iTeos; Non-Financial Interests, Officer, ESMO President 2020-2022: ESMO; Non-Financial Interests, Officer, Council Member & Scientific Committee Chair: ETOP/IBCSG Partners; Non-Financial Interests, Officer, Vice-President Lung Group: SAKK; Non-Financial Interests, Other, Involved in Swiss politics: Swiss Political Activities; Non-Financial Interests, Officer, President and Council Member: Ballet Béjart Lausanne Foundation; Non-Financial Interests, Principal Investigator, Involved in academic trials: ETOP / EORTC / SAKK; Non-Financial Interests, Member: Association of Swiss Physicians FMH (CH), ASCO, AACR, IASLC; Non-Financial Interests, Leadership Role, ESMO President: ESMO; Non-Financial Interests, Member, Vice-President Lung Group: SAKK; Non-Financial Interests, Leadership Role, Vice -President: SAMO; Non-Financial Interests, Member, Association of Swiss interns and residents: ASMAC/VSAO. All other authors have declared no conflicts of interest.