900P - COVID-19 in patients with head and neck cancers (HERODOTUS): An international, registry-based, cohort study

Background

We aimed to study the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on patients with head and neck malignancies and evaluate the efficacy of vaccination.

Methods

The Head and Neck cancERs international cOviD-19collabOraTion (HERODOTUS) registry is a multicentre observational study comprised of a retrospective component and a prospective cohort component. Eligibility criteria were the presence of any head and neck cancer (including salivary gland, thyroid, nasal and paranasal cancer) and a COVID-19 diagnosis. Clinical data were extracted from medical records of consecutive patients from November 1, 2019 until September 30, 2022. Associations between demographic or clinical characteristics and outcomes were measured by odds ratios (ORs) with 95% CIs using univariable and multivariable logistic regression; sex, age, smoking status, and HPV status (for oropharynx cancer) were the covariates included in the multivariable analysis. End points include mortality, hospitalization, symptomatic COVID-19 infection, asymptomatic COVID-19 infection, and delay in cancer therapy.

Results

395 COVID-19+ head and neck cancers were identified, out of which, there were 76 deaths. Univariable analyses revealed that age >63 years (OR 3.4, CI 1.9-5.9)); being a current or former smoker (OR: 2, CI: 1.1-2.8), having comorbidities (OR: 2.4, CI: 1.2-5), having a history of COPD (OR: 3.6, CI: 1.7-8), having squamous cell carcinoma (HNSCC) (OR: 4.3, CI: 1.8-10.2), or receiving treatment with chemotherapy and cetuximab (OR: 3.8, CI: 1.4-10.5) were associated with increased risk of death, whereas vaccination was protective (OR: 0.20,CI: 0.11 – 0.34). On multivariable analysis, age>63 yo (OR: 2.3, CI: 1.0-5.2), COPD (OR: 4.9, CI: 1.8-13.8), and chemotherapy with cetuximab (OR: 6.1, CI: 1.9-20) were associated with increased risk of death. Non-vaccinated HNSCC pts had an OR for death of 27.7 (CI: 6.2-122).

Conclusions

This is the largest, to our knowledge, cohort of patients with Head and Neck Cancer and COVID-19. The data show the negative impact of age, COPD and the chemotherapy plus cetuximab regimens on survival while vaccination was protective.

Clinical trial identification

NCT04632173.

Editorial acknowledgement

Legal entity responsible for the study

Hellenic Cooperative Oncology Group.

Funding

Hellenic Cooperative Oncology Group.

Disclosure

A. Psyrri: Financial Interests, Personal, Invited Speaker: MSD, Merck Serono; Financial Interests, Personal, Advisory Board: Pfizer, Sanofi, MSD, AstraZeneca, BMS, LEO, RAKUTEN, eTheRNA immunotherapies, Merck Serono; Financial Interests, Personal and Institutional, Local PI: AstraZeneca, Pfizer, GSK, GENESIS, Incyte, Amgen, Debiopharm, MSD, Jannsen, Lilly, Regeneron, Sanofi, BI, Roche, Peregrine, Oncolytics Biotech; Financial Interests, Coordinating PI: AstraZeneca; Financial Interests, Personal and Institutional, Steering Committee Member: Iovance, Pfizer, Roche; Financial Interests, Institutional, Steering Committee Member: KURA ONCOLOGY; Financial Interests, Steering Committee Member: KURA ONCOLOGY; Financial Interests, Personal and Institutional, Funding: KURA ONCOLOGY, BMS, Roche, DEMO, Amgen, BI, GENESIS, BMS, Pfizer, Oncolytics Biotech; Financial Interests, Institutional, Funding: Merck Serono, Pfizer; Financial Interests, Personal, Other, Educational activity: MEDSCAPE, PrimeOncology; Financial Interests, Institutional, Local PI: Novartis, Replimmune; Non-Financial Interests, Project Lead, Medical Education with honoraria: MEDSCAPE. R. Mesia Nin: Financial Interests, Personal, Advisory Board: Merck, MSD, Bayer, Seattle Genetics, Nanobiotix, Boehringer, Segean; Financial Interests, Personal, Invited Speaker: Merck, MSD, BMS; Non-Financial Interests, Principal Investigator, Clinical Trial PI: BMS; Non-Financial Interests, Principal Investigator, Observational trial PI: Merck. L.F.L. Licitra: Financial Interests, Personal, Advisory Board, for expert opinion in advisory boards: AstraZeneca, Bayer, BMS, Eisai, MSD, Merck–Serono, Boehringer Ingelheim, Hoffmann-La Roche Ltd, Novartis, Roche, Debiopharm International SA, Sobi, Incyte Biosciences Italy srl, Doxa Pharma srl, Amgen, Nanobiotics e GSK.; Financial Interests, Institutional, Research Grant, Funds received by my institution for clinical studies and research activities in which I am involved: AstraZeneca, BMS, Boehringer Ingelheim, Celgene International, Eisai, Exelixis, Debiopharm International SA, Hoffmann-La Roche ltd, IRX Therapeutics, Medpace, Merck–Serono, Merck Healthcare KGaA, MSD, Novartis, Pfizer, Roche, Buran.. All other authors have declared no conflicts of interest.