899P - Impact of COVID-19 pandemic on treatment and survival in head and neck squamous cell carcinoma (HNSCC) patients (IMPACCT Study)

Background

Standard of care (SOC) treatment (ttm) of HNSCC patients (pts) was compromised and had to be adapted during the COVID-19 pandemic due to collapse of the healthcare system. The IMPACCT study evaluated the impact of COVID19 on ttm and outcome in pts diagnosed during the first-wave (Guillen, P. ASCO 2021, P6061). The 3-year follow-up results are presented.

Methods

Retrospective cohort analysis of newly diagnosed HNSCC pts from January to June 2020 treated with curative intent (CT20) at Institut Català d’Oncologia (ICO). A cohort treated during the same period at ICO from 2018 and 2019 was used as a control group (CG). Pts were followed until 3 years after diagnosis. Clinical characteristics were obtained from in-house prospective database. Ttm deviations from SOC per COVID-19 contingency protocol (CCP) in CT20 were collected. Recurrence-free survival (RFS) and overall survival (OS) rates from 6 to 36 months (m) were compared among cohorts by Log-rank test.

Results

A total of 306 pts were included: CT20=99; CG=207. Despite balanced disease characteristics, a lower proportion of pts underwent surgery as primary ttm in CT20 vs CG (47 vs 60%, p=0.04). In conservative treated pts, persistence disease rate was higher in CT20 vs CG (25 vs 10% p=0.03). CT20 had significantly lower RFS and OS rates only at 6 and 12m, when compared to CG (see table). Within CT20 pts, 39% had ttm modifications from SOC: 27% due to CCP (surgery to conservative ttm 13%, reduction of high-dose cisplatin to 2 cycles 10%, altered radiotherapy 2%, no induction/adjuvant ttm 2%) and 12% due to COVID-19 (delay of ttm start 9%, upstaging 3%). 3-year RFS nor OS did not differ in pts with ttm modifications vs unmodified ones (57 vs 43% p=0.2; 67 vs 55% p=0.1, respectively).

Table: 899P

Conclusions

The COVID-19 pandemic led to ttm modifications from SOC and had an early detrimental impact on RFS and OS when compared to prior years. Ttm modifications did not seem to explain survival differences. Further analyses are ongoing.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

J. Brenes Castro: Financial Interests, Personal, Advisory Role: Merck, Bristol Myers Squibb, Takeda; Financial Interests, Personal, Other, Travel/Accommodation: MSD, Merck, Bristol Myers Squibb, Transgene; Financial Interests, Personal and Institutional, Research Grant: GSK. M. Plana Serrahima: Financial Interests, Personal, Advisory Board: BMS; Financial Interests, Personal, Invited Speaker: MSD; Financial Interests, Institutional, Other: Nanobiotix. M. Oliva: Financial Interests, Personal, Invited Speaker: BMS, Merck, MSD; Financial Interests, Personal, Other, Teaching activities: Merck, MSD; Financial Interests, Personal, Advisory Board: Merck, MSD; Financial Interests, Personal, Writing Engagement: MSD; Financial Interests, Personal, Other, IDMC: Transgene; Non-Financial Interests, Institutional, Local PI: AbbVie, ALX Oncology, Ayala Therapeutics, Bayer, Boehringer Ingelheim, Debiopharm, Gilead, ISA Therapeutics BV, Merck, MSD, Roche, Seagen; Non-Financial Interests, Institutional, Funding: GSK; Non-Financial Interests, Personal and Institutional, Funding: Roche. All other authors have declared no conflicts of interest.