1231P - Machine learning prediction of the case-fatality of COVID-19 and risk factors for adverse outcomes in patients with non-small cell lung cancer

Background

Since the emergence of Coronavirus-2019 (COVID-19) across the globe, patients with cancer have been found to have an increased risk of infection with COVID-19 and are highly likely to experience a severe disease course. This study analyzed the clinical outcomes of COVID-19 in patients with non-small cell lung cancer (NSCLC) and identified the risk factors for adverse outcomes.

Methods

This study analyzed the case-fatality rate and risk factors for COVID-19 among NSCLC patients diagnosed between January 2020 and April 2022 at the Samsung Medical Center, using a machine-learning prediction method. Additionally, the study investigated the effect of COVID-19 on the systemic treatment of patients with advanced-stage NSCLC.

Results

Overall,1,127 patients were included in this study, with 10.3% of the patients being older than 75; of these patients, 51.8% were ex- or current smokers. Among the 584 cured after surgery, 91 had stable disease after concurrent chemo-radiotherapy, and 452 had recurrent or metastatic NSCLC. Of the 452 patients, 387 received palliative systemic treatment during COVID-19, including 188 receiving targeted therapy, 111 receiving cytotoxic chemotherapy, 62 receiving immunotherapy +/- chemotherapy, and 26 receiving other agents. Out of these, 94.6% continued systemic treatment after COVID-19, only one patient discontinued due to complications, and 18 changed their treatment due to disease progression. The case fatality rates were 0.86% for early-stage NSCLC, 4.4% for locally advanced NSCLC, and 9.95% for advanced NSCLC. The factors associated with fatalities included palliative chemotherapy, age (≥75), diabetes, smoking history, lung radiotherapy, hypertension, sex, and COPD. The model using logistic regression and eXtreme gradient boosting performed well (AUC for both = 0.84).

Conclusions

NSCLC patients had a case fatality rate of 4.8% and most continued systemic treatment despite COVID-19. However, those with risk factors need close attention for managing COVID-19 complications.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

M. Ahn: Financial Interests, Personal, Advisory Board: AstraZeneca, Takeda, MSD, Yuhan, Amgen, Alpha Pharmaceutical, Janssen, BMS, Roche, Daiichi Sankyo, Merck, Boronoi. S. Lee: Financial Interests, Personal, Advisory Board: AstraZeneca/MedImmune, Roche, Merck, Pfizer, Lilly, BMS/Ono, Takeda, Janssen, IMBdx; Financial Interests, Personal, Invited Speaker: AstraZeneca/MedImmune, Roche, Merck, Lilly, Amgen; Financial Interests, Institutional, Research Grant: Merck, AstraZeneca, Lunit. All other authors have declared no conflicts of interest.