Abstract 1726P
Background
Cancer patients (pts) have been associated with severe SARS-CoV2 infection and higher mortality compared with the general population. This could be related to the limitation of therapeutic effort based on their prognosis and healthcare prioritization towards non-cancer pts. The oncologist’s role could be crucial for providing high-quality care. We aim to assess the impact of oncologists (ONC) on COVID-19 management.
Methods
Multicentre retrospective analysis of cancer pts diagnosed with COVID-19 between Mar-Apr 2020. We classified pts according to an estimated life expectancy (based on tumor/stage/line) in 3 groups: favourable group (FG) mOS >5 years (y), intermediate (IG) 1-5y and poor (PG) <1y. We studied COVID-19 management based on oncologist’s involvement: mainly-ONC vs. mainly other specialists (Other). Primary endpoint: COVID-19 30-day mortality (early-M). Secondary outcomes: intensive care unit admission (ICUa), the incidence of acute respiratory distress syndrome (ARDS) and antiretroviral treatment (ARVt) and immunomodulatory drugs (ImD) administered.
Results
287 pts were enrolled, median age 69 (35-98), 52% male, 67% with an active tumor (of them 76% had advanced stage). Mostly thoracic tumors (26%), followed by gastrointestinal (21%) and breast (19%). Among 170 pts under treatment, 89 (52%) received chemotherapy (CHT). By prognostic group: 49% were included in FG (n=135), 40% in IG (n=113), and 11% in PG (n=30). Overall early-M rate was 27% (ONC 22% vs. Other 27%). Prognostic groups were associated with early-M: 19% (FG) vs. 31% (IG) vs. 37% (PG) (p=0.022). No significant differences regarding rate of ARDS (23% FG vs. 19% IG vs. 17% PG). The ONC-group (n=18) included 4 PG and 14 IG, 94% had an advanced stage disease, 83% receive CHT and 65% had PS≥2 (p=0.05 compared to Other group). In IG (ONC vs. Other): 7% vs. 2% ICUa, 100% vs. 34% ARVt and 57% vs. 7% ImD (all p<0.001). In PG (ONC vs. Other): 25% vs. 0% ICUa, 75% vs. 34% ARVt and 25% vs. 0% ImD (all p<0.001). Finally, FP managed only by Other: 13% ICUa; 33% ARVt and 13% ImD.
Conclusions
Oncologist mostly treated complex pts compared to other specialists. During COVID-19 crisis, setting prognostic groups helped to individualized therapeutic approaches, reflected by less mortality rate and no differences in terms of complications.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Aleix Prat.
Funding
Has not received any funding.
Disclosure
L. Ghiglione: Licensing/Royalties: Hibor; Licensing/Royalties: Kyowa Kirin; Licensing/Royalties: Vifor Pharma. E. Auclin: Travel/Accommodation/Expenses: Mundipharma; Licensing/Royalties: Sanofi Genzymes. S. Pilotto: Licensing/Royalties: AstraZeneca; Eli-Lilly; BMS;: Boehringer Ingelheim; MSD; Roche. A. Prat: Research grant/Funding (institution), Licensing/Royalties: Roche; Advisory/Consultancy, Research grant/Funding (institution), Licensing/Royalties: Pfizer; Novartis; Amgen; Licensing/Royalties: BMS; Research grant/Funding (institution), Licensing/Royalties: Daiichi Sankyo; Advisory/Consultancy: Puma; Oncolytics Biotech; MSD; Advisory/Consultancy, Research grant/Funding (institution): Lilly; Research grant/Funding (institution), Licensing/Royalties: Nanostring technologies; Officer/Board of Directors: Beast International Group (BIG); Solti's Foundation; Actitud frente al cancer Foundation; Solti; Research grant/Funding (institution): Boehringer; Sysmex Europa GmbH; Medica Scientia inno. Research, SL; Celgene, SLU; Astellas Pharma. L. Mezquita: Research grant/Funding (self), Travel/Accommodation/Expenses, Licensing/Royalties: Bristol-Myers Squibb; Licensing/Royalties: Tecnofarma; Licensing/Royalties, International Mentorship Program: AstraZeneca; Advisory/Consultancy, Travel/Accommodation/Expenses, Licensing/Royalties: Roche; Advisory/Consultancy: Roche Diagnostics; Research grant/Funding (self): Boehringer Ingelheim. All other authors have declared no conflicts of interest.