Abstract 1393P
Background
To explore the risk of SARS-CoV-2-related mortality in NSCLC patients treated with first-line immune-oncology (IO) alone or with chemotherapy (CT).
Methods
We retrospectively reviewed clinical outcomes of 63 patients, with high or any PD-L1 tumour expression, undergoing first-line IO (n=39) or CT+IO (n=24), aiming to describe the mortality rate, death-related causes and dead patients’ clinical characteristics.
Results
The risk of SARS-CoV-2-related mortality was significantly higher in CT+IO compared to IO-treated patients (HR 4.05, p=0015), with SARS-CoV-2 as cause of death in a 37.5% of cases vs. 0% (p=0.06) between the two groups, respectively (Table). Patients who died from SARS-CoV-2 had higher age and performance status (PS), smoking history, higher baseline values of both neutrophil-to-lymphocyte ratio (NLR) and systemic inflammatory index (SII). Table: 1393P
| First-line treatment of NSCLC (no. 63) | P value | ||
| Patients, no. | IO = 39 (62%) | CT+IO = 24 (38%) | |
| FU, median (95% CI) | 19.4 (15.4-23.4) | 10.5 (10.3-10-7) | |
| Death rate, No. (%) | 8 (21%) | 8 (33%) | |
| Death rate, HR (95%) | 1.0 | 4.05 (1.31-12.56) | 0.015 |
| Deaths, causes: PD Chest infection COVID-19 | 6 (75%) 2 (25%) 0 (0%) | 5 (62.5%) 0 (0%) 3 (37.5%) | |
| Dead patients’ features (no. 16) | |||
| IO a (No. 8) | IO+CT a (No. 5) | IO+CT b (No. 3) | |
| Age | 70 (65-78) | 67 (52-79) | 75 (75-79) |
| PS: 0 1 | 3 (37.5%) 5 (62.5%) | 4 (80%) 1 (20%) | 1 (33%) 2 (67%) |
| Smoking: current former | 7 (87.5%) 1 (12.5) | 2 (40%) 3 (60%) | 2 (67%) 1 (33%) |
| NLR c | 3.4 | 2.6 | 4.5 |
| SII c | 1169 | 735 | 1610 |
FU: Follow Up; No: Number; PD:Progressive Disease. aNot SARS-CoV-2-related. bSARS-CoV-2-related. cValue (range)
Conclusions
In our limited series, IO had a scarce impact on the risk of SARS-CoV-2-related mortality, whilst CT, older age, PS 1 and a baseline pro-inflammatory systemic profile could be associated with a higher risk.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.