Factors such as pre-existing lung damage, smoking, advanced age, and comorbidities make patients with chest cancers, such as lung cancer, especially vulnerable to COVID-19. These findings, presented during the American Society of Clinical Oncology (ASCO) 2020 Annual Meeting, which should have been held during these days in Chicago, provide some ideas on the results for cancer patients who develop covid-1, he points out. ASCO President Howard A. Burris.
The study shows that previous use of chemotherapy, alone or in combination with other treatments, in patients with lung cancer and other thoracic cancers diagnosed with covid-19, was associated with an increased risk of death. Data are from the covid international collaborative registry for thoracic cancer (TERAVOLT) and are the latest available.
In the population analyzed, 400 patients with thoracic cancers also diagnosed with covid-19, those treated with chemotherapy within three months after the diagnosis of covid-19 had a significantly higher risk (64%) of dying from the virus.
These findings, presented during the 2020 Annual Meeting of the American Society of Clinical Oncology (ASCO), which should have been held during these days in Chicago
The data is relevant because it provides a better understanding of the risk factors associated with poor outcomes in patients with thoracic cancer who develop covid-19.
As lead author Leora Horn of Vanderbilt University points out, “We have seen that clinical trials are funded, approved and begin to enroll patients in a matter of weeks, when it may take months or years to get trial approval so far” .
Research indicates that only patients treated with chemotherapy (alone or in combination with other therapies) within 3 months of covid-19 diagnosis had a significantly higher risk (64%) of dying from the virus compared to patients who did not receive chemotherapy. Of the 144 patients who died, 79.4% (112) died from covid-19 and 10.6% (15) from cancer.
Patients with thoracic malignancies, which include lung cancer, mesothelioma, thymic malignancies, and carcinoid tumors, are considered high risk given their advanced age, multiple comorbidities, and pre-existing lung damage, among other factors.
The study also found that treatment with anticoagulants (drugs that prevent blood clotting) and corticosteroids (drugs that reduce inflammation) before covid-19 were also associated with an increased risk of death. Doctors had already raised their reservations about corticosteroid use and the risk of coronavirus 2 infection of severe acute respiratory syndrome (SARS-CoV-2) and the severity of covid-19.
Corticosteroid treatment prior to infection with the SARS-CoV-2 virus was associated with a 1.5-fold increased risk of death in patients with chest cancer.
In this work, corticosteroid treatment prior to SARS-CoV-2 virus infection was associated with a 1.5-fold increased risk of death in patients with chest cancer, compared with patients who did not receive corticosteroids, after controlling for a number of other factors.
The findings regarding prior anticoagulant treatment are also relevant, because published reports of coagulation in patients with covid-19 have led some physicians to recommend anticoagulant prophylaxis in all patients with this disease. However, since there were so few patients, more data will be needed to understand how covid-19 affects coagulation in patients with chest cancer.
As for the type of treatment administered specifically for covid-19, this did not appear to affect a patient’s risk of death. Patients received anticoagulants, antibiotics, antivirals, antifungals, corticosteroids, drugs directed at IL-6, and hydroxychloroquine.
As more data is collected, the registry findings are intended to provide information on the management of thoracic cancer and covid-19 in patients with both diseases. Data collection is ongoing, and further analyzes are planned to examine patient and provider perceptions of the impact of covid-19 on cancer care. .