ASCO’20 Scientific Program held a Special Session about the impact of COVID-19 pandemic on the management of cancer patients. Cancer patients have higher risk for complications from COVID-19, however it is not clear that anti-cancer treatments increase that risk.
ASCO’20 Annual Meeting had a session dedicated to the impact of the pandemic in the management of cancer patients: “Cancer Care in the Time of COVID: Assessing Impact and Future Directions”.
In this special session, the results of two international collaborative studies were presented, bringing new information about this topic. These data will help clinicians on decision making, that before this was only based on opinion of experts, information from smaller studies or impact on cancer patients from other infectious diseases.
Dr. Jeremy Lyle Warner, from Venderbilt University Medical Center and first author of the abstract (LBA110), presented the COVID-19 and Cancer Consortium (CCC19), a consortium aiming to collect organised information on people with cancer who are diagnosed with COVID-19. This analysis included 928 cancer patients with COVID-19, mostly from the United States of America (87%), and reported a mortality of 13%. The authors conclude that patients with active cancer and COVID-19 have higher rates of mortality and complications. Male sex, older age and smoking habits are associated with higher risk of mortality. Interestingly, as opposed to what was hypothesised by many, chemotherapy, or other anti-cancer treatments with potential negative influence on immunity, were not associated with higher risk. The study was published on The Lancet journal.
The other study from TERAVOLT: Thoracic Cancers International COVID-19 Collaboration (LBA111), was presented by Dr. Leora Horn, also from Vanderbilt University Medical Center. This study focused on patients with thoracic malignancies, subgroup of cancer patients considered to be in higher risk for COVID-19, reporting a higher mortality of 35.5%. The authors also conclude that these cancer patients, in particular those with older age, have higher risk for COVID-19 mortality. However, contrarily to CCC19, they found that administration of chemotherapy prior to infection with the new coronavirus was associated with worst clinical prognosis, effect that was not found for other anti-cancer treatments, such as immunotherapy. The study was published on The Lancet Oncology journal.
Taking into account the contradictory findings regarding the impact of anti-cancer treatments on the severity of the COVID-19, another recently published study including the largest European series of 890 cancer patients - OnCovid registry - concludes that anti-cancer treatments at COVID-19 diagnosis (chemotherapy, endocrine, targeted therapy and immunotherapy) did not worsen mortality. However, this study also reinforces the higher risk of cancer patients for severe COVID-19, reporting a mortality of 33.6%. This study was published on the Cancer Discovery journal.
In summary, these studies show that cancer patients have higher COVID-19 mortality, particularly those who are male, older, and have more comorbidities and active cancer. However, it seems that anti-cancer treatments are not associated with higher COVID-19 mortality, thus they should be continued whenever they are needed and it is considered to be safe.