medwireNews: Data presented at the 2020 AACR Virtual Annual Meeting I add to the growing body of evidence to suggest that people with cancer have more severe outcomes when infected with SARS-CoV-2 than those without cancer.
The study, by Hongbing Cai (Zhongnan Hospital of Wuhan University, China) and colleagues, which was simultaneously published in Cancer Discovery, shows that patients with metastatic, hematologic, or lung cancer are at particularly high risk for death, intensive care unit (ICU) admission, development of severe/critical symptoms, and the need for invasive mechanical ventilation.
The findings build on early data previously reported by medwireNews suggesting that older age was the only risk factor for worse COVID-19 outcomes among people with cancer.
Among 105 patients admitted to 14 hospitals in Hubei Province, China between 1 January and 24 February 2020, 21.0% had lung cancer, 12.4% had gastrointestinal cancer, 10.5% had breast cancer, 10.5% had thyroid cancer, 8.6% had hematologic cancer, and the remainder had other types of cancer.
Compared with 536 individuals without cancer who were matched for age, hospital location, and time of hospitalization, the individuals with cancer had a significant 2.52-fold higher risk for experiencing any type of severe event while in hospital.
More specifically, the odds ratios for ICU admission, utilization of invasive mechanical ventilation, death, and development of severe symptoms were a significant 3.13, 2.71, 2.17, and 1.99, respectively, among the patients with versus without cancer, after accounting for age, sex, smoking, and comorbidity.
Cai and team also analyzed the data by cancer type and found that individuals with hematologic cancers had the highest risk for severe outcomes, with a significant 6.30-fold increase relative to those without cancer, followed by people with lung cancer who had a 2.59-fold increased risk.
In addition, people with metastatic cancer had a significant 2.48-fold increased risk for severe outcomes overall, relative to no cancer, whereas those with nonmetastatic cancer did not have a significantly increased risk.
Treatment type also impacted the risk for severe outcomes, with surgery and immunotherapy both associated with a significantly increased risk, at hazard ratios of 6.22 and 4.82, respectively. By contrast, individuals who received radiotherapy were no more likely to experience severe events than patients without cancer.
However, the researchers note that the immunotherapy data should be interpreted with caution because only six patients in the current study had received this treatment.
Speaking at the meeting, Cai concluded that the findings suggest that “[i]ndividualized treatment plans need to be developed based on the tumor types and stages of patients by clinicians.”
She suggested that, in COVID-19 outbreak areas, “appropriately postponing […] surgery should be considered” for patients with cancer, whereas radiotherapy could be initiated as planned “with intensive protection and surveillance.”
medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature Group
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2020 AACR Virtual Annual Meeting I; 27–28 April
Cancer Discov 2020; doi:10.1158/2159-8290.CD-20-0422