medwireNews: The first results from the TERAVOLT registry of patients with thoracic cancer who acquire COVID-19 have been reported at the 2020 AACR Virtual Annual Meeting I.
The presenter Marina Garassino (Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy) explained that the registry was established in response to early data suggesting that cancer patients have an increased risk for worse outcomes and mortality as a result of SARS-CoV-2 infection.
She explained that the goals of TERAVOLT (Thoracic cancERs international coVid 19 cOLlaboraTion) “are to provide data for guidance to oncology professionals on managing patients with thoracic malignancies while understanding the risk factors for morbidity and mortality from this novel virus.”
The registry is open to thoracic cancer patients with a laboratory-confirmed diagnosis of symptomatic or asymptomatic COVID-19 and also to those with a suspected diagnosis based on clinical (symptoms and exposure) or radiologic features, said Garassino.
Reporting on the first 200 patients registered from eight countries, a milestone that was achieved in less than a month of inception, the presenter noted that the majority were male (70.5%) and current or former smokers (81.1%). Most (73.5%) had stage IV disease at the time of COVID-19 diagnosis and 75.5% had non-small-cell lung cancer, while 14.5% had small-cell lung cancer.
Comorbidities were common in these patients, observed in 83.8%, with hypertension and chronic obstructive pulmonary disease the most frequent, at 47.0% and 25.8%, respectively.
Nearly three-quarters (73.9%) of the patients were receiving systemic cancer treatment, including chemotherapy (32.7%), immunotherapy (23.1%), tyrosine kinase inhibitor therapy (19.0%), combination chemotherapy and immunotherapy (13.6%), or other therapy (11.6%).
The most common symptoms of COVID-19 at presentation were fever (>37.5°C; 64.1%), dyspnea (53.5%), cough (52.0%), and fatigue (27.3%), which overlap with symptoms of lung cancer, thereby making “the differential diagnosis in these patients very challenging,” noted Garassino.
In terms of COVID-19 outcomes, 79.6% of patients had viral pneumonia, 76.0% needed to be hospitalized, 26.8% experienced acute respiratory distress syndrome, and 34.6% died, which Garassino described as an “unexpectedly high mortality” rate.
She also highlighted that just 8.8% were admitted to an intensive care unit (ICU), with many patients not offered ICU admission possibly due to shortages and institutional rules, and 2.5% received mechanical ventilation.
Neither specific comorbidities nor tumor or therapy type were significantly associated with increased mortality risk in multivariable analysis. But Garassino pointed out the short follow-up duration and selected population as limitations of the study.
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2020 AACR Virtual Annual Meeting I; 27–28 April