medwireNews: People with cancer receiving immunotherapy (IO) or other anticancer treatments are at increased risk for adverse COVID-19 outcomes if they are also receiving immunosuppressive therapy, suggests a registry-based cohort study.
“[T]his represents the largest cohort with comprehensive clinical and biological data of patients with cancer and COVID-19 treated with IO reported so far, helping to evaluate the influence of IO and immunosuppression on patient outcomes and cytokine storm,” say the researchers who drew on the COVID-19 and Cancer Consortium (CCC19) registry for their study.
Of the 12,046 patients (median age 65 years) with a current or past diagnosis of cancer and laboratory-confirmed SARS-CoV-2 infection reported to the registry between March 2020 and May 2022, 5.0% had received IO within 3 months before the COVID-19 diagnosis, 35.9% had received non-IO agents, and 59.1% had not received any anticancer therapy.
In the overall cohort, there was no significant difference between the IO, non-IO, and untreated groups with respect to the severity of COVID-19 or incidence of cytokine storm.
But a multivariable analysis stratified by baseline immunosuppression showed that patients receiving both IO and immunosuppressive therapy had a significantly higher risk for poor COVID-19 outcomes and cytokine storm, at adjusted odds ratios (ORs) relative to untreated patients of 3.33 and 4.41, respectively.
The risks for adverse COVID-19 outcomes and for developing cytokine storm were also increased, albeit to a lesser degree, for individuals with baseline immunosuppression receiving non-IO therapies, with significant adjusted ORs of 1.79 and 2.32, respectively.
No such associations were observed among participants without baseline immunosuppression, note Toni Choueiri, from Dana-Farber Cancer Institute in Boston, Massachusetts, USA, and co-investigators in JAMA Oncology.
And they add that the results were similar in the subset of patients with active cancer and in sensitivity analysis excluding those “who received a combination of cytotoxic chemotherapy and PD-(L)1 inhibitors in the IO group.”
Of note, vaccination against SARS-CoV-2 appeared to attenuate the risk for adverse COVID-19 outcomes and cytokine storm, such that there was no significant difference between individuals with and without baseline immunosuppression.
“The findings of this study help better characterize the association of IO with poor COVID-19 outcomes in relation to immunosuppression among patients with cancer, and also suggest that these agents are relatively safe to use among immunocompetent patients even during peaks of the pandemic,” conclude Choueiri and colleagues.
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group
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