PD-1 blockade may not adversely affect COVID-19 outcomes
medwireNews: Treatment with PD-1 inhibitors does not appear to worsen the severity of SARS-CoV-2 infection in patients with lung cancer, suggests a single-center analysis.
As reported in Cancer Discovery, there was no significant difference in outcomes such as hospitalization or mortality rates among patients who did versus did not have a history of PD-1 blockade.
The researchers therefore write: “These initial results are promising for the safety of continued use of PD-1 blockade during the COVID-19 pandemic.
“Further follow up and expanded sample sizes are needed to confirm long term safety and generalizability of our findings. Universal screening efforts are needed to further determine how PD-1 blockade may impact susceptibility to COVID-19.”
Matthew Hellmann and colleagues, from the Memorial Sloan Kettering Cancer Center in New York, USA, identified 69 lung cancer patients who received a laboratory-confirmed diagnosis of SARS-CoV-2 at their institution between 12 March and 13 April 2020.
The median age of the participants was 69 years, just over half (52%) were women, 64% had a smoking history of 5 pack–years or more, 80% had active or metastatic disease, while 93% had a diagnosis of non-small-cell lung cancer.
There was no significant difference between the 59% of patients who had previously received PD-1 inhibitor therapy and the 41% who had not with regard to the rates of hospitalization or death, at 68% versus 56% and 28% versus 18%, respectively.
This was also the case for a composite endpoint of admission to an intensive care unit, intubation, or transition to do not intubate status, at a rate of 38% for PD-1 inhibitor-treated patients compared with 35% for those who had not received PD-1 inhibitors.
The findings were similar when patients in the PD-1 inhibitor group were stratified by time since exposure, with the three subgroups being those who had received their most recent dose within 6 months or 6 weeks, and those who received their first dose within 3 months.
Hellmann and co-researchers note that univariate analysis indicated a numerical increase in the risk for COVID-19 severity outcomes with PD-1 inhibitor use, but the odds ratios “all diminished to approximately 1” after adjustment for smoking status.
They also report that at the time of data analysis, nearly two-thirds (62%) of the total study cohort had required hospitalization and almost a quarter (24%) had died.
“These findings from our patients at a single center in New York City add to evidence, supported by reports of outcomes of mostly hospitalized patients with cancer from Hubei province, throughout China, and a cohort largely from northern Italy, that patients with lung cancers are a particularly vulnerable population with high rates of severe COVID-19,” conclude the study authors.
medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature Group
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