key: cord-0745537-22ewvopl
authors: Ascierto, P. A.; Secrest, M. H.; Lambert, P.; Sarsour, K.; Tan, A.; Walls, R.; Reddy, J.; Seetasith, A.; Shenison, D.; Ngwa, I.; Yun, C.; Zhang, Q.
title: 1574P Mortality of 1,636 COVID-19 cancer patients (pts) and associated prognostic factors
date: 2021-09-30
journal: Annals of Oncology
DOI: 10.1016/j.annonc.2021.08.1567
sha: 094a8a021f41bb4d07045669665f92df610a2fb5
doc_id: 745537
cord_uid: 22ewvopl

Background: We assessed mortality risk by COVID-19 (C19) infection among treated cancer patients (pts) and the impact of anti-cancer treatment (tx) on mortality. Methods: Optum de-identified Electronic Health Record dataset (2021-01-07 release) were used to find cancer pts with a C19 positive (ICD-9/10-CM codes U071/U072 or positive test result) or negative (negative test and no positive test at any time after the first negative result) status on the first test/diagnosis date (ie the “index date”). Pts with <1 year database history, with no tx 0-90 days before index, <18 years old, with implausible death dates, and with index dates outside of 02/2020 - 11/2020 were excluded. C19 positive and negative pts were exact-matched on cancer type, then 1:1 nearest-neighbor matched on propensity scores (variables in table). Missing values were imputed (n = 5), and outcomes were evaluated by multivariable logistic regression, including interaction terms between tx and C19 positivity. Results: We identified 21,060 pts, of whom 1,636 (7.8%) were positive for C19 and 19,424 (92.2%) negative. Among 1,636 matched pairs of positive/negative C19 pts, the odds ratio (OR) of 30-day mortality comparing C19 positive vs negative patients was 2.14 (95% CI: 0.71 – 6.52). Among the strongest predictors of 30-day mortality were age 75+ (OR = 5.42, 95% CI: 2.21 – 13.28), inpatient C19 testing/diagnosis (OR = 4.78, 95% CI: 3.04, 7.53), CCI of 3+ (OR = 2.24, 95% CI: 1.30 – 3.89), and metastatic disease (OR = 1.80, 95% CI 1.21 – 2.68). Anti-cancer therapies do not appear to modulate risk of death due to C19. Beyond 30-day mortality, matched mortality rate ratios (MRRs) suggested increased risk for C19 positive patients (MRR = 1.85, 95% CI: 1.26 – 2.44). [Formula presented] Conclusions: C19 showed a trend towards increased 30-day mortality risk (not statistically significant), and increased overall mortality risk. Specific tx did not appear to modulate 30-day mortality due to C19. Legal entity responsible for the study: Genentech, Inc. Funding: Roche/Genentech. Disclosure: P.A. Ascierto: Financial Interests, Personal, Advisory Board: Bristol Myers Squibb, Roche-Genentech, Merck Sharp & Dohme, Novartis, Array, Merck Serono, Pierre-Fabre, Incyte, Medimmune, AstraZeneca, Syndax, Sun Pharma, Sanofi, Idera, Ultimovacs, Sandoz, Immunocore, 4SC, Alkermes, Italfarmaco, Nektar, Boehringer Ingelheim;Financial Interests, Personal, Research Grant: Bristol Myers Squibb, Roche-Genentech, Array, Sanofi;Financial Interests, Personal, Other: MSD;Non-Financial Interests, Personal, Advisory Board: TAKIS. M.H. Secrest: Financial Interests, Personal, Full or part-time Employment: Roche/Genentech;Financial Interests, Personal, Stocks/Shares: Roche. P. Lambert: Financial Interests, Personal, Full or part-time Employment: Genentech/Roche;Financial Interests, Personal, Stocks/Shares: Roche. K. Sarsour: Financial Interests, Personal, Full or part-time Employment: Roche/Genentech;Financial Interests, Personal, Stocks/Shares: Roche. A. Tan: Financial Interests, Personal, Full or part-time Employment: Roche/Genentech;Financial Interests, Personal, Stocks/Shares: Roche. R. Walls: Financial Interests, Personal, Full or part-time Employment: Hoffmann-La Roche;Financial Interests, Personal, Stocks/Shares: Hoffmann-La Roche. J. Reddy: Financial Interests, Personal, Full or part-time Employment: Roche/Genentech;Financial Interests, Personal, Stocks/Shares: Roche. A. Seetasith: Financial Interests, Personal, Full or part-time Employment: Genentech, Inc.;Financial Interests, Personal, Stocks/Shares: Roche. D. Shenison: Financial Interests, Personal, Full or part-time Employment: Roche/Genentech;Financial Interests, Personal, Stocks/Shares: Roche, Cigna. I. Ngwa: Financial Interests, Personal, Full or part-time Employment: F. Hoffmann - La Roche Ltd;Financial Interests, Personal, Stocks/Shares: F. Hoffmann - La Roche Ltd. C. Yun: Financial Interests, Personal, Full or part-time Employment: Genentech, Inc.;Financial Interests, Personal, Stocks/Shares: Roche. Q. Zhang: Financial Interests, Personal, Full or part-time Employment: Roche/Genentech;Financial Interests, Personal, Stocks/Shares: Roche, Regeneron, BMS, AbbVie, AC Immune.

First wave mortality data versus full pandemic period from the COVID-CANCER HUIL study Background: Cancer patients are one of the most affected by the current pandemic caused by SARS-CoV-2. Social inequalities influence the incidence rate of this disease, as we have seen in the high incidence in our center. In our study, we asked whether the last covid-19 treatment advances, the capacity for restructuring the health centers and their non-saturation, influences the cancer patients outcomes.

Methods: Retrospective review of 189 cancer patients diagnosed in our center with COVID-19 from March 5, 2020 to February 28, 2021. Study data was collected and managed using REDCap. We compared COVID-19 diagnoses in first-wave cancer patients versus the full pandemic period until data cut-off, as well as patient characteristics and mortality rates. Conclusions: In our center, one of the worst hit by the coronavirus crisis in Spain, with a supersaturation of almost 250% in the middle of the first wave, we have verified how the knowledge of the behavior of this disease, improvements in its treatment and a multidisciplinary management in Oncology ward have led to a significant decrease in mortality, going from almost 50% in the first wave to less than 15%, despite having suffered the disease during the two subsequent waves a greater number of patients with metastatic disease. Conclusions: C19 showed a trend towards increased 30-day mortality risk (not statistically significant), and increased overall mortality risk. Specific tx did not appear to modulate 30-day mortality due to C19.

Legal entity responsible for the study: Genentech, Inc.

Funding: Roche/Genentech. Results: The total number of patients presenting with COVID-19 was higher in wave two (1135 vs 626). 207 of these patients had cancer, and were matched to 452 patients without cancer from both waves. There was a significantly improved chance of mortality in wave 2 (HR 0.41, p < 0.0001). When adjusting for age, sex and comorbidities, cancer was an independent risk factor for mortality amongst patients hospitalised with COVID-19 in wave 1 (HR 1.62, p ¼ 0.02), but not in wave 2. There was a trend towards improved survival for hospitalised patients in wave 2 receiving COVID-19 specific treatment including dexamethasone, remdesivir, tocilizumab (HR 0.75, p ¼ 0.086). For the combined cancer cohort, SACT was an independent predictor of mortality, as was metastatic disease. Conclusions: The mortality for both cancer and non-cancer patients improved between waves of the pandemic. Advances in detection, prevention and treatment may account for this. Cancer was no longer a risk factor for mortality in the second wave, however SACT and metastatic cancer remained risk factors for mortality within the cancer cohort. This emphasises the need for ongoing protection of patients with advanced cancer and those on SACT, including through their prioritisation for COVID-19 vaccination globally.

Legal entity responsible for the study: The authors.

Funding: Has not received any funding.

Disclosure: H. Shaw: Financial Interests, Personal, Invited Speaker, Advisory/Consultancy: Novartis;

Advisory/Consultancy: BMS; Financial Interests, Personal, Invited Speaker, Advisory/Consultancy: MSD; Financial Interests, Personal, Invited Speaker, Advisory/Consultancy: Immunocore; Financial Interests, Personal, Invited Speaker, Advisory/Consultancy: Idera; Financial Interests, Personal

Financial Interests, Personal, Invited Speaker, Advisory/Consultancy: Sanofi Genzyme/Regeneron

Advisory/Consultancy: Macrogenics; Financi Interests, Personal, Invited Speaker, Advisory/Consultancy: Roche. R. Roylance: Financial Interests, Personal, Other, Personal Fees: Novartis; Financial Interests, Personal, Other, Personal Fees & None-financial support: Daiichi Sankyo; Financial Interests, Personal, Other, Personal Fees

Personal Fees: Pfizer; Financial Interests, Personal, Other, Personal Fees & None-financial support: G1 Therapeutics; Non-Financial Interests, Personal, Other, None-financial support: Roche; Non-Financial Interests, Personal, Other, None-financial support: AstraZeneca

1576P COVID-CANCER HUIL -Registry of oncological patients with diagnosis of COVID-19 at Hospital Universitario Infanta Leonor in

During the first year of the SARS-CoV-2 pandemic the management and treatment of COVID-19 have been improved. However, cancer patients continue to be one of the most affected. We evaluate the mortality rate due to COVID-19 and associated risk factors in the cancer population diagnosed in our center during the first year of pandemic. Methods: We retrospectively reviewed the medical records of 189 cancer patients who were diagnosed with COVID-19 between

Predominant cancer treatment: chemotherapy (63/189); 118/189 patients were receiving any type of oncological treatment with palliative intention. Mortality was associated with male gender (45/55 vs 10/55, p¼0.004), presence of comorbidities (48/55 vs 7/55, p¼0.01), lung cancer (28/72 deaths with this tumor vs 27/117 with the rest, p¼0.02), palliative intention cancer treatment (41/55 vs 12/55, p¼0.02), older median age (76 vs 71, p ¼ 0.02), higher median CRP (p¼115.6 mg/dl vs 46 mg/dl), lower median lymphocytes (600/mm3 vs 1000/mm3 p<0.001). No specific treatment against COVID-19 significantly decreased mortality. Neither IL-6 nor ferritin were prognostic biomarkers

Legal entity responsible for the study: Medical Oncology department, Hospital Universitario Infanta Leonor. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest

1577P Early mortality linked to COVID-19 in cancer patients as compared to historical control in pre-pandemic times

Oncoclínicas Group

The primary endpoint was 30-day mortality after isolation of the SARS-CoV-2 by RT-PCR. As historical control, we selected patients from Oncoclínicas Data Lake treated before December 2019 and propensity score-matched to COVID-19 cases (3:1) based on the following clinical characteristics: age, gender, tumor type, disease setting (curative or palliative)

total, 533 cancer patients with COVID-19 were prospectively registered in the database, with median age 60 years, 67% females, most frequent tumor types breast (34%), hematological (16%), gastrointestinal (15%), genitourinary (12%) and