Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19

Csilla Várnai; Claire Palles; Roland Arnold; Helen M. Curley; Karin Purshouse; Vinton W. T. Cheng; Stephen Booth; Naomi A. Campton; Graham P. Collins; Daniel J. Hughes; Austin G. Kulasekararaj; Alvin J. X. Lee; Anna C. Olsson-brown; Archana Sharma-oates; Mieke Van Hemelrijck; Lennard Y. W. Lee; Rachel Kerr; Gary Middleton; Jean-baptiste Cazier; Sian Pugh; Pippa Corrie; Ahmed Bedair; Madeleine Hewish; Pauline Leonard; Jack Illingworth; Stephen Hibbs; Nicolaos Diamantis; Samah Massalha; Claire Fuller; Caroline Usbourne; Duncan Gilbert; Jennifer Davies; Tom Newsom-davis; Rachel Sharkey; Rebecca Lee; Ann Tivey; Rohan Shotton; Clare Griffin; Laura Horsley; Simon Shamas; Joseph J Sacco; Madbuba Choudhury; Jillian Noble; Heather Shaw; Rachel Bolton; Ana Ferreira; Peter Hall; Paul Ramage; Jaishree Bhosle; Alison Massey; Michaela Hill; Leena Mukherjee; Aisha Ghaus; Sarah Derby; Sean Brown; Sarah Lowndes; Saorise Dolly; Beth Russell; Charlotte Moss; Daniel Muller; Annet Pillai; Shakeel Lowe; Lucy Cook; Christopher Scrase; Rema Jyothirmayi; Ruth Board; Stephanie Cornthwaite; Shefail Parikh; Emma Cattell; Nicola Cox; Abigail Gault; Sam Moody; Caroline Dobeson; Mark Baxter; Tom Roques; Alexander Pawsey; Roderick Oakes; Lucinda Melcher; Olivia Chan; Sarah Ayers; Helen Bowyer; Mohammed Althohami; Sajjan Mittal; Laura Feeney; Avinash Aujayeb; Omar Sheikh; Sangary Kathirgamakarthigeyan; Victoria Woodcock; Francesca Holt; Simon Wyatt; Oliver Topping; Michael Tilby; Madhumita Bhattacharyya; Emma Burke; Shawn Ellis; Joseph Chacko; Taslima Rabbi; Michael Rowe; Rebecca Sargent; Christina Thirlwell; Jack Gibson; Robert Goldstein; Mathew Fittall; Spyridon Gennatas; Alicia Okines; James Best; Tania Tillett; Emily Renninson; Simon Grumett; Craig Barrington; Ruth Pettengell; Yingyying Peng; Julia Chackathayil; Akinfemi Akingboye; Helen Hollis; Ik Shin Chin; Vartika Bisht; Simon Hartley; Christopher P Middleton; Anshita Goel; Emily Protheroe; Paingfan Naksukpaiboon; Iris Anil; Joel Michell; Jamie D'costa; Anjui Wu; Diego Ottaviani; Gehan Soosaipillai; Myria Galazi; Neha Chopra; Sarah Benafif; Christopher Ct Sng; Sophia Yn Wong; Martin Scott-brown; Ellen Copson; Timothy Robinson; Zoe Hudson; Fiona Smith; Ali-abdulnabi Abdulnabi Mohamed; Angelos Angelakas; Leoni Eastlake; Ashley Poon-king; Clair Brunner; Amy Kwan; Alec Maynard; Hayley Boyce; Emma Spurrell; Rahul Peck; Bartlomiej Kurec

doi:10.1001/jamanetworkopen.2022.0130

Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19

Csilla Várnai, Claire Palles, Roland Arnold, Helen M. Curley, Karin Purshouse, Vinton W. T. Cheng, Stephen Booth, Naomi A. Campton, Graham P. Collins, Daniel J. Hughes, Austin G. Kulasekararaj, Alvin J. X. Lee, Anna C. Olsson-brown, Archana Sharma-oates, Mieke Van Hemelrijck, Lennard Y. W. Lee, Rachel Kerr, Gary Middleton, Jean-baptiste Cazier, Sian PughPippa Corrie, Ahmed Bedair, Madeleine Hewish, Pauline Leonard, Jack Illingworth, Stephen Hibbs, Nicolaos Diamantis, Samah Massalha, Claire Fuller, Caroline Usbourne, Duncan Gilbert, Jennifer Davies, Tom Newsom-davis, Rachel Sharkey, Rebecca Lee, Ann Tivey, Rohan Shotton, Clare Griffin, Laura Horsley, Simon Shamas, Joseph J Sacco, Madbuba Choudhury, Jillian Noble, Heather Shaw, Rachel Bolton, Ana Ferreira, Peter Hall, Paul Ramage, Jaishree Bhosle, Alison Massey, Michaela Hill, Leena Mukherjee, Aisha Ghaus, Sarah Derby, Sean Brown, Sarah Lowndes, Saorise Dolly, Beth Russell, Charlotte Moss, Daniel Muller, Annet Pillai, Shakeel Lowe, Lucy Cook, Christopher Scrase, Rema Jyothirmayi, Ruth Board, Stephanie Cornthwaite, Shefail Parikh, Emma Cattell, Nicola Cox, Abigail Gault, Sam Moody, Caroline Dobeson, Mark Baxter, Tom Roques, Alexander Pawsey, Roderick Oakes, Lucinda Melcher, Olivia Chan, Sarah Ayers, Helen Bowyer, Mohammed Althohami, Sajjan Mittal, Laura Feeney, Avinash Aujayeb, Omar Sheikh, Sangary Kathirgamakarthigeyan, Victoria Woodcock, Francesca Holt, Simon Wyatt, Oliver Topping, Michael Tilby, Madhumita Bhattacharyya, Emma Burke, Shawn Ellis, Joseph Chacko, Taslima Rabbi, Michael Rowe, Rebecca Sargent, Christina Thirlwell, Jack Gibson, Robert Goldstein, Mathew Fittall, Spyridon Gennatas, Alicia Okines, James Best, Tania Tillett, Emily Renninson, Simon Grumett, Craig Barrington, Ruth Pettengell, Yingyying Peng, Julia Chackathayil, Akinfemi Akingboye, Helen Hollis, Ik Shin Chin, Vartika Bisht, Simon Hartley, Christopher P Middleton, Anshita Goel, Emily Protheroe, Paingfan Naksukpaiboon, Iris Anil, Joel Michell, Jamie D'costa, Anjui Wu, Diego Ottaviani, Gehan Soosaipillai, Myria Galazi, Neha Chopra, Sarah Benafif, Christopher Ct Sng, Sophia Yn Wong, Martin Scott-brown, Ellen Copson, Timothy Robinson, Zoe Hudson, Fiona Smith, Ali-abdulnabi Abdulnabi Mohamed, Angelos Angelakas, Leoni Eastlake, Ashley Poon-king, Clair Brunner, Amy Kwan, Alec Maynard, Hayley Boyce, Emma Spurrell, Rahul Peck, Bartlomiej Kurec

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

Importance Large cohorts of patients with active cancers and COVID-19 infection are needed to provide evidence of the association of recent cancer treatment and cancer type with COVID-19 mortality.

Objective To evaluate whether systemic anticancer treatments (SACTs), tumor subtypes, patient demographic characteristics (age and sex), and comorbidities are associated with COVID-19 mortality.

Design, Setting, and Participants The UK Coronavirus Cancer Monitoring Project (UKCCMP) is a prospective cohort study conducted at 69 UK cancer hospitals among adult patients (≥18 years) with an active cancer and a clinical diagnosis of COVID-19. Patients registered from March 18 to August 1, 2020, were included in this analysis.

Exposures SACT, tumor subtype, patient demographic characteristics (eg, age, sex, body mass index, race and ethnicity, smoking history), and comorbidities were investigated.

Main Outcomes and Measures The primary end point was all-cause mortality within the primary hospitalization.

Results Overall, 2515 of 2786 patients registered during the study period were included; 1464 (58%) were men; and the median (IQR) age was 72 (62-80) years. The mortality rate was 38% (966 patients). The data suggest an association between higher mortality in patients with hematological malignant neoplasms irrespective of recent SACT, particularly in those with acute leukemias or myelodysplastic syndrome (OR, 2.16; 95% CI, 1.30-3.60) and myeloma or plasmacytoma (OR, 1.53; 95% CI, 1.04-2.26). Lung cancer was also significantly associated with higher COVID-19–related mortality (OR, 1.58; 95% CI, 1.11-2.25). No association between higher mortality and receiving chemotherapy in the 4 weeks before COVID-19 diagnosis was observed after correcting for the crucial confounders of age, sex, and comorbidities. An association between lower mortality and receiving immunotherapy in the 4 weeks before COVID-19 diagnosis was observed (immunotherapy vs no cancer therapy: OR, 0.52; 95% CI, 0.31-0.86).

Conclusions and Relevance The findings of this study of patients with active cancer suggest that recent SACT is not associated with inferior outcomes from COVID-19 infection. This has relevance for the care of patients with cancer requiring treatment, particularly in countries experiencing an increase in COVID-19 case numbers. Important differences in outcomes among patients with hematological and lung cancers were observed

Original language	English
Pages (from-to)	e220130
Journal	JAMA Network Open
Volume	5
Issue number	2
Early online date	21 Feb 2022
DOIs	https://doi.org/10.1001/jamanetworkopen.2022.0130
Publication status	E-pub ahead of print - 21 Feb 2022

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10.1001/jamanetworkopen.2022.0130

Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19Final published version, 900 KBLicence: Creative Commons: Attribution (CC-BY)

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789152

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Várnai, C., Palles, C., Arnold, R., Curley, H. M., Purshouse, K., Cheng, V. W. T., Booth, S., Campton, N. A., Collins, G. P., Hughes, D. J., Kulasekararaj, A. G., Lee, A. J. X., Olsson-brown, A. C., Sharma-oates, A., Van Hemelrijck, M., Lee, L. Y. W., Kerr, R., Middleton, G., Cazier, J., ... Kurec, B. (2022). Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19. JAMA Network Open, 5(2), e220130. Advance online publication. https://doi.org/10.1001/jamanetworkopen.2022.0130

@article{c394c38d07b74ad982008a2e4eef6143,

title = "Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19",

abstract = "Importance Large cohorts of patients with active cancers and COVID-19 infection are needed to provide evidence of the association of recent cancer treatment and cancer type with COVID-19 mortality.Objective To evaluate whether systemic anticancer treatments (SACTs), tumor subtypes, patient demographic characteristics (age and sex), and comorbidities are associated with COVID-19 mortality.Design, Setting, and Participants The UK Coronavirus Cancer Monitoring Project (UKCCMP) is a prospective cohort study conducted at 69 UK cancer hospitals among adult patients (≥18 years) with an active cancer and a clinical diagnosis of COVID-19. Patients registered from March 18 to August 1, 2020, were included in this analysis.Exposures SACT, tumor subtype, patient demographic characteristics (eg, age, sex, body mass index, race and ethnicity, smoking history), and comorbidities were investigated.Main Outcomes and Measures The primary end point was all-cause mortality within the primary hospitalization.Results Overall, 2515 of 2786 patients registered during the study period were included; 1464 (58%) were men; and the median (IQR) age was 72 (62-80) years. The mortality rate was 38% (966 patients). The data suggest an association between higher mortality in patients with hematological malignant neoplasms irrespective of recent SACT, particularly in those with acute leukemias or myelodysplastic syndrome (OR, 2.16; 95% CI, 1.30-3.60) and myeloma or plasmacytoma (OR, 1.53; 95% CI, 1.04-2.26). Lung cancer was also significantly associated with higher COVID-19–related mortality (OR, 1.58; 95% CI, 1.11-2.25). No association between higher mortality and receiving chemotherapy in the 4 weeks before COVID-19 diagnosis was observed after correcting for the crucial confounders of age, sex, and comorbidities. An association between lower mortality and receiving immunotherapy in the 4 weeks before COVID-19 diagnosis was observed (immunotherapy vs no cancer therapy: OR, 0.52; 95% CI, 0.31-0.86).Conclusions and Relevance The findings of this study of patients with active cancer suggest that recent SACT is not associated with inferior outcomes from COVID-19 infection. This has relevance for the care of patients with cancer requiring treatment, particularly in countries experiencing an increase in COVID-19 case numbers. Important differences in outcomes among patients with hematological and lung cancers were observed",

author = "Csilla V{\'a}rnai and Claire Palles and Roland Arnold and Curley, {Helen M.} and Karin Purshouse and Cheng, {Vinton W. T.} and Stephen Booth and Campton, {Naomi A.} and Collins, {Graham P.} and Hughes, {Daniel J.} and Kulasekararaj, {Austin G.} and Lee, {Alvin J. X.} and Olsson-brown, {Anna C.} and Archana Sharma-oates and {Van Hemelrijck}, Mieke and Lee, {Lennard Y. W.} and Rachel Kerr and Gary Middleton and Jean-baptiste Cazier and Sian Pugh and Pippa Corrie and Ahmed Bedair and Madeleine Hewish and Pauline Leonard and Jack Illingworth and Stephen Hibbs and Nicolaos Diamantis and Samah Massalha and Claire Fuller and Caroline Usbourne and Duncan Gilbert and Jennifer Davies and Tom Newsom-davis and Rachel Sharkey and Rebecca Lee and Ann Tivey and Rohan Shotton and Clare Griffin and Laura Horsley and Simon Shamas and Sacco, {Joseph J} and Madbuba Choudhury and Jillian Noble and Heather Shaw and Rachel Bolton and Ana Ferreira and Peter Hall and Paul Ramage and Jaishree Bhosle and Alison Massey and Michaela Hill and Leena Mukherjee and Aisha Ghaus and Sarah Derby and Sean Brown and Sarah Lowndes and Saorise Dolly and Beth Russell and Charlotte Moss and Daniel Muller and Annet Pillai and Shakeel Lowe and Lucy Cook and Christopher Scrase and Rema Jyothirmayi and Ruth Board and Stephanie Cornthwaite and Shefail Parikh and Emma Cattell and Nicola Cox and Abigail Gault and Sam Moody and Caroline Dobeson and Mark Baxter and Tom Roques and Alexander Pawsey and Roderick Oakes and Lucinda Melcher and Olivia Chan and Sarah Ayers and Helen Bowyer and Mohammed Althohami and Sajjan Mittal and Laura Feeney and Avinash Aujayeb and Omar Sheikh and Sangary Kathirgamakarthigeyan and Victoria Woodcock and Francesca Holt and Simon Wyatt and Oliver Topping and Michael Tilby and Madhumita Bhattacharyya and Emma Burke and Shawn Ellis and Joseph Chacko and Taslima Rabbi and Michael Rowe and Rebecca Sargent and Christina Thirlwell and Jack Gibson and Robert Goldstein and Mathew Fittall and Spyridon Gennatas and Alicia Okines and James Best and Tania Tillett and Emily Renninson and Simon Grumett and Craig Barrington and Ruth Pettengell and Yingyying Peng and Julia Chackathayil and Akinfemi Akingboye and Helen Hollis and {Shin Chin}, Ik and Vartika Bisht and Simon Hartley and Middleton, {Christopher P} and Anshita Goel and Emily Protheroe and Paingfan Naksukpaiboon and Iris Anil and Joel Michell and Jamie D'costa and Anjui Wu and Diego Ottaviani and Gehan Soosaipillai and Myria Galazi and Neha Chopra and Sarah Benafif and Sng, {Christopher Ct} and Wong, {Sophia Yn} and Martin Scott-brown and Ellen Copson and Timothy Robinson and Zoe Hudson and Fiona Smith and {Abdulnabi Mohamed}, Ali-abdulnabi and Angelos Angelakas and Leoni Eastlake and Ashley Poon-king and Clair Brunner and Amy Kwan and Alec Maynard and Hayley Boyce and Emma Spurrell and Rahul Peck and Bartlomiej Kurec",

note = "Funding Information: Funding/Support: The work was supported by University of Birmingham, University of Oxford, Blood Cancer UK (grant No. 20011), Cancer Research UK (grant No. C17422/A25154), and Bowel Cancer UK (grant No. 18PG0010). Funding Information: Conflict of Interest Disclosures: Dr Palles reported receiving grants from Blood Cancer UK and Bowel Cancer UK during the conduct of the study. Dr Arnold reported receiving grants from Blood Cancer UK during the conduct of the study. Dr Curley reported receiving grants from Blood Cancer UK during the conduct of the study. Dr Purshouse reported receiving a fellowship from the Wellcome Trust during the conduct of the study. Dr Hughes reported received research funding from Nanomab Technology, personal fees from Pfizer, and speakers{\textquoteright} fees from Novartis outside the submitted work. Dr Olsson-Brown reported receiving grant support from Roche, Bristol Myers Squibb, Eli Lilly and Co, Novartis, and UCB Pharma and receiving personal fees from Roche, Merck Sharpe and Dohme, Eisai, and Bristol Myers Squibb outside the submitted work. Prof Middleton reported receiving personal fees from Bristol Myers Squibb, Servier, Roche, Merck Sharpe and Dohme, AstraZeneca, Pfizer, and D2G outside the submitted work. Prof Cazier reported grants from Blood Cancer UK during the conduct of the study. No other disclosures were reported. Publisher Copyright: {\textcopyright} 2022 American Medical Association. All rights reserved.",

year = "2022",

month = feb,

day = "21",

doi = "10.1001/jamanetworkopen.2022.0130",

language = "English",

volume = "5",

pages = "e220130",

journal = "JAMA Network Open",

issn = "2574-3805",

publisher = "American Medical Association",

number = "2",

}

Várnai, C, Palles, C, Arnold, R, Curley, HM, Purshouse, K, Cheng, VWT, Booth, S, Campton, NA, Collins, GP, Hughes, DJ, Kulasekararaj, AG, Lee, AJX, Olsson-brown, AC, Sharma-oates, A, Van Hemelrijck, M, Lee, LYW, Kerr, R, Middleton, G, Cazier, J, Pugh, S, Corrie, P, Bedair, A, Hewish, M, Leonard, P, Illingworth, J, Hibbs, S, Diamantis, N, Massalha, S, Fuller, C, Usbourne, C, Gilbert, D, Davies, J, Newsom-davis, T, Sharkey, R, Lee, R, Tivey, A, Shotton, R, Griffin, C, Horsley, L, Shamas, S, Sacco, JJ, Choudhury, M, Noble, J, Shaw, H, Bolton, R, Ferreira, A, Hall, P, Ramage, P, Bhosle, J, Massey, A, Hill, M, Mukherjee, L, Ghaus, A, Derby, S, Brown, S, Lowndes, S, Dolly, S, Russell, B, Moss, C, Muller, D, Pillai, A, Lowe, S, Cook, L, Scrase, C, Jyothirmayi, R, Board, R, Cornthwaite, S, Parikh, S, Cattell, E, Cox, N, Gault, A, Moody, S, Dobeson, C, Baxter, M, Roques, T, Pawsey, A, Oakes, R, Melcher, L, Chan, O, Ayers, S, Bowyer, H, Althohami, M, Mittal, S, Feeney, L, Aujayeb, A, Sheikh, O, Kathirgamakarthigeyan, S, Woodcock, V, Holt, F, Wyatt, S, Topping, O, Tilby, M, Bhattacharyya, M, Burke, E, Ellis, S, Chacko, J, Rabbi, T, Rowe, M, Sargent, R, Thirlwell, C, Gibson, J, Goldstein, R, Fittall, M, Gennatas, S, Okines, A, Best, J, Tillett, T, Renninson, E, Grumett, S, Barrington, C, Pettengell, R, Peng, Y, Chackathayil, J, Akingboye, A, Hollis, H, Shin Chin, I, Bisht, V, Hartley, S, Middleton, CP, Goel, A, Protheroe, E, Naksukpaiboon, P, Anil, I, Michell, J, D'costa, J, Wu, A, Ottaviani, D, Soosaipillai, G, Galazi, M, Chopra, N, Benafif, S, Sng, CC, Wong, SY, Scott-brown, M, Copson, E, Robinson, T, Hudson, Z, Smith, F, Abdulnabi Mohamed, A, Angelakas, A, Eastlake, L, Poon-king, A, Brunner, C, Kwan, A, Maynard, A, Boyce, H, Spurrell, E, Peck, R & Kurec, B 2022, 'Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19', JAMA Network Open, vol. 5, no. 2, pp. e220130. https://doi.org/10.1001/jamanetworkopen.2022.0130

TY - JOUR

T1 - Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19

AU - Várnai, Csilla

AU - Palles, Claire

AU - Arnold, Roland

AU - Curley, Helen M.

AU - Purshouse, Karin

AU - Cheng, Vinton W. T.

AU - Booth, Stephen

AU - Campton, Naomi A.

AU - Collins, Graham P.

AU - Hughes, Daniel J.

AU - Kulasekararaj, Austin G.

AU - Lee, Alvin J. X.

AU - Olsson-brown, Anna C.

AU - Sharma-oates, Archana

AU - Van Hemelrijck, Mieke

AU - Lee, Lennard Y. W.

AU - Kerr, Rachel

AU - Middleton, Gary

AU - Cazier, Jean-baptiste

AU - Pugh, Sian

AU - Corrie, Pippa

AU - Bedair, Ahmed

AU - Hewish, Madeleine

AU - Leonard, Pauline

AU - Illingworth, Jack

AU - Hibbs, Stephen

AU - Diamantis, Nicolaos

AU - Massalha, Samah

AU - Fuller, Claire

AU - Usbourne, Caroline

AU - Gilbert, Duncan

AU - Davies, Jennifer

AU - Newsom-davis, Tom

AU - Sharkey, Rachel

AU - Lee, Rebecca

AU - Tivey, Ann

AU - Shotton, Rohan

AU - Griffin, Clare

AU - Horsley, Laura

AU - Shamas, Simon

AU - Sacco, Joseph J

AU - Choudhury, Madbuba

AU - Noble, Jillian

AU - Shaw, Heather

AU - Bolton, Rachel

AU - Ferreira, Ana

AU - Hall, Peter

AU - Ramage, Paul

AU - Bhosle, Jaishree

AU - Massey, Alison

AU - Hill, Michaela

AU - Mukherjee, Leena

AU - Ghaus, Aisha

AU - Derby, Sarah

AU - Brown, Sean

AU - Lowndes, Sarah

AU - Dolly, Saorise

AU - Russell, Beth

AU - Moss, Charlotte

AU - Muller, Daniel

AU - Pillai, Annet

AU - Lowe, Shakeel

AU - Cook, Lucy

AU - Scrase, Christopher

AU - Jyothirmayi, Rema

AU - Board, Ruth

AU - Cornthwaite, Stephanie

AU - Parikh, Shefail

AU - Cattell, Emma

AU - Cox, Nicola

AU - Gault, Abigail

AU - Moody, Sam

AU - Dobeson, Caroline

AU - Baxter, Mark

AU - Roques, Tom

AU - Pawsey, Alexander

AU - Oakes, Roderick

AU - Melcher, Lucinda

AU - Chan, Olivia

AU - Ayers, Sarah

AU - Bowyer, Helen

AU - Althohami, Mohammed

AU - Mittal, Sajjan

AU - Feeney, Laura

AU - Aujayeb, Avinash

AU - Sheikh, Omar

AU - Kathirgamakarthigeyan, Sangary

AU - Woodcock, Victoria

AU - Holt, Francesca

AU - Wyatt, Simon

AU - Topping, Oliver

AU - Tilby, Michael

AU - Bhattacharyya, Madhumita

AU - Burke, Emma

AU - Ellis, Shawn

AU - Chacko, Joseph

AU - Rabbi, Taslima

AU - Rowe, Michael

AU - Sargent, Rebecca

AU - Thirlwell, Christina

AU - Gibson, Jack

AU - Goldstein, Robert

AU - Fittall, Mathew

AU - Gennatas, Spyridon

AU - Okines, Alicia

AU - Best, James

AU - Tillett, Tania

AU - Renninson, Emily

AU - Grumett, Simon

AU - Barrington, Craig

AU - Pettengell, Ruth

AU - Peng, Yingyying

AU - Chackathayil, Julia

AU - Akingboye, Akinfemi

AU - Hollis, Helen

AU - Shin Chin, Ik

AU - Bisht, Vartika

AU - Hartley, Simon

AU - Middleton, Christopher P

AU - Goel, Anshita

AU - Protheroe, Emily

AU - Naksukpaiboon, Paingfan

AU - Anil, Iris

AU - Michell, Joel

AU - D'costa, Jamie

AU - Wu, Anjui

AU - Ottaviani, Diego

AU - Soosaipillai, Gehan

AU - Galazi, Myria

AU - Chopra, Neha

AU - Benafif, Sarah

AU - Sng, Christopher Ct

AU - Wong, Sophia Yn

AU - Scott-brown, Martin

AU - Copson, Ellen

AU - Robinson, Timothy

AU - Hudson, Zoe

AU - Smith, Fiona

AU - Abdulnabi Mohamed, Ali-abdulnabi

AU - Angelakas, Angelos

AU - Eastlake, Leoni

AU - Poon-king, Ashley

AU - Brunner, Clair

AU - Kwan, Amy

AU - Maynard, Alec

AU - Boyce, Hayley

AU - Spurrell, Emma

AU - Peck, Rahul

AU - Kurec, Bartlomiej

N1 - Funding Information: Funding/Support: The work was supported by University of Birmingham, University of Oxford, Blood Cancer UK (grant No. 20011), Cancer Research UK (grant No. C17422/A25154), and Bowel Cancer UK (grant No. 18PG0010). Funding Information: Conflict of Interest Disclosures: Dr Palles reported receiving grants from Blood Cancer UK and Bowel Cancer UK during the conduct of the study. Dr Arnold reported receiving grants from Blood Cancer UK during the conduct of the study. Dr Curley reported receiving grants from Blood Cancer UK during the conduct of the study. Dr Purshouse reported receiving a fellowship from the Wellcome Trust during the conduct of the study. Dr Hughes reported received research funding from Nanomab Technology, personal fees from Pfizer, and speakers’ fees from Novartis outside the submitted work. Dr Olsson-Brown reported receiving grant support from Roche, Bristol Myers Squibb, Eli Lilly and Co, Novartis, and UCB Pharma and receiving personal fees from Roche, Merck Sharpe and Dohme, Eisai, and Bristol Myers Squibb outside the submitted work. Prof Middleton reported receiving personal fees from Bristol Myers Squibb, Servier, Roche, Merck Sharpe and Dohme, AstraZeneca, Pfizer, and D2G outside the submitted work. Prof Cazier reported grants from Blood Cancer UK during the conduct of the study. No other disclosures were reported. Publisher Copyright: © 2022 American Medical Association. All rights reserved.

PY - 2022/2/21

Y1 - 2022/2/21

N2 - Importance Large cohorts of patients with active cancers and COVID-19 infection are needed to provide evidence of the association of recent cancer treatment and cancer type with COVID-19 mortality.Objective To evaluate whether systemic anticancer treatments (SACTs), tumor subtypes, patient demographic characteristics (age and sex), and comorbidities are associated with COVID-19 mortality.Design, Setting, and Participants The UK Coronavirus Cancer Monitoring Project (UKCCMP) is a prospective cohort study conducted at 69 UK cancer hospitals among adult patients (≥18 years) with an active cancer and a clinical diagnosis of COVID-19. Patients registered from March 18 to August 1, 2020, were included in this analysis.Exposures SACT, tumor subtype, patient demographic characteristics (eg, age, sex, body mass index, race and ethnicity, smoking history), and comorbidities were investigated.Main Outcomes and Measures The primary end point was all-cause mortality within the primary hospitalization.Results Overall, 2515 of 2786 patients registered during the study period were included; 1464 (58%) were men; and the median (IQR) age was 72 (62-80) years. The mortality rate was 38% (966 patients). The data suggest an association between higher mortality in patients with hematological malignant neoplasms irrespective of recent SACT, particularly in those with acute leukemias or myelodysplastic syndrome (OR, 2.16; 95% CI, 1.30-3.60) and myeloma or plasmacytoma (OR, 1.53; 95% CI, 1.04-2.26). Lung cancer was also significantly associated with higher COVID-19–related mortality (OR, 1.58; 95% CI, 1.11-2.25). No association between higher mortality and receiving chemotherapy in the 4 weeks before COVID-19 diagnosis was observed after correcting for the crucial confounders of age, sex, and comorbidities. An association between lower mortality and receiving immunotherapy in the 4 weeks before COVID-19 diagnosis was observed (immunotherapy vs no cancer therapy: OR, 0.52; 95% CI, 0.31-0.86).Conclusions and Relevance The findings of this study of patients with active cancer suggest that recent SACT is not associated with inferior outcomes from COVID-19 infection. This has relevance for the care of patients with cancer requiring treatment, particularly in countries experiencing an increase in COVID-19 case numbers. Important differences in outcomes among patients with hematological and lung cancers were observed

AB - Importance Large cohorts of patients with active cancers and COVID-19 infection are needed to provide evidence of the association of recent cancer treatment and cancer type with COVID-19 mortality.Objective To evaluate whether systemic anticancer treatments (SACTs), tumor subtypes, patient demographic characteristics (age and sex), and comorbidities are associated with COVID-19 mortality.Design, Setting, and Participants The UK Coronavirus Cancer Monitoring Project (UKCCMP) is a prospective cohort study conducted at 69 UK cancer hospitals among adult patients (≥18 years) with an active cancer and a clinical diagnosis of COVID-19. Patients registered from March 18 to August 1, 2020, were included in this analysis.Exposures SACT, tumor subtype, patient demographic characteristics (eg, age, sex, body mass index, race and ethnicity, smoking history), and comorbidities were investigated.Main Outcomes and Measures The primary end point was all-cause mortality within the primary hospitalization.Results Overall, 2515 of 2786 patients registered during the study period were included; 1464 (58%) were men; and the median (IQR) age was 72 (62-80) years. The mortality rate was 38% (966 patients). The data suggest an association between higher mortality in patients with hematological malignant neoplasms irrespective of recent SACT, particularly in those with acute leukemias or myelodysplastic syndrome (OR, 2.16; 95% CI, 1.30-3.60) and myeloma or plasmacytoma (OR, 1.53; 95% CI, 1.04-2.26). Lung cancer was also significantly associated with higher COVID-19–related mortality (OR, 1.58; 95% CI, 1.11-2.25). No association between higher mortality and receiving chemotherapy in the 4 weeks before COVID-19 diagnosis was observed after correcting for the crucial confounders of age, sex, and comorbidities. An association between lower mortality and receiving immunotherapy in the 4 weeks before COVID-19 diagnosis was observed (immunotherapy vs no cancer therapy: OR, 0.52; 95% CI, 0.31-0.86).Conclusions and Relevance The findings of this study of patients with active cancer suggest that recent SACT is not associated with inferior outcomes from COVID-19 infection. This has relevance for the care of patients with cancer requiring treatment, particularly in countries experiencing an increase in COVID-19 case numbers. Important differences in outcomes among patients with hematological and lung cancers were observed

U2 - 10.1001/jamanetworkopen.2022.0130

DO - 10.1001/jamanetworkopen.2022.0130

M3 - Article

SN - 2574-3805

VL - 5

SP - e220130

JO - JAMA Network Open

JF - JAMA Network Open

IS - 2

ER -

Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19

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