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Impact of COVID-19 on Patients with Cancer Receiving Immune Checkpoint Inhibitors

Authors :
Ai-Tram N. Bui
Kevin Tyan
Anita Giobbie-Hurder
Isaac A. Klein
Michael P. Manos
Leyre Zubiri
Kerry Reynolds
Shilpa Grover
Gerald L. Weinhouse
Patrick A. Ott
Nicole R. LeBoeuf
Osama Rahma
Source :
Journal of Immunotherapy and Precision Oncology, Pp 35-44 (2021)
Publication Year :
2021
Publisher :
Innovative Healthcare Institute, 2021.

Abstract

Introduction: To evaluate the impact of Sars-Cov-2 infection on mortality and immune checkpoint inhibitor (ICI) toxicity in patients with cancer receiving ICIs compared to those not receiving ICIs. Methods: We conducted a retrospective matched cohort study of 25 patients receiving ICIs within 1 year of coronavirus disease 2019 (COVID-19) diagnosis between March 20, 2020, and June 3, 2020, at the Dana-Farber Cancer Institute/Mass General Brigham. Cases were matched 1:1 with controls based on age, sex, and anticancer therapy within the prior 6 months. Results: Seven of 25 (28%) patients receiving ICIs died from COVID-19 as compared with nine of 25 (36%) controls. Through multivariable analysis adjusting for age, sex, and anticancer therapy, ICI use was not associated with increased risk for COVID-19 death (OR [odds ratio] 0.36, 95% CI 0.07–1.87). Determinants of mortality included age (OR 1.14, 95% CI 1.03–1.27) and chronic obstructive pulmonary disease (OR 12.26, 95% CI 1.76–85.14). Statin use was protective against mortality (OR 0.08, 95% CI 0.01–0.63). Two patients experienced persistent immune-related adverse events (irAEs) (hypophysitis); one had new-onset irAE (hypothyroidism) during their COVID-19 course. Patients with ICIs had significantly higher platelet (p = 0.017) and D-dimer (p = 0.037) levels. Elevated troponin levels (p = 0.01) were associated with COVID-19 death in patients using ICI. Conclusion: There is insufficient evidence to conclude COVID-19–related outcomes are associated with ICIs, and we did not observe an increased risk of COVID-19–related death associated with ICIs. The potential protective effect of statin therapy and role of laboratory biomarkers warrant further investigation.

Details

Language :
English
ISSN :
26662345 and 2590017X
Database :
Directory of Open Access Journals
Journal :
Journal of Immunotherapy and Precision Oncology
Publication Type :
Academic Journal
Accession number :
edsdoj.34234964abed47a0b6617ad080e21725
Document Type :
article
Full Text :
https://doi.org/10.36401/JIPO-20-34