Systemic pro-inflammatory response identifies patients with cancer with adverse outcomes from SARS-CoV-2 infection: the OnCovid Inflammatory Score.

Autor:	Dettorre GM; Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK., Dolly S; Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK., Loizidou A; Department of Infectious Diseases, Internal Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium., Chester J; Medical Oncology, School of Medicine, Cardiff University, Cardiff, UK.; Medical Oncology, Velindre Cancer Centre, Cardiff, UK., Jackson A; Clinical Trials, Velindre Cancer Centre, Cardiff, UK., Mukherjee U; Medical Oncology, Barts Health NHS Trust, London, UK., Zambelli A; Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy., Aguilar-Company J; Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain.; Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain., Bower M; Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK., Sng CCT; Cancer Division, University College London Hospitals, London, UK., Salazar R; Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Spain., Bertuzzi A; Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy., Brunet J; Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain., Mesia R; Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain., Sita-Lumsden A; Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK., Seguí E; Department of Medical Oncology, Hospital Clinic, Barcelona, Spain., Biello F; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy., Generali D; Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Cremona, Italy.; Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy., Grisanti S; Medical Oncology Unit, Spedali Civili, Brescia, Italy., Seeva P; Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK., Rizzo G; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Libertini M; Medical Oncology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy., Maconi A; Infrastruttura Ricerca Formazione Innovazione, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy., Moss C; Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK., Russell B; Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK., Harbeck N; Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany., Vincenzi B; Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Italy., Bertulli R; Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy., Ottaviani D; Cancer Division, University College London Hospitals, London, UK., Liñan R; Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain., Marrari A; Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy., Carmona-García MC; Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain., Chopra N; Cancer Division, University College London Hospitals, London, UK., Tondini CA; Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy., Mirallas O; Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain., Tovazzi V; Medical Oncology Unit, Spedali Civili, Brescia, Italy., Fotia V; Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy., Cruz CA; Department of Medical Oncology, Hospital Clinic, Barcelona, Spain., Saoudi-Gonzalez N; Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain., Felip E; Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain., Roqué A; Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain., Lee AJX; Cancer Division, University College London Hospitals, London, UK., Newsom-Davis T; Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK., García-Illescas D; Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain., Reyes R; Department of Medical Oncology, Hospital Clinic, Barcelona, Spain., Wong YNS; Cancer Division, University College London Hospitals, London, UK., Ferrante D; Department of Translational Medicine, Unit of Cancer Epidemiology, CPO-Piemonte, University of Eastern Piedmont, Novara, Italy., Scotti L; Department of Translational Medicine, Unit of Cancer Epidemiology, CPO-Piemonte, University of Eastern Piedmont, Novara, Italy., Marco-Hernández J; Department of Internal Medicine, Hospital Clinic, Barcelona, Spain., Ruiz-Camps I; Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain., Patriarca A; Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy., Rimassa L; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy., Chiudinelli L; Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy., Franchi M; Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy., Santoro A; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy., Prat A; Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain., Gennari A; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy., Van Hemelrijck M; Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK.; Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK., Tabernero J; Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain., Diamantis N; Medical Oncology, Barts Health NHS Trust, London, UK., Pinato DJ; Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK david.pinato@imperial.ac.uk.; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy.
Jazyk:	angličtina
Zdroj:	Journal for immunotherapy of cancer [J Immunother Cancer] 2021 Mar; Vol. 9 (3).
DOI:	10.1136/jitc-2020-002277
Abstrakt:	Background: Patients with cancer are particularly susceptible to SARS-CoV-2 infection. The systemic inflammatory response is a pathogenic mechanism shared by cancer progression and COVID-19. We investigated systemic inflammation as a driver of severity and mortality from COVID-19, evaluating the prognostic role of commonly used inflammatory indices in SARS-CoV-2-infected patients with cancer accrued to the OnCovid study. Methods: In a multicenter cohort of SARS-CoV-2-infected patients with cancer in Europe, we evaluated dynamic changes in neutrophil:lymphocyte ratio (NLR); platelet:lymphocyte ratio (PLR); Prognostic Nutritional Index (PNI), renamed the OnCovid Inflammatory Score (OIS); modified Glasgow Prognostic Score (mGPS); and Prognostic Index (PI) in relation to oncological and COVID-19 infection features, testing their prognostic potential in independent training (n=529) and validation (n=542) sets. Results: We evaluated 1071 eligible patients, of which 625 (58.3%) were men, and 420 were patients with malignancy in advanced stage (39.2%), most commonly genitourinary (n=216, 20.2%). 844 (78.8%) had ≥1 comorbidity and 754 (70.4%) had ≥1 COVID-19 complication. NLR, OIS, and mGPS worsened at COVID-19 diagnosis compared with pre-COVID-19 measurement (p<0.01), recovering in survivors to pre-COVID-19 levels. Patients in poorer risk categories for each index except the PLR exhibited higher mortality rates (p<0.001) and shorter median overall survival in the training and validation sets (p<0.01). Multivariable analyses revealed the OIS to be most independently predictive of survival (validation set HR 2.48, 95% CI 1.47 to 4.20, p=0.001; adjusted concordance index score 0.611). Conclusions: Systemic inflammation is a validated prognostic domain in SARS-CoV-2-infected patients with cancer and can be used as a bedside predictor of adverse outcome. Lymphocytopenia and hypoalbuminemia as computed by the OIS are independently predictive of severe COVID-19, supporting their use for risk stratification. Reversal of the COVID-19-induced proinflammatory state is a putative therapeutic strategy in patients with cancer. Competing Interests: Competing interests: DJP received lecture fees from ViiV Healthcare and Bayer Healthcare and travel expenses from BMS and Bayer Healthcare; consulting fees for Mina Therapeutics, EISAI, Roche, and Astra Zeneca; research funding (to institution) from MSD and BMS. AP has declared personal honoraria from Pfizer, Novartis, Roche, MSD Oncology, Eli Lilly, and Daiichi Sankyo; travel, accommodations, and expenses paid by Daiichi Sankyo; research funding from Roche and Novartis; and consulting/advisory role for NanoString Technologies, Amgen, Roche, Novartis, Pfizer and Bristol-Myers Squibb. TND has declared consulting/advisory role for Amgen, Bayer, AstraZeneca, BMS, Boehringer Ingelheim, Eli Lilly, MSD, Novartis, Otsuka, Pfizer, Roche, and Takeda; speakers fees from AstraZeneca, MSD, Roche, Takeda; and travel, accommodations and expenses paid by AstraZenca, BMS, Boehringer Ingelheim, Lilly, MSD, Otsuka, Roche, and Takeda. JB has declared consulting/advisory role for MSD and Astra Zeneca. PPS has declared consulting/advisory role for Sanofi and Abbvie. AP has declared consulting/advisory role for Takeda and Sanofi. MP has declared consulting/advisory role for Gilead and Bayer. AG has declared consulting/advisory role for Roche, MSD, Eli Lilly, Pierre Fabre, EISAI, and Daichii Sankyo; speakers bureau for Eisai, Novartis, Eli Lilly, Roche, Teva, Gentili, Pfizer, Astra Zeneca, Celgene, and Daichii Sankyo; research funds: EISAI, Eli Lilly, and Roche. LR reports receiving consulting fees from Amgen, ArQule, AstraZeneca, Basilea, Bayer, Celgene, Eisai, Exelixis, Hengrui, Incyte, Ipsen, Lilly, MSD, Nerviano Medical Sciences, Roche, and Sanofi; lectures fees from AbbVie, Amgen, Eisai, Gilead, Incyte, Ipsen, Lilly, Roche, and Sanofi; travel fees from Ipsen; and institutional research funding from Agios, ARMO BioSciences, AstraZeneca, BeiGene, Eisai, Exelixis, Fibrogen, Incyte, Ipsen, Lilly, MSD, and Roche. All remaining authors have declared no conflicts of interest. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu