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

Autor:	Bui AN; Harvard Medical School, Boston, MA, USA., Tyan K; Harvard Medical School, Boston, MA, USA., Giobbie-Hurder A; Division of Biostatistics, Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA., Klein IA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.; Whitehead Institute of Biomedical Research, Cambridge, MA, USA., Manos MP; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA., Zubiri L; Department of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA., Reynolds K; Department of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA., Grover S; Harvard Medical School, Boston, MA, USA.; Department of Medicine, Division of Gastroenterology, Brigham and Women's Hospital, Boston, MA, USA., Weinhouse GL; Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA., Ott PA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA., LeBoeuf NR; Harvard Medical School, Boston, MA, USA.; Department of Dermatology, Center for Cutaneous Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA., Rahma O; Harvard Medical School, Boston, MA, USA.; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Journal of immunotherapy and precision oncology [J Immunother Precis Oncol] 2021 May 14; Vol. 4 (2), pp. 35-44. Date of Electronic Publication: 2021 May 14 (Print Publication: 2021).
DOI:	10.36401/JIPO-20-34
Abstrakt:	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. Competing Interests: Conflict of Interest: Isaac A. Klein is a shareholder and member of the Scientific Advisory Board of Dewpoint Therapeutics, a shareholder in Infinite MD, and consultant to Day-to-Day Health. Shilpa Grover is an editor in gastroenterology at UpToDate, Wolters Kluwer Inc. Nicole R. LeBoeuf is a consultant and has received honoraria from Bayer, Seattle Genetics, and Sanofi. Osama Rahma has received research support from Merck; serves as a speaker for activities supported by educational grants from BMS and Merck; consultant for Merck, Celgene, Five Prime, GSK, Bayer, Roche/Genentech, Puretech, Imvax, and Sobi; and has a pending patent titled “Methods of Using Pembrolizumab and Trebananib.” The remaining authors had nothing to disclose. (© Innovative Healthcare Institute 2021.)
Databáze:	MEDLINE
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