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

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.

• 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
• Journal: Journal of immunotherapy and precision oncology (J Immunother Precis Oncol) Vol. 4 Issue 2 Pg. 35-44 (May 2021) ISSN: 2590-017X [Electronic] United States
• PMID: 35663537 (Publication Type: Journal Article)
• Copyright: © Innovative Healthcare Institute 2021.