Mortality among adults with cancer undergoing chemotherapy or immunotherapy and infected with COVID-19

UKCCMP team

doi:10.1001/jamanetworkopen.2022.0130

Mortality among adults with cancer undergoing chemotherapy or immunotherapy and infected with COVID-19

UKCCMP team

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

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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.

Original language	English
Article number	e220130
Number of pages	11
Journal	JAMA network open
Volume	5
Issue number	2
DOIs	https://doi.org/10.1001/jamanetworkopen.2022.0130
Publication status	Published - 21 Feb 2022

Bibliographical 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).

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.

Keywords

Aged
Aged, 80 and over
COVID-19/complications
Cohort Studies
Drug Therapy
Female
Hematologic Neoplasms/complications
Humans
Immunotherapy
Lung Neoplasms/complications
Male
Middle Aged
Prospective Studies
Registries
SARS-CoV-2
United Kingdom

ASJC Scopus subject areas

Medicine(all)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1001/jamanetworkopen.2022.0130Licence: Creative Commons: Attribution (CC BY)

VárnaiC2022MortalityFinal published version, 897 KBLicence: Creative Commons: Attribution (CC BY)

Identification and characterisation of inherited causes of CRC in young patients
Palles, C.
BOWEL CANCER UK
1/11/18 → 1/03/22
Project: Research

Cite this

@article{5d01830bc6cd4a1193ea4b2022a2d78e,

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.",

keywords = "Aged, Aged, 80 and over, COVID-19/complications, Cohort Studies, Drug Therapy, Female, Hematologic Neoplasms/complications, Humans, Immunotherapy, Lung Neoplasms/complications, Male, Middle Aged, Prospective Studies, Registries, SARS-CoV-2, United Kingdom",

author = "{UKCCMP team} and 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",

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). 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",

journal = "JAMA network open",

issn = "2574-3805",

publisher = "American Medical Association",

number = "2",

}

TY - JOUR

T1 - Mortality among adults with cancer undergoing chemotherapy or immunotherapy and infected with COVID-19

AU - UKCCMP team

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

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). 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.

KW - Aged

KW - Aged, 80 and over

KW - COVID-19/complications

KW - Cohort Studies

KW - Drug Therapy

KW - Female

KW - Hematologic Neoplasms/complications

KW - Humans

KW - Immunotherapy

KW - Lung Neoplasms/complications

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Registries

KW - SARS-CoV-2

KW - United Kingdom

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U2 - 10.1001/jamanetworkopen.2022.0130

DO - 10.1001/jamanetworkopen.2022.0130

M3 - Article

C2 - 35188551

SN - 2574-3805

VL - 5

JO - JAMA network open

JF - JAMA network open

IS - 2

M1 - e220130

ER -

Mortality among adults with cancer undergoing chemotherapy or immunotherapy and infected with COVID-19

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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Projects

Identification and characterisation of inherited causes of CRC in young patients

Cite this