Oncologic immunomodulatory agents in patients with cancer and COVID-19
Abstract Corticosteroids, anti-CD20 agents, immunotherapies, and cytotoxic chemotherapy are commonly used in the treatment of patients with cancer. It is unclear how these agents affect patients with cancer who are infected with SARS-CoV-2. We retrospectively investigated associations between SARS-C...
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doaj-ac5a7ce592fd4888901daa72413e1e592021-03-11T12:21:54ZengNature Publishing GroupScientific Reports2045-23222021-03-011111610.1038/s41598-021-84137-5Oncologic immunomodulatory agents in patients with cancer and COVID-19Justin Jee0Aaron J. Stonestrom1Sean Devlin2Teresa Nguyentran3Beatriz Wills4Varun Narendra5Michael B. Foote6Melissa Lumish7Santosha A. Vardhana8Stephen M. Pastores9Neha Korde10Dhwani Patel11Steven Horwitz12Michael Scordo13Anthony F. Daniyan14Department of Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer CenterDepartment of Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Medicine, Memorial Sloan Kettering Cancer CenterAbstract Corticosteroids, anti-CD20 agents, immunotherapies, and cytotoxic chemotherapy are commonly used in the treatment of patients with cancer. It is unclear how these agents affect patients with cancer who are infected with SARS-CoV-2. We retrospectively investigated associations between SARS-CoV-2-associated respiratory failure or death with receipt of the aforementioned medications and with pre-COVID-19 neutropenia. The study included all cancer patients diagnosed with SARS-CoV-2 at Memorial Sloan Kettering Cancer Center until June 2, 2020 (N = 820). We controlled for cancer-related characteristics known to predispose to worse COVID-19 as well as level of respiratory support during corticosteroid administration. Corticosteroid administration was associated with worse outcomes prior to use of supplemental oxygen; no statistically significant difference was observed in sicker cohorts. In patients with metastatic thoracic cancer, 9 of 25 (36%) and 10 of 31 (32%) had respiratory failure or death among those who did and did not receive immunotherapy, respectively. Seven of 23 (30%) and 52 of 187 (28%) patients with hematologic cancer had respiratory failure or death among those who did and did not receive anti-CD20 therapy, respectively. Chemotherapy itself was not associated with worse outcomes, but pre-COVID-19 neutropenia was associated with worse COVID-19 course. Relative prevalence of chemotherapy-associated neutropenia in previous studies may account for different conclusions regarding the risks of chemotherapy in patients with COVID-19. In the absence of prospective studies and evidence-based guidelines, our data may aid providers looking to assess the risks and benefits of these agents in caring for cancer patients in the COVID-19 era.https://doi.org/10.1038/s41598-021-84137-5 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Justin Jee Aaron J. Stonestrom Sean Devlin Teresa Nguyentran Beatriz Wills Varun Narendra Michael B. Foote Melissa Lumish Santosha A. Vardhana Stephen M. Pastores Neha Korde Dhwani Patel Steven Horwitz Michael Scordo Anthony F. Daniyan |
spellingShingle |
Justin Jee Aaron J. Stonestrom Sean Devlin Teresa Nguyentran Beatriz Wills Varun Narendra Michael B. Foote Melissa Lumish Santosha A. Vardhana Stephen M. Pastores Neha Korde Dhwani Patel Steven Horwitz Michael Scordo Anthony F. Daniyan Oncologic immunomodulatory agents in patients with cancer and COVID-19 Scientific Reports |
author_facet |
Justin Jee Aaron J. Stonestrom Sean Devlin Teresa Nguyentran Beatriz Wills Varun Narendra Michael B. Foote Melissa Lumish Santosha A. Vardhana Stephen M. Pastores Neha Korde Dhwani Patel Steven Horwitz Michael Scordo Anthony F. Daniyan |
author_sort |
Justin Jee |
title |
Oncologic immunomodulatory agents in patients with cancer and COVID-19 |
title_short |
Oncologic immunomodulatory agents in patients with cancer and COVID-19 |
title_full |
Oncologic immunomodulatory agents in patients with cancer and COVID-19 |
title_fullStr |
Oncologic immunomodulatory agents in patients with cancer and COVID-19 |
title_full_unstemmed |
Oncologic immunomodulatory agents in patients with cancer and COVID-19 |
title_sort |
oncologic immunomodulatory agents in patients with cancer and covid-19 |
publisher |
Nature Publishing Group |
series |
Scientific Reports |
issn |
2045-2322 |
publishDate |
2021-03-01 |
description |
Abstract Corticosteroids, anti-CD20 agents, immunotherapies, and cytotoxic chemotherapy are commonly used in the treatment of patients with cancer. It is unclear how these agents affect patients with cancer who are infected with SARS-CoV-2. We retrospectively investigated associations between SARS-CoV-2-associated respiratory failure or death with receipt of the aforementioned medications and with pre-COVID-19 neutropenia. The study included all cancer patients diagnosed with SARS-CoV-2 at Memorial Sloan Kettering Cancer Center until June 2, 2020 (N = 820). We controlled for cancer-related characteristics known to predispose to worse COVID-19 as well as level of respiratory support during corticosteroid administration. Corticosteroid administration was associated with worse outcomes prior to use of supplemental oxygen; no statistically significant difference was observed in sicker cohorts. In patients with metastatic thoracic cancer, 9 of 25 (36%) and 10 of 31 (32%) had respiratory failure or death among those who did and did not receive immunotherapy, respectively. Seven of 23 (30%) and 52 of 187 (28%) patients with hematologic cancer had respiratory failure or death among those who did and did not receive anti-CD20 therapy, respectively. Chemotherapy itself was not associated with worse outcomes, but pre-COVID-19 neutropenia was associated with worse COVID-19 course. Relative prevalence of chemotherapy-associated neutropenia in previous studies may account for different conclusions regarding the risks of chemotherapy in patients with COVID-19. In the absence of prospective studies and evidence-based guidelines, our data may aid providers looking to assess the risks and benefits of these agents in caring for cancer patients in the COVID-19 era. |
url |
https://doi.org/10.1038/s41598-021-84137-5 |
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