Impact of PD-1 Blockade on Severity of COVID-19 in Patients with Lung Cancers

Luo, Jia; Rizvi, Hira; Egger, Jacklynn V.; Preeshagul, Isabel R.; Wolchok, Jedd D.; Hellmann, Matthew D.

doi:10.1158/2159-8290.cd-20-0596

Cited by 226 publications

(295 citation statements)

References 36 publications

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“…Among the 13 subjects with COVID-19 diagnosis con rmed by RT-PCR, mortality was 38.5%, higher than previously reported (range 0-36% in previous studies) [13][14][15][16][17][18][19][20][21][22][23][24]. This could be explained by unfavorable characteristics such as higher median age (range 56-68 years in previous studies [13][14][15][16][17][18][19][20][21][22][23],…”

Section: Covid-19 Impact On the Staffmentioning

confidence: 73%

“…This generated a large body of recommendations, surveys and guidelines [7][8][10][11]. Nevertheless, currently published clinical data are still limited, especially considering subjects on active treatment [12][13][14][15][16][17][18][19].…”

Section: Covid-19 Impact On the Staffmentioning

confidence: 99%

“…Previous series, including from 3 to 69 COVID-19 positive patients, reported an infection rate ranging from 0.79% to 2.7% among cancer patients and a mortality rate of 0-36% in infected subjects [13][14][15][16][17][18][19][20][21][22][23]. Only a fraction of the cases were receiving active treatment, mainly consisting of chemotherapy and immunotherapy or target therapy, and infection determined in almost all the cases treatment suspension [13][14][15][16][17][18][19][20][21][22][23].…”

Section: Covid-19 Impact On the Staffmentioning

confidence: 99%

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Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

Buglione

Spiazzi

Guerini

et al. 2020

Preprint

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Abstract Background: Coronavirus Disease 2019 (COVID-19) pandemic had an overwhelming impact on healthcare worldwide. Outstandingly, the aftermath on neoplastic patients is still largely unknown, and only isolated cases of COVID-19 during radiotherapy have been published. We will report the two-months experience of our Department, set in Lombardy “red-zone”.Methods: data of 402 cancer patients undergoing active treatment from February 24 to April 24, 2020 were retrospectively reviewed; several indicators of the Department functioning were also analyzed.Results: dedicated measures allowed an overall limited reduction of the workload. Decrease of radiotherapy treatment number reached 17%, while the number of administration of systemic treatment and follow up evaluations kept constant. Conversely, new treatment planning faced substantial decline. Considering the patients, infection rate was 3.23% (13/402) and mortality 1.24% (5/402). Median age of COVID-19 patients was 69.7 years, the large majority were male and smokers (84.6%); lung cancer was the most common tumor type (61.5%), 84.6% of subjects were stage III-IV and 92.3% had comorbidities. Remarkably, 92.3% of the cases were detected before March 24. Globally, only 2.5% of ongoing treatments were suspended due to suspect or confirmed COVID-19 and 46.2% of positive patients carried on radiotherapy without interruption. Considering only the last month, infection rate among patients undergoing treatment precipitated to 0.43% (1/232) and no new contagions were reported within our staff. Conclusions: although mortality rate in COVID-19 cancer patients is elevated, our results support the feasibility and safety of continuing anticancer treatment during SARS-Cov-2 pandemic by endorsing consistent preventive measures.

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Section: Covid-19 Impact On the Staffmentioning

confidence: 73%

Section: Covid-19 Impact On the Staffmentioning

confidence: 99%

Section: Covid-19 Impact On the Staffmentioning

confidence: 99%

See 1 more Smart Citation

Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

Buglione

Spiazzi

Guerini

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…24 This has supported the initiation of a clinical trial using nivolumab (NCT04343144) to treat COVID-19 infection. In addition, confounding factors such as smoking status have affected the severity of COVID-19 infection in PD-1 blockade-exposed patients with lung cancer 25 ; this finding has not been seen in patients with gynecologic cancer. Currently, it is unclear whether immunotherapy has a deleterious effect on COVID-19-infected patients.…”

Section: Discussionmentioning

confidence: 99%

COVID‐19 outcomes of patients with gynecologic cancer in New York City

Lara

O’Cearbhaill

Smith

et al. 2020

Cancer

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Background New York City (NYC) is the epicenter of severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID‐19]) in the United States. Clinical characteristics and outcomes of vulnerable populations, such as those with gynecologic cancer who develop COVID‐19 infections, is limited. Methods Patients from 6 NYC‐area hospital systems with known gynecologic cancer and a COVID‐19 diagnosis were identified. Demographic and clinical outcome data were abstracted through a review of electronic medical records. Results Records for 121 patients with gynecologic cancer and COVID‐19 were abstracted; the median age at the COVID‐19 diagnosis was 64.0 years (interquartile range, 51.0‐73.0 years). Sixty‐six of the 121 patients (54.5%) required hospitalization; among the hospitalized patients, 45 (68.2%) required respiratory intervention, 20 (30.3%) were admitted to the intensive care unit, and 9 (13.6%) underwent invasive mechanical ventilation. Seventeen patients (14.0%) died of COVID‐19 complications. No patient requiring mechanical ventilation survived. On multivariable analysis, hospitalization was associated with an age ≥64 years (risk ratio [RR], 1.73; 95% confidence interval [CI], 1.18‐2.51), African American race (RR, 1.56; 95% CI, 1.13‐2.15), and 3 or more comorbidities (RR, 1.43; 95% CI, 1.03‐1.98). Only recent immunotherapy use (RR, 3.49; 95% CI, 1.08‐11.27) was associated with death due to COVID‐19 on multivariable analysis; chemotherapy treatment and recent major surgery were not predictive of COVID‐19 severity or mortality. Conclusions The case fatality rate among gynecologic oncology patients with a COVID‐19 infection is 14.0%. Recent immunotherapy use is associated with an increased risk of mortality related to COVID‐19 infection. Lay Summary The case fatality rate among gynecologic oncology patients with a coronavirus disease 2019 (COVID‐19) infection is 14.0%; there is no association between cytotoxic chemotherapy and cancer‐directed surgery and COVID‐19 severity or death. As such, patients can be counseled regarding the safety of continued anticancer treatments during the pandemic. This is important because the ability to continue cancer therapies for cancer control and cure is critical.

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“…It has been shown that healing from COVID-19 is associated with LT PD-1 expression normalization. 51 Nivolumab, a PD-1 blocker, was approved for metastatic melanoma at 3 mg/kg given intravenously once every 2 weeks. It is being evaluated for the efficacy and safety in nivolumab in hospitalized COVID-19 patients at 3 mg/kg intravenously and in a pilot study of adult patients with COVID-19 to evaluate the efficacy of anti-PD-1 antibody in relation to viral clearance and its safety at the low dose of 0.3 mg/kg intravenously.…”

Section: Complement System Inhibitorsmentioning

confidence: 99%

Immunomodulatory Therapeutic Proteins in COVID‐19: Current Clinical Development and Clinical Pharmacology Considerations

Chen

Golding

et al. 2020

The Journal of Clinical Pharma

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The coronavirus disease 2019 (COVID‐19) pandemic caused by infection with SARS‐CoV‐2 has led to more than 600 000 deaths worldwide. Patients with severe disease often experience acute respiratory distress characterized by upregulation of multiple cytokines. Immunomodulatory biological therapies are being evaluated in clinical trials for the management of the systemic inflammatory response and pulmonary complications in patients with advanced stages of COVID‐19. In this review, we summarize the clinical pharmacology considerations in the development of immunomodulatory therapeutic proteins for mitigating the heightened inflammatory response identified in COVID‐19.

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Impact of PD-1 Blockade on Severity of COVID-19 in Patients with Lung Cancers

Abstract: In 69 patients with lung cancer who developed COVID-19, disease severity and mortality were high, but prior PD-1 blockade was not a risk factor for poor outcomes in this group, suggesting the therapy should be used when indicated.

Cited by 226 publications

References 36 publications

Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

COVID‐19 outcomes of patients with gynecologic cancer in New York City

Immunomodulatory Therapeutic Proteins in COVID‐19: Current Clinical Development and Clinical Pharmacology Considerations

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