Changes in anticancer treatment plans in patients with solid cancer hospitalized with COVID-19: analysis of the nationwide BSMO-COVID registry providing lessons for the future.
Changes in anticancer treatment plans in patients with solid cancer hospitalized with COVID-19: analysis of the nationwide BSMO-COVID registry providing lessons for the future.pdf
COVID-19; cancer; prognosis; solid tumours; treatment changes; Humans; Belgium/epidemiology; SARS-CoV-2; Retrospective Studies; COVID-19 Testing; Medical Oncology; Registries; Lung Neoplasms/drug therapy; Belgium; Lung Neoplasms; Oncology; Cancer Research
Abstract :
[en] [en] BACKGROUND: Solid cancer is an independent prognostic factor for poor outcome with COVID-19. As guidelines for patient management in that setting depend on retrospective efforts, we here present the first analyses of a nationwide database of patients with cancer hospitalized with COVID-19 in Belgium, with a focus on changes in anticancer treatment plans at the time of SARS-CoV-2 infection.
METHODS: Nineteen Belgian hospitals identified all patients with a history of solid cancer hospitalized with COVID-19 between March 2020 and February 2021. Demographic, cancer-specific and COVID-specific data were pseudonymously entered into a central Belgian Society of Medical Oncology (BSMO)-COVID database. The association between survival and primary cancer type was analyzed through multivariate multinomial logistic regression. Group comparisons for categorical variables were carried out through a Chi-square test.
RESULTS: A total of 928 patients were registered in the database; most of them were aged ≥70 years (61.0%) and with poor performance scores [57.2% Eastern Cooperative Oncology Group (ECOG) ≥2]. Thirty-day COVID-related mortality was 19.8%. In multivariate analysis, a trend was seen for higher mortality in patients with lung cancer (27.6% versus 20.8%, P = 0.062) and lower mortality for patients with breast cancer (13.0% versus 23.3%, P = 0.052) compared with other tumour types. Non-curative treatment was associated with higher 30-day COVID-related mortality rates compared with curative or no active treatment (25.8% versus 14.3% versus 21.9%, respectively, P < 0.001). In 33% of patients under active treatment, the therapeutic plan was changed due to COVID-19 diagnosis, most frequently involving delays/interruptions in systemic treatments (18.6%). Thirty-day COVID-related mortality was not significantly different between patients with and without treatment modifications (21.4% versus 20.5%).
CONCLUSION: Interruption in anticancer treatments at the time of SARS-CoV-2 infection was not associated with a reduction in COVID-related mortality in our cohort of patients with solid cancer, highlighting that treatment continuation should be strived for, especially in the curative setting.
Disciplines :
Oncology
Author, co-author :
Geukens, T; Laboratory for Translational Breast Cancer Research, KU Leuven, Leuven. Electronic address: tatjana.geukens@kuleuven.be
Brandão, M; Department of Medical Oncology, Institut Jules Bordet and L'Université Libre de Bruxelles (U.L.B), Brussels
Laenen, A; Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat), KU Leuven, Leuven
Collignon, Joëlle ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'oncologie médicale
Van Marcke, C; Department of Medical Oncology, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Brussels, Institut de Recherche Expérimentale et Clinique (IREC), Pole of Medical Imaging, Radiotherapy and Oncology (MIRO), Université Catholique de Louvain (UCLouvain), Brussels
Louviaux, I; Department of Medical Oncology, CHR Citadelle, Liège
Demey, W; Department of Medical Oncology, AZ Klina, Brasschaat
Van Wambeke, S; Department of Medical Oncology, Ziekenhuisnetwerk Antwerpen, Antwerp
Schrijvers, D; Department of Medical Oncology, Ziekenhuisnetwerk Antwerpen, Antwerp
Lecomte, S; Department of Medical Oncology, CHU Brugmann, Brussels
Mebis, J; Department of Medical Oncology, Jessa Hospital, Hasselt
Rutten, A; Department of Medical Oncology, Ziekenhuizen Gasthuiszusters Antwerp, Antwerp
Fontaine, C; Department of Medical Oncology, UZ Brussels, Brussels
Lybaert, W; Department of Medical Oncology, VITAZ, Sint-Niklaas
Aspeslagh, S; Department of Medical Oncology, UZ Brussels, Brussels
Goeminne, J-C; Department of Medical Oncology, CHU-UCL Namur, Namur
Van Den Bulck, H; Department of Medical Oncology, Imelda Hospital, Bonheiden
Seront, E; Department of Medical Oncology, Hopital de Jolimont, Haine Saint Paul
De Backer, L; Department of Medical Oncology, Sint-Andriesziekenhuis, Tielt
De Roock, W; Department of Oncology-Hematology-Radiotherapy, Ziekenhuis Oost-Limburg and Limburgs Oncologisch Centrum, Genk
Ignatiadis, M; Department of Medical Oncology, Institut Jules Bordet and L'Université Libre de Bruxelles (U.L.B), Brussels, Academic Trials Promoting Team (ATPT), Institut Jules Bordet, Brussels
Prenen, H; Department of Oncology, University Hospital Antwerp, Edegem
Van Beckhoven, D; Department of Epidemiology and Public Health, Sciensano, Brussels
Heijlen, M; Department of General Medical Oncology and Multidisciplinary Breast Centre, Leuven Cancer Institute and University Hospitals Leuven, Leuven
Verheezen, J; Department of Medical Oncology, St. Trudo Hospital, Sint-Truiden
Rottey, S; Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
Punie, K; Department of General Medical Oncology and Multidisciplinary Breast Centre, Leuven Cancer Institute and University Hospitals Leuven, Leuven
de Azambuja, E; Department of Medical Oncology, Institut Jules Bordet and L'Université Libre de Bruxelles (U.L.B), Brussels
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