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Pinato DJ, Aguilar-Company J, Ferrante D, Hanbury G, Bower M, Salazar R, Mirallas O, Sureda A, Plaja A, Cucurull M, Mesia R, Townsend S, Jackson A, Dalla Pria A, Newsom-Davis T, Handford J, Sita-Lumsden A, Apthorp E, Vincenzi B, Bertuzzi A, Brunet J, Lambertini M, Maluquer C, Pedrazzoli P, Biello F, Sinclair A, Bawany S, Khalique S, Rossi S, Rogers L, Murphy C, Belessiotis K, Carmona-García MC, Sharkey R, García-Illescas D, Rizzo G, Perachino M, Saoudi-Gonzalez N, Doonga K, Fox L, Roldán E, Gaidano G, Ruiz-Camps I, Bruna R, Patriarca A, Martinez-Vila C, Cantini L, Zambelli A, Giusti R, Mazzoni F, Caliman E, Santoro A, Grosso F, Parisi A, Queirolo P, Aujayeb A, Rimassa L, Prat A, Tucci M, Libertini M, Grisanti S, Mukherjee U, Diamantis N, Fusco V, Generali D, Provenzano S, Gennari A, Tabernero J, Cortellini A, Evans JS, Swallow J, Chung C, Patel M, Dettorre G, Ottaviani D, Chowdhury A, Merry E, Chopra N, Lee AJX, Sng CCT, Yu T, Shawe-Taylor M, Bain HDC, Wong YNS, Galazi M, Benafif S, Dileo P, Earnshaw I, Patel G, Wu A, Soosaipillai G, Cooper L, Andaleeb R, Dolly S, Apthorp E, Srikandarajah K, Jones E, Van Hemelrijck M, Moss C, Russell B, Chester J, Loizidou A, Piccart M, Cruz CA, Reyes R, Segui E, Marco-Hernández J, Viladot M, Eremiev S, Fort-Culillas R, Garcia I, Liñan R, Roqué Lloveras A, Harbeck N, Wuerstlein R, Henze F, Mahner S, Felip E, Pous A, D'Avanzo F, Scotti L, Krengli M, Marrari A, Delfanti S, Maconi A, Betti M, Tonini G, Di Fazio GR, Tondini C, Chiudinelli L, Franchi M, Libertini M, Bertulli R, Baggi A, Tovazzi V, Ficorella C, Porzio G, Saponara M, Filetti M, Zoratto F, Paoloni F, Berardi R, Guida A, Bracarda S, Iglesias M, Sanchez de Torre A, Tagliamento M, Colomba E, Pommeret F. Outcomes of the SARS-CoV-2 omicron (B.1.1.529) variant outbreak among vaccinated and unvaccinated patients with cancer in Europe: results from the retrospective, multicentre, OnCovid registry study. Lancet Oncol 2022;23:865-875. [PMID: 35660139 PMCID: PMC9162476 DOI: 10.1016/s1470-2045(22)00273-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 12/11/2022]

Abstract

BACKGROUND

The omicron (B.1.1.529) variant of SARS-CoV-2 is highly transmissible and escapes vaccine-induced immunity. We aimed to describe outcomes due to COVID-19 during the omicron outbreak compared with the prevaccination period and alpha (B.1.1.7) and delta (B.1.617.2) waves in patients with cancer in Europe.

METHODS

In this retrospective analysis of the multicentre OnCovid Registry study, we recruited patients aged 18 years or older with laboratory-confirmed diagnosis of SARS-CoV-2, who had a history of solid or haematological malignancy that was either active or in remission. Patient were recruited from 37 oncology centres from UK, Italy, Spain, France, Belgium, and Germany. Participants were followed up from COVID-19 diagnosis until death or loss to follow-up, while being treated as per standard of care. For this analysis, we excluded data from centres that did not actively enter new data after March 1, 2021 (in France, Germany, and Belgium). We compared measures of COVID-19 morbidity, which were complications from COVID-19, hospitalisation due to COVID-19, and requirement of supplemental oxygen and COVID-19-specific therapies, and COVID-19 mortality across three time periods designated as the prevaccination (Feb 27 to Nov 30, 2020), alpha-delta (Dec 1, 2020, to Dec 14, 2021), and omicron (Dec 15, 2021, to Jan 31, 2022) phases. We assessed all-cause case-fatality rates at 14 days and 28 days after diagnosis of COVID-19 overall and in unvaccinated and fully vaccinated patients and in those who received a booster dose, after adjusting for country of origin, sex, age, comorbidities, tumour type, stage, and status, and receipt of systemic anti-cancer therapy. This study is registered with ClinicalTrials.gov, NCT04393974, and is ongoing.

FINDINGS

As of Feb 4, 2022 (database lock), the registry included 3820 patients who had been diagnosed with COVID-19 between Feb 27, 2020, and Jan 31, 2022. 3473 patients were eligible for inclusion (1640 [47·4%] were women and 1822 [52·6%] were men, with a median age of 68 years [IQR 57-77]). 2033 (58·5%) of 3473 were diagnosed during the prevaccination phase, 1075 (31·0%) during the alpha-delta phase, and 365 (10·5%) during the omicron phase. Among patients diagnosed during the omicron phase, 113 (33·3%) of 339 were fully vaccinated and 165 (48·7%) were boosted, whereas among those diagnosed during the alpha-delta phase, 152 (16·6%) of 915 were fully vaccinated and 21 (2·3%) were boosted. Compared with patients diagnosed during the prevaccination period, those who were diagnosed during the omicron phase had lower case-fatality rates at 14 days (adjusted odds ratio [OR] 0·32 [95% CI 0·19-0·61) and 28 days (0·34 [0·16-0·79]), complications due to COVID-19 (0·26 [0·17-0·46]), and hospitalisation due to COVID-19 (0·17 [0·09-0·32]), and had less requirements for COVID-19-specific therapy (0·22 [0·15-0·34]) and oxygen therapy (0·24 [0·14-0·43]) than did those diagnosed during the alpha-delta phase. Unvaccinated patients diagnosed during the omicron phase had similar crude case-fatality rates at 14 days (ten [25%] of 40 patients vs 114 [17%] of 656) and at 28 days (11 [27%] of 40 vs 184 [28%] of 656) and similar rates of hospitalisation due to COVID-19 (18 [43%] of 42 vs 266 [41%] of 652) and complications from COVID-19 (13 [31%] of 42 vs 237 [36%] of 659) as those diagnosed during the alpha-delta phase.

INTERPRETATION

Despite time-dependent improvements in outcomes reported in the omicron phase compared with the earlier phases of the pandemic, patients with cancer remain highly susceptible to SARS-CoV-2 if they are not vaccinated against SARS-CoV-2. Our findings support universal vaccination of patients with cancer as a protective measure against morbidity and mortality from COVID-19.

FUNDING

National Institute for Health and Care Research Imperial Biomedical Research Centre and the Cancer Treatment and Research Trust.

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Wong YNS, Sng CCT, Ottaviani D, Patel G, Chowdhury A, Earnshaw I, Sinclair A, Merry E, Wu A, Galazi M, Benafif S, Soosaipillai G, Chopra N, Roylance R, Shaw H, Lee AJX. Systemic Anti-Cancer Therapy and Metastatic Cancer Are Independent Mortality Risk Factors during Two UK Waves of the COVID-19 Pandemic at University College London Hospital. Cancers (Basel) 2021;13:6085. [PMID: 34885194 PMCID: PMC8657102 DOI: 10.3390/cancers13236085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/18/2021] [Accepted: 11/26/2021] [Indexed: 12/15/2022] Open

Affiliation(s)

Yien Ning Sophia Wong Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.) UCL Cancer Institute, University College London, London WC1E 6BT, UK
Christopher C. T. Sng Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.)
Diego Ottaviani Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.)
Grisma Patel Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.)
Amani Chowdhury Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.)
Irina Earnshaw Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.)
Alasdair Sinclair Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.)
Eve Merry Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.)
Anjui Wu Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.)
Myria Galazi Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.)
Sarah Benafif Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.)
Gehan Soosaipillai Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.)
Neha Chopra Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.)
Rebecca Roylance Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.) NIHR University College London Hospitals Biomedical Research Centre, London W1T 7DN, UK
Heather Shaw Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.)
Alvin J. X. Lee Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (Y.N.S.W.); (C.C.T.S.); (D.O.); (G.P.); (A.C.); (I.E.); (A.S.); (E.M.); (A.W.); (M.G.); (S.B.); (G.S.); (N.C.); (R.R.); (H.S.) UCL Cancer Institute, University College London, London WC1E 6BT, UK

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Pinato DJ, Tabernero J, Bower M, Scotti L, Patel M, Colomba E, Dolly S, Loizidou A, Chester J, Mukherjee U, Zambelli A, Dalla Pria A, Aguilar-Company J, Ottaviani D, Chowdhury A, Merry E, Salazar R, Bertuzzi A, Brunet J, Lambertini M, Tagliamento M, Pous A, Sita-Lumsden A, Srikandarajah K, Colomba J, Pommeret F, Seguí E, Generali D, Grisanti S, Pedrazzoli P, Rizzo G, Libertini M, Moss C, Evans JS, Russell B, Harbeck N, Vincenzi B, Biello F, Bertulli R, Liñan R, Rossi S, Carmona-García MC, Tondini C, Fox L, Baggi A, Fotia V, Parisi A, Porzio G, Saponara M, Cruz CA, García-Illescas D, Felip E, Roqué Lloveras A, Sharkey R, Roldán E, Reyes R, Earnshaw I, Ferrante D, Marco-Hernández J, Ruiz-Camps I, Gaidano G, Patriarca A, Bruna R, Sureda A, Martinez-Vila C, Sanchez de Torre A, Cantini L, Filetti M, Rimassa L, Chiudinelli L, Franchi M, Krengli M, Santoro A, Prat A, Van Hemelrijck M, Diamantis N, Newsom-Davis T, Gennari A, Cortellini A. Prevalence and impact of COVID-19 sequelae on treatment and survival of patients with cancer who recovered from SARS-CoV-2 infection: evidence from the OnCovid retrospective, multicentre registry study. Lancet Oncol 2021;22:1669-1680. [PMID: 34741822 PMCID: PMC8565932 DOI: 10.1016/s1470-2045(21)00573-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 12/14/2022]

Abstract

BACKGROUND

The medium-term and long-term impact of COVID-19 in patients with cancer is not yet known. In this study, we aimed to describe the prevalence of COVID-19 sequelae and their impact on the survival of patients with cancer. We also aimed to describe patterns of resumption and modifications of systemic anti-cancer therapy following recovery from SARS-CoV-2 infection.

METHODS

OnCovid is an active European registry study enrolling consecutive patients aged 18 years or older with a history of solid or haematological malignancy and who had a diagnosis of RT-PCR confirmed SARS-CoV-2 infection. For this retrospective study, patients were enrolled from 35 institutions across Belgium, France, Germany, Italy, Spain, and the UK. Patients who were diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, and entered into the registry at the point of data lock (March 1, 2021), were eligible for analysis. The present analysis was focused on COVID-19 survivors who underwent clinical reassessment at each participating institution. We documented prevalence of COVID-19 sequelae and described factors associated with their development and their association with post-COVID-19 survival, which was defined as the interval from post-COVID-19 reassessment to the patients' death or last follow-up. We also evaluated resumption of systemic anti-cancer therapy in patients treated within 4 weeks of COVID-19 diagnosis. The OnCovid study is registered in ClinicalTrials.gov, NCT04393974.

FINDINGS

2795 patients diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, were entered into the study by the time of the data lock on March 1, 2021. After the exclusion of ineligible patients, the final study population consisted of 2634 patients. 1557 COVID-19 survivors underwent a formal clinical reassessment after a median of 22·1 months (IQR 8·4-57·8) from cancer diagnosis and 44 days (28-329) from COVID-19 diagnosis. 234 (15·0%) patients reported COVID-19 sequelae, including respiratory symptoms (116 [49·6%]) and residual fatigue (96 [41·0%]). Sequelae were more common in men (vs women; p=0·041), patients aged 65 years or older (vs other age groups; p=0·048), patients with two or more comorbidities (vs one or none; p=0·0006), and patients with a history of smoking (vs no smoking history; p=0·0004). Sequelae were associated with hospitalisation for COVID-19 (p<0·0001), complicated COVID-19 (p<0·0001), and COVID-19 therapy (p=0·0002). With a median post-COVID-19 follow-up of 128 days (95% CI 113-148), COVID-19 sequelae were associated with an increased risk of death (hazard ratio [HR] 1·80 [95% CI 1·18-2·75]) after adjusting for time to post-COVID-19 reassessment, sex, age, comorbidity burden, tumour characteristics, anticancer therapy, and COVID-19 severity. Among 466 patients on systemic anti-cancer therapy, 70 (15·0%) permanently discontinued therapy, and 178 (38·2%) resumed treatment with a dose or regimen adjustment. Permanent treatment discontinuations were independently associated with an increased risk of death (HR 3·53 [95% CI 1·45-8·59]), but dose or regimen adjustments were not (0·84 [0·35-2·02]).

INTERPRETATION

Sequelae post-COVID-19 affect up to 15% of patients with cancer and adversely affect survival and oncological outcomes after recovery. Adjustments to systemic anti-cancer therapy can be safely pursued in treatment-eligible patients.

FUNDING

National Institute for Health Research Imperial Biomedical Research Centre and the Cancer Treatment and Research Trust.

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Affiliation(s)

David J Pinato Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
Josep Tabernero Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
Mark Bower Department of Oncology, Chelsea and Westminster Hospital, London, UK; National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
Lorenza Scotti Unit of Medical Statistics, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
Meera Patel Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
Emeline Colomba Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
Saoirse Dolly Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
Angela Loizidou Department of Infectious Diseases, Internal Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
John Chester Medical Oncology, School of Medicine, Cardiff University, Cardiff, UK; Medical Oncology, Velindre Cancer Centre, Cardiff, UK
Uma Mukherjee Medical Oncology, Barts Health NHS Trust, London, UK
Alberto Zambelli Oncology Unit, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
Alessia Dalla Pria Department of Oncology, Chelsea and Westminster Hospital, London, UK; National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
Juan Aguilar-Company Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
Diego Ottaviani Cancer Division, University College London Hospitals, London, UK
Amani Chowdhury Cancer Division, University College London Hospitals, London, UK
Eve Merry Cancer Division, University College London Hospitals, London, UK
Ramon Salazar Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program, Hospitalet de Llobregat, Barcelona, Spain
Alexia Bertuzzi Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
Joan Brunet Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
Matteo Lambertini Medical Oncology Department, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genova, Genova, Italy
Marco Tagliamento Medical Oncology Department, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genova, Genova, Italy
Anna Pous Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
Ailsa Sita-Lumsden Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
Krishnie Srikandarajah Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
Johann Colomba Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
Fanny Pommeret Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
Elia Seguí Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
Daniele Generali Multidisciplinary Breast Pathology and Translational Research Unit, Azienda Socio Sanitaria Territoriale Cremona, Cremona, Italy; Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
Salvatore Grisanti Medical Oncology Unit, Spedali Civili, Brescia, Italy; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
Paolo Pedrazzoli Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
Gianpiero Rizzo Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
Michela Libertini Medical Oncology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
Charlotte Moss Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
Joanne S Evans Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
Beth Russell Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
Nadia Harbeck Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and Comprehensive Cancer Center Munich, University Hospital Munich, Munich, Germany
Bruno Vincenzi Policlinico Universitario Campus Bio-Medico, Rome, Italy
Federica Biello Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Azienda Ospedaliera Maggiore Della Caritá, Novara, Italy
Rossella Bertulli Medical Oncology 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
Raquel Liñan Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
Sabrina Rossi Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
Maria Carmen Carmona-García Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
Carlo Tondini Oncology Unit, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
Laura Fox Haematology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
Alice Baggi Medical Oncology Unit, Spedali Civili, Brescia, Italy; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
Vittoria Fotia Oncology Unit, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
Alessandro Parisi Department of Life, Health & Environmental Sciences, University of L'Aquila, L'Aquila, Italy
Giampero Porzio Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
Maristella Saponara Melanoma and Sarcoma Medical Treatment Unit, Istituto Europeo di Oncologia, Milan, Italy
Claudia Andrea Cruz Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
David García-Illescas Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
Eudald Felip Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
Ariadna Roqué Lloveras Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
Rachel Sharkey Department of Oncology, Chelsea and Westminster Hospital, London, UK; National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
Elisa Roldán Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
Roxana Reyes Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
Irina Earnshaw Cancer Division, University College London Hospitals, London, UK
Daniela Ferrante Unit of Medical Statistics, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
Javier Marco-Hernández Department of Internal Medicine, Hospital Clinic, Barcelona, Spain
Isabel Ruiz-Camps Infectious Diseases, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
Gianluca Gaidano Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Azienda Ospedaliera Maggiore Della Caritá, Novara, Italy
Andrea Patriarca Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Azienda Ospedaliera Maggiore Della Caritá, Novara, Italy
Riccardo Bruna Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Azienda Ospedaliera Maggiore Della Caritá, Novara, Italy
Anna Sureda Haematology Department, ICO L'Hospitalet, Oncobell Program, Hospitalet de Llobregat, Barcelona, Spain
Clara Martinez-Vila Fundació Althaia Manresa, Manresa, Spain
Ana Sanchez de Torre Hospital Universitario XII de Octubre, Madrid, Spain
Luca Cantini Medical Oncology, Azienda Ospedaliero Universitaria, Ospedali Riuniti, Polytechnic University of the Marche Region, Ancona, Italy
Marco Filetti Medical Oncology, Sant'Andrea Hospital, Rome, Italy
Lorenza Rimassa Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
Lorenzo Chiudinelli Oncology Unit, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
Michela Franchi Oncology Unit, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
Marco Krengli Division of Radiotherapy, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Azienda Ospedaliera Maggiore Della Caritá, Novara, Italy
Armando Santoro Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
Aleix Prat Department of Medical Oncology, Hospital Clinic, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain, Barcelona, Spain
Mieke Van Hemelrijck Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
Nikolaos Diamantis Medical Oncology, Barts Health NHS Trust, London, UK
Thomas Newsom-Davis Department of Oncology, Chelsea and Westminster Hospital, London, UK; National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
Alessandra Gennari Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Azienda Ospedaliera Maggiore Della Caritá, Novara, Italy
Alessio Cortellini Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy

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Merry E, Thway K, Jones RL, Huang PH. Predictive and prognostic transcriptomic biomarkers in soft tissue sarcomas. NPJ Precis Oncol 2021;5:17. [PMID: 33674685 PMCID: PMC7935908 DOI: 10.1038/s41698-021-00157-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/04/2021] [Indexed: 02/06/2023] Open

Abstract

Soft tissue sarcomas (STS) are rare and heterogeneous tumours comprising over 80 different histological subtypes. Treatment options remain limited in advanced STS with high rates of recurrence following resection of localised disease. Prognostication in clinical practice relies predominantly on histological grading systems as well as sarcoma nomograms. Rapid developments in gene expression profiling technologies presented opportunities for applications in sarcoma. Molecular profiling of sarcomas has improved our understanding of the cancer biology of these rare cancers and identified potential novel therapeutic targets. In particular, transcriptomic signatures could play a role in risk classification in sarcoma to aid prognostication. Unlike other solid and haematological malignancies, transcriptomic signatures have not yet reached routine clinical use in sarcomas. Herein, we evaluate early developments in gene expression profiling in sarcomas that laid the foundations for transcriptomic signature development. We discuss the development and clinical evaluation of key transcriptomic biomarker signatures in sarcomas, including Complexity INdex in SARComas (CINSARC), Genomic Grade Index, and hypoxia-associated signatures. Prospective validation of these transcriptomic signatures is required, and prospective trials are in progress to evaluate reliability for clinical application. We anticipate that integration of these gene expression signatures alongside existing prognosticators and other Omics methodologies, including proteomics and DNA methylation analysis, could improve the identification of 'high-risk' patients who would benefit from more aggressive or selective treatment strategies. Moving forward, the incorporation of these transcriptomic prognostication signatures in clinical practice will undoubtedly advance precision medicine in the routine clinical management of sarcoma patients.

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Merry E, Marples M, Danson S, Harding D, Denny J, Vazquez I, Chesshire L, Taylor F, Fusi A, Dalgleish A. Effect of carboplatin when administered after dacarbazine failure: Clinical benefit of sequential therapy. Mol Clin Oncol 2020;13:73. [DOI: 10.3892/mco.2020.2144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 08/13/2020] [Indexed: 11/05/2022] Open

Merry E, Smrke A, Halai K, Patel G, Thway K, Jones RL, Benson C. Paraneoplastic dermatomyositis associated with metastatic leiomyosarcoma of unknown primary. Clin Sarcoma Res 2020;10:15. [PMID: 32864095 PMCID: PMC7448307 DOI: 10.1186/s13569-020-00140-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/17/2020] [Indexed: 11/10/2022] Open

Abstract

Background

Sarcomas are rare and heterogeneous tumours of mesenchymal origin, with over 100 histological subtypes. Paraneoplastic dermatomyositis has rarely been described in sarcoma. This is the first documented case of paraneoplastic dermatomyositis in a patient with metastatic leiomyosarcoma.

Case presentation

A 43-year-old female diagnosed with metastatic leiomyosarcoma of unknown primary presented with a mild rash in sun-exposed areas of her face and upper chest, with no other neuromuscular symptoms. This rash resolved with systemic treatment with doxorubicin for metastatic leiomyosarcoma. Imaging assessment confirmed overall stable disease after chemotherapy completion. She presented acutely 2 months later with new onset rash in a shawl-like distribution, periorbital oedema and proximal muscle weakness. Based on the characteristic cutaneous signs and symmetrical proximal muscle weakness, abnormal electromyography and raised skeletal muscle enzymes with a positive anti-transcription intermediary factor-1 gamma antibody result, a diagnosis of paraneoplastic dermatomyositis was made. Re-evaluation of her metastatic leiomyosarcoma revealed disease progression. Second-line chemotherapy was commenced once the dermatomyositis was controlled on steroid therapy. Systemic anti-cancer therapy was again associated with mild improvement in dermatomyositis symptoms.

Discussion

Paraneoplastic dermatomyositis heralded disease progression after first-line chemotherapy; however, in hindsight, subtle cutaneous features were present at sarcoma diagnosis. The temporal relationship between paraneoplastic dermatomyositis and metastatic leiomyosarcoma is key in this case, as fluctuations in dermatomyositis severity correlated with growth of metastatic disease. Understanding this relationship may provide clues for tumour progression and prompt timely initiation of anti-cancer therapy. It is important to recognise that in addition to the more common cancers associated with paraneoplastic dermatomyositis, it can also occur in rarer tumours such as leiomyosarcoma.

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Younger E, Smrke A, Lidington E, Farag S, Ingley K, Chopra N, Maleddu A, Augustin Y, Merry E, Wilson R, Benson C, Miah A, Zaidi S, McTiernan A, Strauss SJ, Dileo P, Gennatas S, Husson O, Jones RL. Health-Related Quality of Life and Experiences of Sarcoma Patients during the COVID-19 Pandemic. Cancers (Basel) 2020;12:cancers12082288. [PMID: 32823999 PMCID: PMC7547383 DOI: 10.3390/cancers12082288] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/05/2020] [Accepted: 08/10/2020] [Indexed: 01/08/2023] Open

Affiliation(s)

Eugenie Younger The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
Alannah Smrke The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
Emma Lidington The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
Sheima Farag The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
Katrina Ingley University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
Neha Chopra University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
Alessandra Maleddu University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
Yolanda Augustin The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
Eve Merry The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
Roger Wilson Sarcoma Patients EuroNet e.V./Association, D-61200 Wolfersheim, Germany;
Charlotte Benson The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
Aisha Miah The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.) Institute of Cancer Research, London SM2 5NG, UK;
Shane Zaidi The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
Anne McTiernan University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
Sandra J. Strauss University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
Palma Dileo University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
Spyridon Gennatas The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
Olga Husson Institute of Cancer Research, London SM2 5NG, UK;
Robin L. Jones The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.) Institute of Cancer Research, London SM2 5NG, UK; Correspondence: ; Tel.: +44-207-352-8171

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Smrke A, Younger E, Wilson R, Husson O, Farag S, Merry E, Macklin-Doherty A, Cojocaru E, Arthur A, Benson C, Miah AB, Zaidi S, Gennatas S, Jones RL. Telemedicine During the COVID-19 Pandemic: Impact on Care for Rare Cancers. JCO Glob Oncol 2020;6:1046-1051. [PMID: 32639877 PMCID: PMC7392777 DOI: 10.1200/go.20.00220] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open

Rayner L, Merry E. Continuation of acid suppression therapy on intensive care discharge: a clinical audit. Clin Med (Lond) 2017;17:s4. [PMID: 30958766 PMCID: PMC6334146 DOI: 10.7861/clinmedicine.17-3-s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]

Chavele KM, Merry E, Ehrenstein MR. Cutting edge: circulating plasmablasts induce the differentiation of human T follicular helper cells via IL-6 production. J Immunol 2015;194:2482-5. [PMID: 25681343 PMCID: PMC4356730 DOI: 10.4049/jimmunol.1401190] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]

Coulter F, Armstrong KM, Armstrong EM, Davies A, Merry E, Skinner ER, Corrigan FM. The role of lipids in the increased mortality following bereavement. Clin Chim Acta 1993;214:119-22. [PMID: 8453773 DOI: 10.1016/0009-8981(93)90311-q] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]