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Mostaghim A, Minkove S, Aguilar-Company J, Ruiz-Camps I, Eremiev-Eremiev S, Dettorre GM, Fox L, Tondini C, Brunet J, Carmona-García MC, Lambertini M, Bower M, Newsom-Davis T, Sharkey R, Pria AD, Rossi M, Plaja A, Salazar R, Sureda A, Prat A, Michalarea V, Van Hemelrijck M, Sita-Lumsden A, Bertuzzi A, Rimassa L, Rossi S, Rizzo G, Pedrazzoli P, Lee AJ, Murphy C, Belessiotis K, Diamantis N, Mukherjee U, Pommeret F, Stoclin A, Martinez-Vila C, Bruna R, Gaidano G, D'Avanzo F, Gennari A, Athale J, Eichacker P, Pinato DJ, Torabi-Parizi P, Cortellini A. Previous immune checkpoint inhibitor therapy is associated with decreased COVID-19-related hospitalizations and complications in patients with cancer: Results of a propensity-matched analysis of the OnCovid registry. Int J Infect Dis 2024; 139:13-20. [PMID: 38029831 DOI: 10.1016/j.ijid.2023.11.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/06/2023] [Accepted: 11/16/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVES To date, studies have not provided definitive answers regarding whether previous immune checkpoint inhibitor (ICI) treatment alters outcomes for cancer patients with COVID-19. METHODS The OnCovid registry (NCT04393974) was searched from February 27, 2020, to January 31, 2022, for patients who received systemic anti-cancer therapy in the 4 weeks before laboratory-confirmed COVID-19 diagnosis. Propensity-score matching using country, vaccination status, primary tumor type, sex, age, comorbidity burden, tumor stage, and remission status investigated differences in predefined clinical outcomes comparing those who had or had not received ICIs. RESULTS Of 3523 patients screened, 137 ICI-only and 1378 non-ICI met inclusion criteria. Before matching, ICI patients were older, male, enrolled at centers in Italy, and had histories of smoking, thoracic cancers, advanced cancer stages, and active malignancies (P ≤0.02). After matching, there were 120 ICI and 322 non-ICI patients. ICI patients had no differences (odds ratio: 95% CI) in presenting COVID-19 symptoms (0.69: 0.37-1.28), receipt of COVID-specific therapy (0.88: 0.54-1.41), 14-day (0.95: 0.56-1.61), or 28-day (0.79: 0.48-1.29) mortalities. However, ICI patients required less COVID-19-related hospitalization (0.37: 0.21-0.67) and oxygen therapy (0.51: 0.31-0.83) and developed fewer complications (0.57: 0.36-0.92). CONCLUSION In this propensity-score matched analysis, previous ICI therapy did not worsen and potentially improved COVID-19 outcomes in patients with cancer.
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Affiliation(s)
- Anahita Mostaghim
- Critical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, USA; Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, USA
| | - Samuel Minkove
- Critical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, USA
| | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain; Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Isabel Ruiz-Camps
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain; Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Simeon Eremiev-Eremiev
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain; Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Gino M Dettorre
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, USA
| | - Laura Fox
- Department of Hematology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Carlo Tondini
- Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Joan Brunet
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - MCarmen Carmona-García
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Matteo Lambertini
- Medical Oncology Department, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Thomas Newsom-Davis
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Alessia Dalla Pria
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Maura Rossi
- Oncology Unit, Azienda Ospedaliera "SS Antonio e Biagio e Cesare Arrigo", Alessandria, Italy
| | - Andrea Plaja
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology-Badalona, Spain
| | - Ramon Salazar
- Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Sureda
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - Vasiliki Michalarea
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Mieke Van Hemelrijck
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK; Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Lorenza Rimassa
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, Milan, Italy
| | - Sabrina Rossi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Alvin Jx Lee
- Cancer Division, University College London Hospital, London, UK
| | - Cian Murphy
- Cancer Division, University College London Hospital, London, UK
| | | | | | - Uma Mukherjee
- Medical Oncology, Barts Health NHS Trust, London, UK
| | - Fanny Pommeret
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - Annabelle Stoclin
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | | | - Riccardo Bruna
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Ospedale Maggiore della Carità Hospital, Novara, Italy
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Ospedale Maggiore della Carità Hospital, Novara, Italy
| | - Francesca D'Avanzo
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Janhavi Athale
- Critical Care Medicine, Mayo Clinic Arizona, Phoenix, USA
| | - Peter Eichacker
- Critical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, USA
| | - David J Pinato
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Department of Surgery and Cancer, Imperial College of London, Hammersmith Hospital Campus, London, UK
| | - Parizad Torabi-Parizi
- Critical Care Medicine Department, Clinical Center and National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Alessio Cortellini
- Department of Surgery and Cancer, Imperial College of London, Hammersmith Hospital Campus, London, UK; Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128, Roma, Italy.
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Nickl-Jockschat T, Sharkey R, Bacon C, Peterson Z, Rootes-Murdy K, Salvador R, Pomarol E, Karuk A, Homan P, Ji E, Omlor W, Homan S, Georgiadis F, Kaiser S, Kirschner M, Ehrlich S, Dannlowski U, Grotegerd D, Goltermann J, Meinert S, Kircher T, Stein F, Brosch K, Krug A, Nenadic I, Sim K, Piras F, Banaj N, Sponheim S, Demro C, Ramsay I, King M, Quidé Y, Green M, Nguyen D, Preda A, Calhoun V, Turner J, van Erp T, Spalletta G. Neural Correlates of Positive and Negative Formal Thought Disorder in Individuals with Schizophrenia: An ENIGMA Schizophrenia Working Group Study. Res Sq 2023:rs.3.rs-3179362. [PMID: 37841855 PMCID: PMC10571603 DOI: 10.21203/rs.3.rs-3179362/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Formal thought disorder (FTD) is a key clinical factor in schizophrenia, but the neurobiological underpinnings remain unclear. In particular, relationship between FTD symptom dimensions and patterns of regional brain volume deficiencies in schizophrenia remain to be established in large cohorts. Even less is known about the cellular basis of FTD. Our study addresses these major obstacles based on a large multi-site cohort through the ENIGMA Schizophrenia Working Group (752 individuals with schizophrenia and 1256 controls), to unravel the neuroanatomy of positive, negative and total FTD in schizophrenia and their cellular bases. We used virtual histology tools to relate brain structural changes associated with FTD to cellular distributions in cortical regions. We identified distinct neural networks for positive and negative FTD. Both networks encompassed fronto-occipito-amygdalar brain regions, but negative FTD showed a relative sparing of orbitofrontal cortical thickness, while positive FTD also affected lateral temporal cortices. Virtual histology identified distinct transcriptomic fingerprints associated for both symptom dimensions. Negative FTD was linked to neuronal and astrocyte fingerprints, while positive FTD was also linked to microglial cell types. These findings relate different dimensions of FTD to distinct brain structural changes and their cellular underpinnings, improve our mechanistic understanding of these key psychotic symptoms.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster
| | | | | | | | | | | | | | | | - Igor Nenadic
- Philipps University Marburg / Marburg University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | - Vince Calhoun
- Georgia Institute of Technology, Emory University and Georgia State University
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3
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Tagliamento M, Gennari A, Lambertini M, Salazar R, Harbeck N, Del Mastro L, Aguilar-Company J, Bower M, Sharkey R, Dalla Pria A, Plaja A, Jackson A, Handford J, Sita-Lumsden A, Martinez-Vila C, Matas M, Miguel Rodriguez A, Vincenzi B, Tonini G, Bertuzzi A, Brunet J, Pedrazzoli P, D'Avanzo F, Biello F, Sinclair A, Lee AJ, Rossi S, Rizzo G, Mirallas O, Pimentel I, Iglesias M, Sanchez de Torre A, Guida A, Berardi R, Zambelli A, Tondini C, Filetti M, Mazzoni F, Mukherjee U, Diamantis N, Parisi A, Aujayeb A, Prat A, Libertini M, Grisanti S, Rossi M, Zoratto F, Generali D, Saura C, Lyman GH, Kuderer NM, Pinato DJ, Cortellini A. Pandemic Phase-Adjusted Analysis of COVID-19 Outcomes Reveals Reduced Intrinsic Vulnerability and Substantial Vaccine Protection From Severe Acute Respiratory Syndrome Coronavirus 2 in Patients With Breast Cancer. J Clin Oncol 2023; 41:2800-2814. [PMID: 36720089 PMCID: PMC10414724 DOI: 10.1200/jco.22.01667] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/07/2022] [Accepted: 12/12/2022] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Although representing the majority of newly diagnosed cancers, patients with breast cancer appear less vulnerable to COVID-19 mortality compared with other malignancies. In the absence of patients on active cancer therapy included in vaccination trials, a contemporary real-world evaluation of outcomes during the various pandemic phases, as well as of the impact of vaccination, is needed to better inform clinical practice. METHODS We compared COVID-19 morbidity and mortality among patients with breast cancer across prevaccination (February 27, 2020-November 30, 2020), Alpha-Delta (December 1, 2020-December 14, 2021), and Omicron (December 15, 2021-January 31, 2022) phases using OnCovid registry participants (ClinicalTrials.gov identifier: NCT04393974). Twenty-eight-day case fatality rate (CFR28) and COVID-19 severity were compared in unvaccinated versus double-dosed/boosted patients (vaccinated) with inverse probability of treatment weighting models adjusted for country of origin, age, number of comorbidities, tumor stage, and receipt of systemic anticancer therapy within 1 month of COVID-19 diagnosis. RESULTS By the data lock of February 4, 2022, the registry counted 613 eligible patients with breast cancer: 60.1% (n = 312) hormone receptor-positive, 25.2% (n = 131) human epidermal growth factor receptor 2-positive, and 14.6% (n = 76) triple-negative. The majority (61%; n = 374) had localized/locally advanced disease. Median age was 62 years (interquartile range, 51-74 years). A total of 193 patients (31.5%) presented ≥ 2 comorbidities and 69% (n = 330) were never smokers. In total, 392 (63.9%), 164 (26.8%), and 57 (9.3%) were diagnosed during the prevaccination, Alpha-Delta, and Omicron phases, respectively. Analysis of CFR28 demonstrates comparable estimates of mortality across the three pandemic phases (13.9%, 12.2%, 5.3%, respectively; P = .182). Nevertheless, a significant improvement in outcome measures of COVID-19 severity across the three pandemic time periods was observed. Importantly, when reported separately, unvaccinated patients from the Alpha-Delta and Omicron phases achieved comparable outcomes to those from the prevaccination phase. Of 566 patients eligible for the vaccination analysis, 72 (12.7%) were fully vaccinated and 494 (87.3%) were unvaccinated. We confirmed with inverse probability of treatment weighting multivariable analysis and following a clustered robust correction for participating center that vaccinated patients achieved improved CFR28 (odds ratio [OR], 0.19; 95% CI, 0.09 to 0.40), hospitalization (OR, 0.28; 95% CI, 0.11 to 0.69), COVID-19 complications (OR, 0.16; 95% CI, 0.06 to 0.45), and reduced requirement of COVID-19-specific therapy (OR, 0.24; 95% CI, 0.09 to 0.63) and oxygen therapy (OR, 0.24; 95% CI, 0.09 to 0.67) compared with unvaccinated controls. CONCLUSION Our findings highlight a consistent reduction of COVID-19 severity in patients with breast cancer during the Omicron outbreak in Europe. We also demonstrate that even in this population, a complete severe acute respiratory syndrome coronavirus 2 vaccination course is a strong determinant of improved morbidity and mortality from COVID-19.
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Affiliation(s)
- Marco Tagliamento
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
- Medical Oncology Department, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Ramon Salazar
- Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Barcelona, Spain
| | - Nadia Harbeck
- Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany
| | - Lucia Del Mastro
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
- Medical Oncology Department, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
- Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom
| | - Alessia Dalla Pria
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom
| | - Andrea Plaja
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology-Badalona, Badalona, Spain
| | | | - Jasmine Handford
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, United Kingdom
| | | | | | | | - Bruno Vincenzi
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Giuseppe Tonini
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - 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
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Francesca D'Avanzo
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Federica Biello
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Alasdair Sinclair
- Cancer Division, University College London Hospitals, London, United Kingdom
| | - Alvin J.X. Lee
- Cancer Division, University College London Hospitals, London, United Kingdom
| | - Sabrina Rossi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Oriol Mirallas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Isabel Pimentel
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - Annalisa Guida
- Department of Oncology, Azienda Ospedaliera Santa Maria, Terni, Italy
| | - Rossana Berardi
- Medical Oncology, AOU Ospedali Riuniti, Polytechnic University of the Marche Region, Ancona, Italy
| | | | - Carlo Tondini
- Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Uma Mukherjee
- Medical Oncology, Barts Health NHS Trust, London, United Kingdom
| | | | - Alessandro Parisi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, North Shields, United Kingdom
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - Michela Libertini
- Medical Oncology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | | | - Maura Rossi
- Oncology Unit, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo,” Alessandria, Italy
| | | | - Daniele Generali
- Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Cremona, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Cristina Saura
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Gary H. Lyman
- Public Health Sciences Division and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, University of Washington School of Medicine, Seattle, WA
- Divisions of Public Health Science and Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
| | | | - David J. Pinato
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Alessio Cortellini
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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Cortellini A, Tabernero J, Mukherjee U, Salazar R, Sureda A, Maluquer C, Ferrante D, Bower M, Sharkey R, Mirallas O, Plaja A, Cucurull M, Mesia R, Dalla Pria A, Newsom-Davis T, Van Hemelrijck M, Sita-Lumsden A, Apthorp E, Vincenzi B, Di Fazio GR, Tonini G, Pantano F, Bertuzzi A, Rossi S, Brunet J, Lambertini M, Pedrazzoli P, Biello F, D'Avanzo F, Lee AJX, Shawe-Taylor M, Rogers L, Murphy C, Cooper L, Andaleeb R, Khalique S, Bawany S, Ahmed S, Carmona-García MC, Fort-Culillas R, Liñan R, Zoratto F, Rizzo G, Perachino M, Doonga K, Gaidano G, Bruna R, Patriarca A, Martinez-Vila C, Pérez Criado I, Giusti R, Mazzoni F, Antonuzzo L, Santoro A, Parisi A, Queirolo P, Aujayeb A, Rimassa L, Diamantis N, Bertulli R, Fulgenzi CAM, D'Alessio A, Ruiz-Camps I, Saoudi-Gonzalez N, Garcia Illescas D, Medina I, Fox L, Gennari A, Aguilar-Company J, Pinato DJ. SARS-CoV-2 omicron (B.1.1.529)-related COVID-19 sequelae in vaccinated and unvaccinated patients with cancer: results from the OnCovid registry. Lancet Oncol 2023; 24:335-346. [PMID: 36898391 PMCID: PMC9991062 DOI: 10.1016/s1470-2045(23)00056-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND COVID-19 sequelae can affect about 15% of patients with cancer who survive the acute phase of SARS-CoV-2 infection and can substantially impair their survival and continuity of oncological care. We aimed to investigate whether previous immunisation affects long-term sequelae in the context of evolving variants of concern of SARS-CoV-2. METHODS OnCovid is an active registry that includes patients aged 18 years or older from 37 institutions across Belgium, France, Germany, Italy, Spain, and the UK with a laboratory-confirmed diagnosis of COVID-19 and a history of solid or haematological malignancy, either active or in remission, followed up from COVID-19 diagnosis until death. We evaluated the prevalence of COVID-19 sequelae in patients who survived COVID-19 and underwent a formal clinical reassessment, categorising infection according to the date of diagnosis as the omicron (B.1.1.529) phase from Dec 15, 2021, to Jan 31, 2022; the alpha (B.1.1.7)-delta (B.1.617.2) phase from Dec 1, 2020, to Dec 14, 2021; and the pre-vaccination phase from Feb 27 to Nov 30, 2020. The prevalence of overall COVID-19 sequelae was compared according to SARS-CoV-2 immunisation status and in relation to post-COVID-19 survival and resumption of systemic anticancer therapy. This study is registered with ClinicalTrials.gov, NCT04393974. FINDINGS At the follow-up update on June 20, 2022, 1909 eligible patients, evaluated after a median of 39 days (IQR 24-68) from COVID-19 diagnosis, were included (964 [50·7%] of 1902 patients with sex data were female and 938 [49·3%] were male). Overall, 317 (16·6%; 95% CI 14·8-18·5) of 1909 patients had at least one sequela from COVID-19 at the first oncological reassessment. The prevalence of COVID-19 sequelae was highest in the pre-vaccination phase (191 [19·1%; 95% CI 16·4-22·0] of 1000 patients). The prevalence was similar in the alpha-delta phase (110 [16·8%; 13·8-20·3] of 653 patients, p=0·24), but significantly lower in the omicron phase (16 [6·2%; 3·5-10·2] of 256 patients, p<0·0001). In the alpha-delta phase, 84 (18·3%; 95% CI 14·6-22·7) of 458 unvaccinated patients and three (9·4%; 1·9-27·3) of 32 unvaccinated patients in the omicron phase had sequelae. Patients who received a booster and those who received two vaccine doses had a significantly lower prevalence of overall COVID-19 sequelae than unvaccinated or partially vaccinated patients (ten [7·4%; 95% CI 3·5-13·5] of 136 boosted patients, 18 [9·8%; 5·8-15·5] of 183 patients who had two vaccine doses vs 277 [18·5%; 16·5-20·9] of 1489 unvaccinated patients, p=0·0001), respiratory sequelae (six [4·4%; 1·6-9·6], 11 [6·0%; 3·0-10·7] vs 148 [9·9%; 8·4-11·6], p=0·030), and prolonged fatigue (three [2·2%; 0·1-6·4], ten [5·4%; 2·6-10·0] vs 115 [7·7%; 6·3-9·3], p=0·037). INTERPRETATION Unvaccinated patients with cancer remain highly vulnerable to COVID-19 sequelae irrespective of viral strain. This study confirms the role of previous SARS-CoV-2 immunisation as an effective measure to protect patients from COVID-19 sequelae, disruption of therapy, and ensuing mortality. FUNDING UK National Institute for Health and Care Research Imperial Biomedical Research Centre and the Cancer Treatment and Research Trust.
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Affiliation(s)
- Alessio Cortellini
- Department of Surgery and Cancer, Imperial College London, London, UK; Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy.
| | - Josep Tabernero
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Uma Mukherjee
- Medical Oncology, Barts Health NHS Trust, London, UK
| | - Ramon Salazar
- Catalan Institute of Oncology (ICO), University of Barcelona, Bellvitge Biomedical Research Institute (IDIBELL), CIBERONC, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Sureda
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Clara Maluquer
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Daniela Ferrante
- Unit of Medical Statistics, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Oriol Mirallas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Andrea Plaja
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology, Badalona, Spain
| | - Marc Cucurull
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology, Badalona, Spain
| | - Ricard Mesia
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology, Badalona, Spain
| | - Alessia Dalla Pria
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Thomas Newsom-Davis
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Mieke Van Hemelrijck
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK; Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | | | | | - Bruno Vincenzi
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Giuseppina Rita Di Fazio
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Giuseppe Tonini
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Francesco Pantano
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Sabrina Rossi
- 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, UO Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genova, Genova, Italy
| | - Paolo Pedrazzoli
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federica Biello
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Francesca D'Avanzo
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Alvin J X Lee
- Cancer Division, University College London Hospitals, London, UK
| | | | - Lucy Rogers
- Cancer Division, University College London Hospitals, London, UK
| | - Cian Murphy
- Cancer Division, University College London Hospitals, London, UK
| | - Lee Cooper
- Cancer Division, University College London Hospitals, London, UK
| | - Ramis Andaleeb
- Cancer Division, University College London Hospitals, London, UK
| | - Saira Khalique
- Cancer Division, University College London Hospitals, London, UK
| | - Samira Bawany
- Cancer Division, University College London Hospitals, London, UK
| | - Sarah Ahmed
- Cancer Division, University College London Hospitals, London, UK
| | - M Carmen Carmona-García
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Roser Fort-Culillas
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Raquel Liñan
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | | | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marta Perachino
- Medical Oncology Department, UO Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genova, Genova, Italy
| | - Kris Doonga
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Riccardo Bruna
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Andrea Patriarca
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale 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
| | - Alessandro Parisi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Paola Queirolo
- Melanoma and Sarcoma Medical Treatment Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - 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
| | | | - Rossella Bertulli
- Medical Oncology 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Claudia A M Fulgenzi
- Department of Surgery and Cancer, Imperial College London, London, UK; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Antonio D'Alessio
- Department of Surgery and Cancer, Imperial College London, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Isabel Ruiz-Camps
- Department of Infectious Diseases, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - Nadia Saoudi-Gonzalez
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - David Garcia Illescas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Irene Medina
- Department of Hematology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - Laura Fox
- Department of Hematology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain; Department of Infectious Diseases, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - David J Pinato
- Department of Surgery and Cancer, Imperial College London, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
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Pinato D, Aguilar-Company J, Bertuzzi A, Hanbury G, Bower M, Salazar R, Lambertini M, Pedrazzoli P, Lee A, Sinclair A, Townsend S, Plaja Salarich A, Sita-Lumsden A, Mukherjee U, Diamantis N, Sharkey R, Gaidano G, Gennari A, Tabernero J, Cortellini A. 504P SARS-CoV-2 Omicron (B.1.1.529) variant infection leads to high morbidity and mortality in unvaccinated patients with cancer. Ann Oncol 2022. [PMCID: PMC9472535 DOI: 10.1016/j.annonc.2022.07.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Pinato DJ, Ferrante D, Aguilar-Company J, Bower M, Salazar R, Mirallas O, Sureda A, Bertuzzi A, Brunet J, Lambertini M, Maluquer C, Pedrazzoli P, Biello F, Lee AJX, Sng CCT, Liñan R, Rossi S, Carmona-García MC, Sharkey R, Eremiev S, Rizzo G, Bain HD, Yu T, Cruz CA, Perachino M, Saoudi-Gonzalez N, Fort-Culillas R, Doonga K, Fox L, Roldán E, Zoratto F, Gaidano G, Ruiz-Camps I, Bruna R, Patriarca A, Shawe-Taylor M, Fusco V, Martinez-Vila C, Berardi R, Filetti M, Mazzoni F, Santoro A, Delfanti S, Parisi A, Queirolo P, Aujayeb A, Rimassa L, Prat A, Tabernero J, Gennari A, Cortellini A. Vaccination against SARS-CoV-2 protects from morbidity, mortality and sequelae from COVID19 in patients with cancer. Eur J Cancer 2022; 171:64-74. [PMID: 35704976 PMCID: PMC9124924 DOI: 10.1016/j.ejca.2022.04.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/18/2022] [Accepted: 04/25/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Although SARS-CoV-2 vaccines immunogenicity in patients with cancer has been investigated, whether they can significantly improve the severity of COVID-19 in this specific population is undefined. METHODS Capitalizing on OnCovid (NCT04393974) registry data we reported COVID-19 mortality and proxies of COVID-19 morbidity, including post-COVID-19 outcomes, according to the vaccination status of the included patients. RESULTS 2090 eligible patients diagnosed with COVID-19 between 02/2020 and 11/2021 were included, of whom 1930 (92.3%) unvaccinated, 91 (4.4%) fully vaccinated and 69 (3.3%) partially vaccinated. With the exception of a higher prevalence of patients from the UK (p = 0.0003) and receiving systemic anticancer therapy at COVID-19 diagnosis (p = 0.0082) among fully vaccinated patients, no demographics/oncological features were associated with vaccination status. The 14-days case fatality rate (CFR) (5.5% vs 20.7%, p = 0.0004) and the 28-days CFR (13.2% vs 27.4%, p = 0.0028) demonstrated a significant improvement for fully vaccinated patients in comparison with unvaccinated patients. The receipt of prior full vaccination was also associated with reduced symptomatic COVID-19 (79.1% vs 88.5%, p = 0.0070), need of COVID-19 oriented therapy (34.9% vs 63.2%, p < 0.0001), complications from COVID-19 (28.6% vs 39.4%, p = 0.0379), hospitalizations due to COVID-19 (42.2% vs 52.5%, p = 0.0007) and oxygen therapy requirement (35.7% vs 52%, p = 0.0036). Following Inverse Probability Treatment Weighting (IPTW) procedure no statistically significant difference according to the vaccination status was confirmed; however, all COVID-19 related outcomes were concordantly in favour of full vaccination. Among the 1228 (58.8%) patients who underwent a formal reassessment at participating centres after COVID-19 resolution, fully vaccinated patients experienced less sequelae than unvaccinated patients (6.7% vs 17.2%, p = 0.0320). CONCLUSIONS This analysis provides initial evidence in support of the beneficial effect of SARS-CoV-2 vaccines against morbidity and mortality from COVID-19 in patients with cancer.
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Affiliation(s)
- David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Daniela Ferrante
- Department of Translational Medicine, Unit of Medical Statistics, University of Piemonte Orientale, Novara, Italy
| | - Juan Aguilar-Company
- Medical Oncology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain; Infectious Diseases, Vall D'Hebron University Hospital, Barcelona, Spain
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Ramon Salazar
- Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Spain
| | - Oriol Mirallas
- Medical Oncology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna Sureda
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, 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, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Clara Maluquer
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia Italy
| | - Federica Biello
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Alvin J X Lee
- Cancer Division, University College London Hospitals, London, UK
| | | | - 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
| | - M Carmen Carmona-García
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Simeon Eremiev
- Medical Oncology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Hamish Dc Bain
- Cancer Division, University College London Hospitals, London, UK
| | - Tamara Yu
- Cancer Division, University College London Hospitals, London, UK
| | - Claudia A Cruz
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Marta Perachino
- Medical Oncology Department, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Nadia Saoudi-Gonzalez
- Medical Oncology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Roser Fort-Culillas
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Kris Doonga
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Laura Fox
- Department of Hematology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Elisa Roldán
- Medical Oncology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore Della Carità Hospital, Novara, Italy
| | - Isabel Ruiz-Camps
- Infectious Diseases, Vall D'Hebron University Hospital, Barcelona, Spain
| | - Riccardo Bruna
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore Della Carità Hospital, Novara, Italy
| | - Andrea Patriarca
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore Della Carità Hospital, Novara, Italy
| | | | - Vittorio Fusco
- Oncology Unit and Centro Documentazione Osteonecrosi, Azienda Ospedaliera "SS Antonio e Biagio e Cesare Arrigo", Alessandria, Italy
| | | | - Rossana Berardi
- Medical Oncology, AOU Ospedali Riuniti, Polytechnic University of the Marche Region, Ancona, Italy
| | | | | | - Armando Santoro
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy
| | - Sara Delfanti
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alessandro Parisi
- Department of Life, Health & Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Paola Queirolo
- Melanoma and Sarcoma Medical Treatment Unit, IEO - Istituto Europeo di Oncologia, Milan, Italy
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Lorenza Rimassa
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - Josep Tabernero
- Medical Oncology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Alessio Cortellini
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK.
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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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Cortellini A, Aguilar-Company J, Sharkey R, Sureda Balari A, Bertuzzi AF, Brunet J, Rizzo G, Perachino M, Lee AJX, Chowdhury A, Ruiz-Camps I, Plaja A, Hanbury GH, Van Hemelrijck M, Diamantis N, Gaidano G, Grosso F, Gennari A, Tabernero J, Pinato DJJ. Clinical assessment of the Omicron outbreak in Europe and trends in morbidity and mortality from COVID-19 and cancer. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e18673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e18673 Background: Whilst patients (pts) with cancer are at increased risk of adverse outcome from Coronavirus disease 2019 (COVID-19), no evidence exists as to the natural history of the SARS-CoV-2 B.1.1.529 (Omicron) variant in this population. Methods: Capitalizing on OnCovid study data (NCT04393974), a European registry that collects data on consecutive patients with cancer and COVID-19, we analysed COVID-19 morbidity and case fatality rates at 14 days (CFR14) across 3 phases defined following the evolution of the pandemic in Europe, according to date of COVID-19 diagnosis: “Pre-vaccination” phase (27/02/2020-30/11/2020), “Alpha-Delta variant” phase (01/12/2020-14/12/2021), “Omicron variant” phase (15/12/2020-31/01/2022). Results: By the data lock of 04/02/2022, 3820 consecutive pts were enrolled, 3473 of whom were eligible for this analysis. Among them, 2033 (58.6%), 1075 (30.9%) and 365 (10.5%) were diagnosed during the Pre-vaccination, Alpha-Delta and Omicron phases. Pts diagnosed in the Omicron phase were more likely aged < 65 years (48.6% vs 42.5%, 39.4% p = 0.01), had < 2 comorbidities (61.9% vs 55.6%, 52.1% p = 0.01). They had more advanced-stage tumours (62.1% vs 53.3%, 49.0%, p < 0.01) and were more likely receiving systemic anticancer therapy (SACT) at COVID-19 diagnosis (54.9% vs 43.9%, 39.6%, p < 0.01). Proportions of fully vaccinated/boosted pts were higher in the Omicron phase (33.9%-48.1%) compared to the Alpha-Delta phase (16.6%-2.3%, p < 0.01). Pts diagnosed in the Omicron phase had improved CFR14 (9.0% vs 13.9%, 23.1%, p < 0.01) lower hospitalization rates due to COVID-19 (24.4% vs 41.4%, 56.6%, p < 0.01), lower complications rates (15.3% vs 33.6%, 39.4%, p < 0.01) and reduced need for COVID-19 specific therapy (22.4% vs 43.0%, 65.7% p < 0.01) compared to the Alpha-Delta and pre-vaccinal phase. After adjusting for country of origin, sex, age, comorbidities, tumour stage, status and receipt of SACT at COVID-19, patients diagnosed in the Omicron phase displayed the lowest risk of death at 14 days compared to earlier phases. Similarly, rates of hospitalization and complicated COVID-19 were lowest for Omicron phase. Conclusions: This is the first study to portray the evolution of the SARS-CoV-2 Omicron outbreak in Europe, documenting an improvement in all COVID-19 outcomes compared to earlier phases of the pandemic. Enhanced healthcare capacity, improved disease management, immunization campaigns alongside differential virulence of viral strains are likely contributing to improved outcomes across phases.[Table: see text]
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Affiliation(s)
- Alessio Cortellini
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Juan Aguilar-Company
- Vall d’Hebron University Hospital Institute of Oncology (VHIO), Barcelona, Spain
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom
| | - Anna Sureda Balari
- Institut Català d'Oncologia-Hospital Duran i Reynals, Hospitalet del Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Alexia Francesca Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Joan Brunet
- Medical Oncology, Catalan Institute of Oncology and Girona Biomedical Research Institute (IDIBGi), Girona, Spain
| | | | | | | | | | - Isabel Ruiz-Camps
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Andrea Plaja
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology-Badalona, Badalona, Spain
| | | | - Mieke Van Hemelrijck
- Department of Translational Oncology and Urology Research, King's College London, London, United Kingdom
| | | | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, University of Piemonte Orientale Amedeo Avogadro, Novara, Italy
| | - Federica Grosso
- SS Antonio e Biagio Hospital, Department of Oncology, Alessandria, Italy
| | - Alessandra Gennari
- Università del Piemonte Orientale - Dipartimento di Medicina Traslazionale - DIMET, Novara, Italy
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9
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Cortellini A, Gennari A, Pommeret F, Patel G, Newsom-Davis T, Bertuzzi A, Viladot M, Aguilar-Company J, Mirallas O, Felip E, Lee AJX, Pria AD, Sharkey R, Brunet J, Garcia MCC, Chester J, Mukherjee U, Scotti L, Dolly S, Sita-Lumsden A, Ferrante D, Van Hemelrijck M, Moss C, Russell B, Seguí E, Biello F, Krengli M, Marco-Hernández J, Gaidano G, Patriarca A, Bruna R, Roldán E, Fox L, Pous A, Griscelli F, Salazar R, Martinez-Vila C, Sureda A, Loizidou A, Maluquer C, Stoclin A, Iglesias M, Pedrazzoli P, Rizzo G, Santoro A, Rimassa L, Rossi S, Harbeck N, de Torre AS, Vincenzi B, Libertini M, Provenzano S, Generali D, Grisanti S, Berardi R, Tucci M, Mazzoni F, Lambertini M, Tagliamento M, Parisi A, Zoratto F, Queirolo P, Giusti R, Guida A, Zambelli A, Tondini C, Maconi A, Betti M, Colomba E, Diamantis N, Sinclair A, Bower M, Ruiz-Camps I, Pinato DJ. COVID-19 Sequelae and the Host Pro-Inflammatory Response: An Analysis From the OnCovid Registry. J Natl Cancer Inst 2022; 114:979-987. [PMID: 35417006 PMCID: PMC9047221 DOI: 10.1093/jnci/djac057] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 01/06/2022] [Revised: 02/15/2022] [Accepted: 03/11/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND 15% of patients with cancer experience symptomatic sequelae, which impair post COVID-19 outcomes. In this study we investigated whether a pro-inflammatory status is associated with the development of COVID-19 sequelae. METHODS OnCovid recruited 2795 consecutive patients, diagnosed with SARS-CoV-2 infection between 27/02/2020-14/02/2021. This analysis focused on COVID-19 survivors who underwent a clinical re-assessment after the exclusion of patients with haematological malignancies. We evaluated the association of inflammatory markers collected at COVID-19 diagnosis with sequelae, considering the impact of prior systemic anticancer therapy (SACT). RESULTS Out of 1339 patients eligible, 203 experienced at least one sequela (15.2%). Median baseline C-reactive protein (CRP, 77.5 mg/L vs 22.2 mg/L, p<.001), lactate dehydrogenase (LDH, 310 UI/L vs 274 UI/L, p=.028) and neutrophil-to-lymphocyte ratio (NLR, 6.0 vs 4.3, p=.001) were statistically significantly higher among patients who experienced sequelae, while no association were reported for platelet-to-lymphocyte ratio (PLR) and the OnCovid Inflammatory Score (OIS), which includes albumin and lymphocytes. The widest Area under the ROC curve was reported for baseline CRP (AUC 0.66,95%CI:0.63-0.69), followed by the NLR (AUC0.58,95%CI:0.55-0.61) and LDH (AUC=0.57,95%CI:0.52-0.61). Using a fixed categorical multivariable analysis high CRP (OR 2.56,95%CI:1.67-3.91) and NLR (OR 1.45,95%CI:1.01-2.10) were confirmed to be statistically significantly associated with an increased risk of sequelae. Exposure to chemotherapy was associated with a decreased risk of sequelae (OR 0.57,95%CI:0.36-0.91), while no associations with immune checkpoint inhibitors, endocrine therapy, and other types of SACT were found. CONCLUSIONS Although the association between inflammatory status, recent chemotherapy and sequelae warrants further investigations, our findings suggest that a deranged pro-inflammatory reaction at COVID-19 diagnosis may predict for sequelae development.
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Affiliation(s)
- Alessio Cortellini
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Fanny Pommeret
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France
| | - Grisma Patel
- Cancer Division, University College London Hospitals, London, UK
| | - Thomas Newsom-Davis
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit,Humanitas Cancer Center,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | | | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain.,Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Orial Mirallas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Eudald Felip
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology-Badalona, Spain
| | - Alvin J X Lee
- Cancer Division, University College London Hospitals, London, UK
| | - Alessia Dalla Pria
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Joan Brunet
- Department of Medical Oncology, Catalan Institute of Oncology,University Hospital Josep Trueta, Girona, Spain
| | - MCarmen Carmona Garcia
- Department of Medical Oncology, Catalan Institute of Oncology,University Hospital Josep Trueta, Girona, Spain
| | - 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
| | - Lorenza Scotti
- Department of Translational Medicine, Unit of Medical Statistics, University of Piemonte Orientale, Novara, Italy
| | - Saoirse Dolly
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Daniela Ferrante
- Department of Translational Medicine, Unit of Medical Statistics, University of Piemonte Orientale, Novara, Italy
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Charlotte Moss
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Elia Seguí
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Federica Biello
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Marco Krengli
- Division of Radiotherapy, Department of Translational Medicine, University of Piemonte Orientale and Azienda Ospedaliera Maggiore Della Carita, Novara, Italy
| | | | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Andrea Patriarca
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Riccardo Bruna
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Elisa Roldán
- Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Laura Fox
- Hematology Department, Vall d´Hebron Institute of Oncology (VHIO), Vall d´Hebron Hospital Universitari, Barcelona, Spain
| | - Anna Pous
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology-Badalona, Spain
| | - Franck Griscelli
- Département de Biologie et Pathologie, Gustave Roussy Cancer Campus, Villejuif 94800, France.,Université de Paris, Sorbonne Paris Cité, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France
| | - Ramon Salazar
- Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program (IDIBELL),CIBERONC, Hospitalet de Llobregat, Spain
| | | | - Anna Sureda
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Angela Loizidou
- Department of Infectious Diseases, Internal Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Clara Maluquer
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Annabelle Stoclin
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France
| | | | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia Italy
| | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Armando Santoro
- Medical Oncology and Hematology Unit,Humanitas Cancer Center,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
| | - Lorenza Rimassa
- Medical Oncology and Hematology Unit,Humanitas Cancer Center,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
| | - Sabrina Rossi
- Medical Oncology and Hematology Unit,Humanitas Cancer Center,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Nadia Harbeck
- Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany
| | | | - Bruno Vincenzi
- Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Michela Libertini
- Medical Oncology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Salvatore Provenzano
- Medical Oncology 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Daniele Generali
- Multidisciplinary Breast Pathology and Translational Research Unit,ASST Cremona, Italy.,Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
| | | | - Rossana Berardi
- Medical Oncology, AOU Ospedali Riuniti, Polytechnic University of the Marche Region, Ancona, Italy
| | - Marco Tucci
- Section of Medical Oncology, Department of Biomedical Sciences and Clinical Oncology (DIMO), University of Bari 'Aldo Moro', Bari, Italy.,IRCCS, Istituto Tumori Giovanni Paolo II, Bari
| | | | - Matteo Lambertini
- Medical Oncology Department, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), 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 (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Alessandro Parisi
- Department of Life, Health & Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Paola Queirolo
- Melanoma and Sarcoma Medical Treatment Unit, IEO - Istituto Europeo di Oncologia, Milan, Italy
| | | | - Annalisa Guida
- Department of Oncology, Azienda Ospedaliera Santa Maria, Terni, Italy
| | | | - Carlo Tondini
- Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Antonio Maconi
- Infrastruttura Ricerca Formazione Innovazione, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Marta Betti
- Infrastruttura Ricerca Formazione Innovazione, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Emeline Colomba
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France
| | - Nikolaos Diamantis
- Department of Translational Medicine, Unit of Medical Statistics, University of Piemonte Orientale, Novara, Italy
| | | | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Isabel Ruiz-Camps
- Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK.,Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
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10
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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
| | | | | | - 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
| | | | - 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
| | | | - 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
| | | | | | - Luca Cantini
- Medical Oncology, Azienda Ospedaliero Universitaria, Ospedali Riuniti, Polytechnic University of the Marche Region, Ancona, 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
| | | | - 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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Pinato DJ, Patel M, Scotti L, Colomba E, Dolly S, Loizidou A, Chester J, Mukherjee U, Zambelli A, Dalla Pria A, Aguilar-Company J, Bower M, 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, Ottaviani D, Liñan R, Rossi S, Carmona-García MC, Tondini C, Fox L, Baggi A, Fotia V, Parisi A, Porzio G, Queirolo P, Cruz CA, Saoudi-Gonzalez N, Felip E, Roqué Lloveras A, Newsom-Davis T, Sharkey R, Roldán E, Reyes R, Zoratto F, 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, Berardi R, Giusti R, Mazzoni F, Guida A, Rimassa L, Chiudinelli L, Franchi M, Krengli M, Santoro A, Prat A, Tabernero J, Van Hemelrijck M, Diamantis N, Gennari A, Cortellini A. Time-Dependent COVID-19 Mortality in Patients With Cancer: An Updated Analysis of the OnCovid Registry. JAMA Oncol 2021; 8:114-122. [PMID: 34817562 DOI: 10.1001/jamaoncol.2021.6199] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Whether the severity and mortality of COVID-19 in patients with cancer have improved in terms of disease management and capacity is yet to be defined. Objective To test whether severity and mortality from COVID-19 among patients with cancer have improved during the course of the pandemic. Design, Setting, and Participants OnCovid is a European registry that collects data on consecutive patients with solid or hematologic cancer and COVID-19. This multicenter case series study included real-world data from 35 institutions across 6 countries (UK, Italy, Spain, France, Belgium, and Germany). This update included patients diagnosed between February 27, 2020, and February, 14, 2021. Inclusion criteria were confirmed diagnosis of SARS-CoV-2 infection and a history of solid or hematologic cancer. Exposures SARS-CoV-2 infection. Main Outcomes and Measures Deaths were differentiated at 14 days and 3 months as the 2 landmark end points. Patient characteristics and outcomes were compared by stratifying patients across 5 phases (February to March 2020, April to June 2020, July to September 2020, October to December 2020, and January to February 2021) and across 2 major outbreaks (February to June 2020 and July 2020 to February 2021). Results At data cutoff, 2795 consecutive patients were included, with 2634 patients eligible for analysis (median [IQR] age, 68 [18-77] years ; 52.8% men). Eligible patients demonstrated significant time-dependent improvement in 14-day case-fatality rate (CFR) with estimates of 29.8% (95% CI, 0.26-0.33) for February to March 2020; 20.3% (95% CI, 0.17-0.23) for April to June 2020; 12.5% (95% CI, 0.06-22.90) for July to September 2020; 17.2% (95% CI, 0.15-0.21) for October to December 2020; and 14.5% (95% CI, 0.09-0.21) for January to February 2021 (all P < .001) across the predefined phases. Compared with the second major outbreak, patients diagnosed in the first outbreak were more likely to be 65 years or older (974 of 1626 [60.3%] vs 564 of 1008 [56.1%]; P = .03), have at least 2 comorbidities (793 of 1626 [48.8%] vs 427 of 1008 [42.4%]; P = .001), and have advanced tumors (708 of 1626 [46.4%] vs 536 of 1008 [56.1%]; P < .001). Complications of COVID-19 were more likely to be seen (738 of 1626 [45.4%] vs 342 of 1008 [33.9%]; P < .001) and require hospitalization (969 of 1626 [59.8%] vs 418 of 1008 [42.1%]; P < .001) and anti-COVID-19 therapy (1004 of 1626 [61.7%] vs 501 of 1008 [49.7%]; P < .001) during the first major outbreak. The 14-day CFRs for the first and second major outbreaks were 25.6% (95% CI, 0.23-0.28) vs 16.2% (95% CI, 0.13-0.19; P < .001), respectively. After adjusting for country, sex, age, comorbidities, tumor stage and status, anti-COVID-19 and anticancer therapy, and COVID-19 complications, patients diagnosed in the first outbreak had an increased risk of death at 14 days (hazard ratio [HR], 1.85; 95% CI, 1.47-2.32) and 3 months (HR, 1.28; 95% CI, 1.08-1.51) compared with those diagnosed in the second outbreak. Conclusions and Relevance The findings of this registry-based study suggest that mortality in patients with cancer diagnosed with COVID-19 has improved in Europe; this improvement may be associated with earlier diagnosis, improved management, and dynamic changes in community transmission over time.
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Affiliation(s)
| | - David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom.,Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Meera Patel
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Lorenza Scotti
- Department of Translational Medicine, Unit of Medical Statistics, University of Piemonte Orientale, Novara, Italy
| | - 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, United Kingdom
| | - 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, United Kingdom.,Medical Oncology, Velindre Cancer Centre, Cardiff, United Kingdom
| | - Uma Mukherjee
- Medical Oncology, Barts Health NHS Trust, London, United Kingdom
| | - Alberto Zambelli
- Oncology Unit, Azienda Socio Sanitaria Territoriale, Papa Giovanni XXIII, Bergamo, Italy
| | - Alessia Dalla Pria
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom
| | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain.,Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom
| | - Ramon Salazar
- Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program, CIBERONC, Hospitalet de Llobregat, Spain
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Istituto di Ricovero e Cura a Carattere Scientifico, 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, Istituto di Ricovero e Cura a Carattere Scientifico, 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, Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genova, Genova, Italy
| | - Anna Pous
- Medical Oncology Department, Badalona Applied Research Group in Oncology, Institut Germans Trias i Pujol, Catalan Institute of Oncology-Badalona, Spain
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - 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, Italy.,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | | | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Humanitas Research Hospital, Policlinico San Matteo, Pavia, Italy.,Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Humanitas Research Hospital, 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, United Kingdom
| | - Joanne S Evans
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Beth Russell
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - 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
| | - Rossella Bertulli
- Medical Oncology 2, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Humanitas Research Hospital, Istituto Nazionale dei Tumori, Milan, Italy
| | - Diego Ottaviani
- Cancer Division, University College London Hospitals, London, United Kingdom
| | - 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, Istituto di Ricovero e Cura a Carattere Scientifico, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - M 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
- Department of Hematology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - Alice Baggi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, 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
| | - Paola Queirolo
- Melanoma and Sarcoma Medical Treatment Unit, Istituto Europeo di Oncologia, Milan, Italy
| | | | - Nadia Saoudi-Gonzalez
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - Eudald Felip
- Medical Oncology Department, Badalona Applied Research Group in Oncology, Institut Germans Trias i Pujol, Catalan Institute of Oncology-Badalona, Spain
| | - Ariadna Roqué Lloveras
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Thomas Newsom-Davis
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom
| | - 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, United Kingdom
| | - Daniela Ferrante
- Department of Translational Medicine, Unit of Medical Statistics, University of Piemonte Orientale, Novara, Italy
| | | | - Isabel Ruiz-Camps
- Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Andrea Patriarca
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Riccardo Bruna
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Anna Sureda
- Haematology Department, Institut Catala d'Oncologia Hospitalet, Hospitalet de Llobregat, Bellvitge Institute for Biomedical Research, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Rossana Berardi
- Medical Oncology, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Polytechnic University of the Marche Region, Ancona, Italy
| | | | | | - Annalisa Guida
- Department of Oncology, Azienda Ospedaliera Santa Maria, Terni, Italy
| | - Lorenza Rimassa
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Istituto di Ricovero e Cura a Carattere Scientifico, Humanitas Research Hospital, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 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 and Azienda Ospedaliera Maggiore Della Carità, Novara, Italy
| | - Armando Santoro
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Istituto di Ricovero e Cura a Carattere Scientifico, Humanitas Research Hospital, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, Milan, Italy
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain.,Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - Josep Tabernero
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, Baselga Oncological Institute at Quiron, Universitat de Vic - Universitat Central de Catalunya, Barcelona, Spain
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | | | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Alessio Cortellini
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom.,Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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12
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Garrigós L, Saura C, Martinez-Vila C, Zambelli A, Bower M, Pistilli B, Lambertini M, Ottaviani D, Diamantis N, Lumsden A, Pernas S, Generali D, Seguí E, Viñas G, Felip E, Sanchez A, Rizzo G, Santoro A, Cortellini A, Perone Y, Chester J, Iglesias M, Betti M, Vincenzi B, Libertini M, Mazzoni F, Zoratto F, Berardi R, Guida A, Wuerstlein R, Loizidou A, Sharkey R, Aguilar Company J, Matas M, Saggia C, Chiudinelli L, Colomba-Blameble E, Galazi M, Mukherjee U, Van Hemelrijck M, Marin M, Strina C, Prat A, Pla H, Ciruelos EM, Bertuzzi A, del Mastro L, Porzio G, Newsom-Davis T, Ruiz I, Delany MB, Krengli M, Fotia V, Viansone A, Chopra N, Romeo M, Salazar R, Perez I, d’Avanzo F, Franchi M, Milani M, Pommeret F, Tucci M, Pedrazzoli P, Harbeck N, Ferrante D, Pinato DJ, Gennari A. COVID-19 in breast cancer patients: a subanalysis of the OnCovid registry. Ther Adv Med Oncol 2021; 13:17588359211053416. [PMID: 34777582 PMCID: PMC8573484 DOI: 10.1177/17588359211053416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 05/23/2021] [Accepted: 09/22/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cancer patients are at higher risk of COVID-19 complications and mortality than the rest of the population. Breast cancer patients seem to have better prognosis when infected by SARS-CoV-2 than other cancer patients. METHODS We report a subanalysis of the OnCovid study providing more detailed information in the breast cancer population. RESULTS We included 495 breast cancer patients with a SARS-CoV-2 infection. Mean age was 62.6 years; 31.5% presented more than one comorbidity. The most frequent breast cancer subtype was luminal-like (n = 245, 49.5%) and 177 (35.8%) had metastatic disease. A total of 332 (67.1%) patients were receiving active treatment, with radical intent in 232 (47.6%) of them. Hospitalization rate was 58.2% and all-cause mortality rate was 20.3%. One hundred twenty-nine (26.1%) patients developed one COVID-19 complication, being acute respiratory failure the most common (n = 74, 15.0%). In the multivariable analysis, age older than 70 years, presence of COVID-19 complications, and metastatic disease were factors correlated with worse outcomes, while ongoing anticancer therapy at time of COVID-19 diagnosis appeared to be a protective factor. No particular oncological treatment was related to higher risk of complications. In the context of SARS-CoV-2 infection, 73 (18.3%) patients had some kind of modification on their oncologic treatment. At the first oncological reassessment (median time: 46.9 days ± 36.7), 255 (51.6%) patients reported to be fully recovered from the infection. There were 39 patients (7.9%) with long-term SARS-CoV-2-related complications. CONCLUSION In the context of COVID-19, our data confirm that breast cancer patients appear to have lower complications and mortality rate than expected in other cancer populations. Most breast cancer patients can be safely treated for their neoplasm during SARS-CoV-2 pandemic. Oncological treatment has no impact on the risk of SARS-CoV-2 complications, and, especially in the curative setting, the treatment should be modified as little as possible.
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Affiliation(s)
- Laia Garrigós
- Department of Medical Oncology, Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Cristina Saura
- Head Breast Cancer Unit, Vall d’Hebron University Hospital and Principal Investigator Breast Group, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebrón 119-129, 08035 Barcelona, Spain
| | | | | | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Barbara Pistilli
- Department of Medical Oncology, Institute Gustave-Roussy, Villejuif, France
| | - Matteo Lambertini
- Department of Medical Oncology, UOC Clinica di Oncologia Medica, IRCCS Policlinico San Martino Hospital, Genoa, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
| | - Diego Ottaviani
- Cancer Division, University College London Hospitals, London, UK
| | | | - Ailsa Lumsden
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
| | - Sonia Pernas
- Department of Medical Oncology, Catalan Institute of Oncology, L’Hospitalet, Spain
- Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Barcelona, Spain
| | - Daniele Generali
- Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Casalmaggiore, Italy
| | - Elia Seguí
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Gemma Viñas
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Eudald Felip
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain
| | - Ana Sanchez
- Department Medical Oncology, Hospital XII de Octubre, Madrid, Spain
| | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Armando Santoro
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alessio Cortellini
- Department of Biotechnology and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
- Division of Surgery and Cancer, Hammersmith Hospital, Imperial College London, London, UK
| | - Ylenia Perone
- Medical Oncology, Velindre Cancer Centre, Cardiff, UK
| | - John Chester
- Medical Oncology, Velindre Cancer Centre, Cardiff, UK
| | - Maria Iglesias
- Department of Oncology, Hospital Universitario Son Llatzer, Palma de Mallorca, Spain
| | - Marta Betti
- Research Infrastructure, Research and Innovation Department, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Bruno Vincenzi
- Department of Oncology, University “Campus Bio-Medico”, Rome, Italy
| | - Michela Libertini
- Medical Oncology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Francesca Mazzoni
- Department of Oncology, Careggi University Hospital, Florence, Italy
| | | | - Rossana Berardi
- Oncology Clinic, Università Politecnica Delle Marche, Ospedali Riuniti Di Ancona, Ancona, Italy
| | - Annalisa Guida
- Struttura Complessa di Oncologia Medica e Traslazionale, Azienda Ospedaliera Santa Maria di Terni, Italy
| | - Rachel Wuerstlein
- Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany
| | - Angela Loizidou
- Department of Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Belgium
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Juan Aguilar Company
- Department of Medical Oncology, Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
- Department of Infectious Diseases, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Marta Matas
- Department of Oncology, Hospital Althaia Manresa, Barcelona, Spain
| | - Chiara Saggia
- Department of Translational Medicine, University of Piemonte Orientale, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
| | | | | | - Myria Galazi
- Cancer Division, University College London Hospitals, London, UK
| | - Uma Mukherjee
- Medical Oncology, Barts Health NHS Trust, London, UK
| | - Mieke Van Hemelrijck
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
| | - Mar Marin
- Department of Medical Oncology, Catalan Institute of Oncology, L’Hospitalet (Barcelona), Spain
| | - Carla Strina
- Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Casalmaggiore, Italy
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
- Translational Genomics and Targeted therapies Group, IDIBAPS, Barcelona, Spain
| | - Helena Pla
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | | | - Alexia Bertuzzi
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Lucia del Mastro
- Breast Unit, IRCCS Policlinico San Martino Hospital, Genoa, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
| | | | - Thomas Newsom-Davis
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Isabel Ruiz
- Department of Infectious Diseases, Vall d’Hebron University Hospital, Barcelona, Spain
| | | | - Marco Krengli
- Division of Radiotherapy, Department of Translational Medicine, University of Eastern Piedmont and Hospital “Maggiore della Carità”, Novara, Italy
| | | | | | - Neha Chopra
- Cancer Division, University College London Hospitals, London, UK
| | - Margarita Romeo
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain
| | - Ramon Salazar
- Department of Medical Oncology, Catalan Institute of Oncology, L’Hospitalet (Barcelona), Spain
- Oncobell Program (IDIBELL), CIBERONC. Hospitalet de Llobregat, Spain
| | - Ignacio Perez
- Department of Oncology, Hospital Althaia Manresa, Barcelona, Spain
| | - Francesca d’Avanzo
- Department of Translational Medicine, University of Piemonte Orientale, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
| | | | - Manuela Milani
- Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Casalmaggiore, Italy
| | - Fanny Pommeret
- Department of Medical Oncology, Institute Gustave-Roussy, Villejuif, France
| | - Marco Tucci
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Nadia Harbeck
- Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany
| | - Daniela Ferrante
- Department of Translational Medicine, Unit of Medical Statistics, University of Piemonte Orientale and Cancer Epidemiology, CPO Piemonte, Novara, Italy
| | - David J. Pinato
- Division of Surgery and Cancer, Hammersmith Hospital, Imperial College London, London, UK
- Department of Translational Medicine, University of Piemonte Orientale, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
| | - Alessandra Gennari
- Department of Translational Medicine, University of Piemonte Orientale, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
- Department of Surgery and Cancer, Imperial College London, London, UK
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13
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Patel M, Felip E, Sharkey R, Krengli M, Chester J, Sita-Lumsden A, Mukherjee U, Russell B, Loizidou A, Colomba J, Cruz CA, Cabirta A, Camps IR, Brunet J, Sureda A, Patriarca A, Tondini C, Pinato D, Cortellini A. 1588P SARS-CoV-2 antibody seroprevalence and safety of vaccines in cancer patients who recovered from COVID-19. Ann Oncol 2021. [PMCID: PMC8454348 DOI: 10.1016/j.annonc.2021.08.1581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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14
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Pinato DJ, Scotti L, Gennari A, Colomba-Blameble E, Dolly S, Loizidou A, Chester J, Mukherjee U, Zambelli A, Aguilar-Company J, Bower M, Galazi M, Salazar R, Bertuzzi A, Brunet J, Mesia R, Sita-Lumsden A, Colomba J, Pommeret F, Seguí E, Biello F, Generali D, Grisanti S, Rizzo G, Libertini M, Moss C, Evans JS, Russell B, Wuerstlein R, Vincenzi B, Bertulli R, Ottaviani D, Liñan R, Marrari A, Carmona-García MC, Sng CCT, Tondini C, Mirallas O, Tovazzi V, Fotia V, Cruz CA, Saoudi-Gonzalez N, Felip E, R Lloveras A, Lee AJX, Newsom-Davis T, Sharkey R, Chung C, García-Illescas D, Reyes R, Sophia Wong YN, Ferrante D, Marco-Hernández J, Ruiz-Camps I, Gaidano G, Patriarca A, Sureda A, Martinez-Vila C, Sanchez de Torre A, Rimassa L, Chiudinelli L, Franchi M, Krengli M, Santoro A, Prat A, Tabernero J, V Hemelrijck M, Diamantis N, Cortellini A. Determinants of enhanced vulnerability to coronavirus disease 2019 in UK patients with cancer: a European study. Eur J Cancer 2021; 150:190-202. [PMID: 33932726 PMCID: PMC8023206 DOI: 10.1016/j.ejca.2021.03.035] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Despite high contagiousness and rapid spread, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to heterogeneous outcomes across affected nations. Within Europe (EU), the United Kingdom (UK) is the most severely affected country, with a death toll in excess of 100,000 as of January 2021. We aimed to compare the national impact of coronavirus disease 2019 (COVID-19) on the risk of death in UK patients with cancer versus those in continental EU. METHODS We performed a retrospective analysis of the OnCovid study database, a European registry of patients with cancer consecutively diagnosed with COVID-19 in 27 centres from 27th February to 10th September 2020. We analysed case fatality rates and risk of death at 30 days and 6 months stratified by region of origin (UK versus EU). We compared patient characteristics at baseline including oncological and COVID-19-specific therapy across UK and EU cohorts and evaluated the association of these factors with the risk of adverse outcomes in multivariable Cox regression models. FINDINGS Compared with EU (n = 924), UK patients (n = 468) were characterised by higher case fatality rates (40.38% versus 26.5%, p < 0.0001) and higher risk of death at 30 days (hazard ratio [HR], 1.64 [95% confidence interval {CI}, 1.36-1.99]) and 6 months after COVID-19 diagnosis (47.64% versus 33.33%; p < 0.0001; HR, 1.59 [95% CI, 1.33-1.88]). UK patients were more often men, were of older age and have more comorbidities than EU counterparts (p < 0.01). Receipt of anticancer therapy was lower in UK than in EU patients (p < 0.001). Despite equal proportions of complicated COVID-19, rates of intensive care admission and use of mechanical ventilation, UK patients with cancer were less likely to receive anti-COVID-19 therapies including corticosteroids, antivirals and interleukin-6 antagonists (p < 0.0001). Multivariable analyses adjusted for imbalanced prognostic factors confirmed the UK cohort to be characterised by worse risk of death at 30 days and 6 months, independent of the patient's age, gender, tumour stage and status; number of comorbidities; COVID-19 severity and receipt of anticancer and anti-COVID-19 therapy. Rates of permanent cessation of anticancer therapy after COVID-19 were similar in the UK and EU cohorts. INTERPRETATION UK patients with cancer have been more severely impacted by the unfolding of the COVID-19 pandemic despite societal risk mitigation factors and rapid deferral of anticancer therapy. The increased frailty of UK patients with cancer highlights high-risk groups that should be prioritised for anti-SARS-CoV-2 vaccination. Continued evaluation of long-term outcomes is warranted.
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Affiliation(s)
- David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
| | - Lorenza Scotti
- Unit of Cancer Epidemiology, Department of Translational Medicine, CPO-Piemonte, University of Piemonte Orientale, Novara, Italy
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Emeline Colomba-Blameble
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Saoirse Dolly
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), 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
| | | | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain; Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Myria Galazi
- Cancer Division, University College London Hospitals, London, UK
| | - Ramon Salazar
- Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Spain
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Joan Brunet
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Ricard Mesia
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Johann Colomba
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Fanny Pommeret
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Elia Seguí
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Federica Biello
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Daniele Generali
- Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Italy; Department of Medical, Surgical and Health Sciences, University of Trieste, 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 (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Joanne S Evans
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Rachel Wuerstlein
- Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany
| | - Bruno Vincenzi
- Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Rossella Bertulli
- Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Diego Ottaviani
- Cancer Division, University College London Hospitals, London, UK
| | - Raquel Liñan
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Andrea Marrari
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - M C Carmona-García
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | | | - Carlo Tondini
- Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Oriol Mirallas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - Claudia A Cruz
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Nadia Saoudi-Gonzalez
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Eudald Felip
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain
| | - Ariadna R Lloveras
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Alvin J X Lee
- Cancer Division, University College London Hospitals, London, UK
| | - Thomas Newsom-Davis
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Chris Chung
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - David García-Illescas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Roxana Reyes
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | | | - Daniela Ferrante
- Unit of Cancer Epidemiology, Department of Translational Medicine, CPO-Piemonte, University of Piemonte Orientale, Novara, Italy
| | | | - Isabel Ruiz-Camps
- Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Andrea Patriarca
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Anna Sureda
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Lorenza Rimassa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy; Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | | | | | - Marco Krengli
- Division of Radiotherapy, Department of Translational Medicine, University of Piemonte Orientale and Azienda Ospedaliera Maggiore Della Carita, Novara, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy; Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Aleix Prat
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - Josep Tabernero
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Mieke V Hemelrijck
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK; Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | | | - Alessio Cortellini
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy.
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15
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Soosaipillai G, Sureda A, Maluquer Artigal C, Benafif S, Chopra N, Harbeck N, Wuerstlein R, Mesia Nin R, Felip E, Ottaviani D, Galazi M, Lee A, Salazar R, Sharkey R, Reyes R, Evans J, Carmona Garcia M, Tabernero J, Prat A, Pinato D. 1671MO Provision of palliative care for patients with cancer and SARS-CoV-2 infection. Ann Oncol 2020. [PMCID: PMC7506333 DOI: 10.1016/j.annonc.2020.08.1736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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16
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Pinato DJ, Zambelli A, Aguilar-Company J, Bower M, Sng C, Salazar R, Bertuzzi A, Brunet J, Mesia R, Segui E, Biello F, Generali D, Grisanti S, Rizzo G, Libertini M, Maconi A, Harbeck N, Vincenzi B, Bertulli R, Ottaviani D, Carbo A, Bruna R, Benafif S, Marrari A, Wuerstlein R, Carmona-Garcia MC, Chopra N, Tondini C, Mirallas O, Tovazzi V, Betti M, Provenzano S, Fotia V, Cruz CA, Dalla Pria A, D'Avanzo F, Evans JS, Saoudi-Gonzalez N, Felip E, Galazi M, Garcia-Fructuoso I, Lee AJX, Newsom-Davis T, Patriarca A, Garcia-Illescas D, Reyes R, Dileo P, Sharkey R, Wong YNS, Ferrante D, Marco-Hernandez J, Sureda A, Maluquer C, Ruiz-Camps I, Gaidano G, Rimassa L, Chiudinelli L, Izuzquiza M, Cabirta A, Franchi M, Santoro A, Prat A, Tabernero J, Gennari A. Clinical portrait of the SARS-CoV-2 epidemic in European cancer patients. Cancer Discov 2020; 10:CD-20-0773. [PMID: 32737082 PMCID: PMC7668225 DOI: 10.1158/2159-8290.cd-20-0773] [Citation(s) in RCA: 134] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/22/2020] [Accepted: 07/28/2020] [Indexed: 02/06/2023]
Abstract
The SARS-Cov-2 pandemic significantly impacted on oncology practice across the globe. There is uncertainty as to the contribution of patients' demographics and oncological features on severity and mortality from Covid-19 and little guidance as to the role of anti-cancer and anti-Covid-19 therapy in this population. In a multi-center study of 890 cancer patients with confirmed Covid-19 we demonstrated a worsening gradient of mortality from breast cancer to haematological malignancies and showed that male gender, older age, and number of co-morbidities identifies a subset of patients with significantly worse mortality rates from Covid-19. Provision of chemotherapy, targeted therapy and immunotherapy did not worsen mortality. Exposure to antimalarials was associated with improved mortality rates independent of baseline prognostic factors. This study highlights the clinical utility of demographic factors for individualized risk-stratification of patients and support further research into emerging anti-Covid-19 therapeutics in SARS-Cov-2 infected cancer patients.
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Affiliation(s)
| | | | | | - Mark Bower
- National Centre for HIV Malignancy, Chelsea and Westminster Hospital, UK
| | - Christopher Sng
- Cancer Division, University College London Hospitals NHS Foundation Trust
| | - Ramon Salazar
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Traslational Research Laboratory, ICO-Bellvitge Biomedical Research Institute (IDIBELL)-CIBERONC, L'Hospitalet de Llobregat
| | | | - Joan Brunet
- Medical Oncology, Catalan Institute of Oncology Hospital Josep Trueta
| | - Ricard Mesia
- Institut Catala d'Oncologia - L'Hospitalet, Universitat de Barcelona, IDIBELL
| | | | | | - Daniele Generali
- US Terapia Molecolare e Farmacogenomica, Az Istituti Ospitalieri di Cremona
| | | | | | | | - Antonio Maconi
- Research Education Innovation Infrastrucure, Ospedale Antonio e Biagio e Cesare Arrigo, Alessandria
| | | | | | - Rossella Bertulli
- Medical Oncology Unit 2 - Adult mesenchymal tumour and rare cancer network, Cancer Medicine department, Istituto Nazionale dei Tumori
| | | | - Anna Carbo
- Medical Oncology, Catalan Institute of Oncology, Girona
| | - Riccardo Bruna
- Department of Translational Medicine, Universita del Piemonte Orientale
| | | | | | | | - M Carmen Carmona-Garcia
- Medical Oncology Service, Hospital Universitari de Girona Doctor Josep Trueta- Catalan Insitute of Oncology
| | | | | | - Oriol Mirallas
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona
| | | | - Marta Betti
- Infrastruttura Ricerca Formazione Innovazione, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo
| | - Salvatore Provenzano
- Medical Oncology Unit 2 - Adult mesenchymal tumour and rare cancer network, Cancer Medicine Department, Istituto Nazionale dei Tumori
| | | | | | | | | | | | | | - Eudald Felip
- Medical Oncology Department, Institut Catala d'Oncologia-Badalona, B-ARGO group- IGTP
| | | | | | | | | | - Andrea Patriarca
- Department of Translational Medicine, Universita del Piemonte Orientale
| | | | | | | | | | | | - Daniela Ferrante
- Department of Translational Medicine, Department of Translational Medicine, Unit of Medical Statistics, University of Eastern Piedmont and Cancer Epidemiology, CPO Piemonte, Novara
| | | | - Anna Sureda
- Hospital Duran i Reynals, Institut Catala d'Oncología (ICO)
| | | | | | - Gianluca Gaidano
- Hematology, Division of Hematology, Amedeo Avogadro Univeristy of Eastern Piedmont
| | - Lorenza Rimassa
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS; Department of Biomedical Sciences, Humanitas University
| | - Lorenzo Chiudinelli
- Dipartimento di Ingegneria Industriale e dell'Informazione, University of Pavia
| | | | - Alba Cabirta
- Hematology, Vall d'Hebron University Hospital, Barcelona
| | - Michela Franchi
- FROM Research Foundation, Ospedale Papa Giovanni XXIII, Bergamo
| | | | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic de Barcelona
| | - Josep Tabernero
- Medical Oncology Department, Vall d'Hebron University Hospital
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17
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Pinato DJ, Lee AJX, Biello F, Seguí E, Aguilar-Company J, Carbó A, Bruna R, Bower M, Rizzo G, Benafif S, Carmona C, Chopra N, Cruz CA, D’Avanzo F, Evans JS, Galazi M, Garcia-Fructuoso I, Dalla Pria A, Newsom-Davis T, Ottaviani D, Patriarca A, Reyes R, Sharkey R, Sng CCT, Wong YNS, Ferrante D, Scotti L, Avanzi GC, Bellan M, Castello LM, Marco-Hernández J, Mollà M, Pirisi M, Ruiz-Camps I, Sainaghi PP, Gaidano G, Brunet J, Tabernero J, Prat A, Gennari A. Presenting Features and Early Mortality from SARS-CoV-2 Infection in Cancer Patients during the Initial Stage of the COVID-19 Pandemic in Europe. Cancers (Basel) 2020; 12:E1841. [PMID: 32650523 PMCID: PMC7408670 DOI: 10.3390/cancers12071841] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [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: 06/29/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 12/19/2022] Open
Abstract
We describe the outcomes in cancer patients during the initial outbreak of the COVID-19 in Europe from the retrospective, multi-center observational OnCovid study. We identified 204 cancer patients from eight centers in the United Kingdom, Italy, and Spain aged > 18 (mean = 69) and diagnosed with COVID-19 between February 26th and April 1st, 2020. A total of 127 (62%) were male, 184 (91%) had a diagnosis of solid malignancy, and 103 (51%) had non-metastatic disease. A total of 161 (79%) had > 1 co-morbidity. A total of 141 (69%) patients had > 1 COVID-19 complication. A total of 36 (19%) were escalated to high-dependency or intensive care. A total of 59 (29%) died, 53 (26%) were discharged, and 92 (45%) were in-hospital survivors. Mortality was higher in patients aged > 65 (36% versus 16%), in those with > 2 co-morbidities (40% versus 18%) and developing > 1 complication from COVID-19 (38% versus 4%, p = 0.004). Multi-variable analyses confirmed age > 65 and > 2 co-morbidities to predict for patient mortality independent of tumor stage, active malignancy, or anticancer therapy. During the early outbreak of SARS-CoV-2 infection in Europe co-morbid burden and advancing age predicted for adverse disease course in cancer patients. The ongoing OnCovid study will allow us to compare risks and outcomes in cancer patients between the initial and later stages of the COVID-19 pandemic.
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Affiliation(s)
- David J. Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London W12 0HS, UK;
| | - Alvin J. X. Lee
- Department of Oncology, University College London Hospitals, London NW1 2PG, UK; (A.J.X.L.); (S.B.); (N.C.); (M.G.); (D.O.); (C.C.T.S.); (Y.N.S.W.)
| | - Federica Biello
- Department of Translational Medicine, Division of Oncology, University of Piemonte Orientale and Maggiore della Carita’ Hospital, 28100 Novara, Italy; (F.B.); (F.D.); (A.G.)
| | - Elia Seguí
- Department of Medical Oncology, Hospital Clinic, 08036 Barcelona, Spain; (E.S.); (C.A.C.); (R.R.); (A.P.)
| | - Juan Aguilar-Company
- Department of Medical Oncology, Vall d’Hebron University Hospital and Institute of Oncology (VHIO), 08035 Barcelona, Spain; (J.A.-C.); (J.T.)
- Department of Infectious Diseases, Vall d’Hebron University Hospital, 08035 Barcelona, Spain;
| | - Anna Carbó
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, 17007 Girona, Spain; (A.C.); (C.C.); (I.G.-F.); (J.B.)
| | - Riccardo Bruna
- Department of Translational Medicine, Division of Haematology, University of Piemonte Orientale and Maggiore della Carita’ Hospital, 28100 Novara, Italy; (R.B.); (A.P.); (R.S.); (G.G.)
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea & Westminster Hospital, London SW109NH, UK; (M.B.); (A.D.P.); (T.N.-D.)
| | - Gianpiero Rizzo
- Department of Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Sarah Benafif
- Department of Oncology, University College London Hospitals, London NW1 2PG, UK; (A.J.X.L.); (S.B.); (N.C.); (M.G.); (D.O.); (C.C.T.S.); (Y.N.S.W.)
| | - Carme Carmona
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, 17007 Girona, Spain; (A.C.); (C.C.); (I.G.-F.); (J.B.)
| | - Neha Chopra
- Department of Oncology, University College London Hospitals, London NW1 2PG, UK; (A.J.X.L.); (S.B.); (N.C.); (M.G.); (D.O.); (C.C.T.S.); (Y.N.S.W.)
| | - Claudia Andrea Cruz
- Department of Medical Oncology, Hospital Clinic, 08036 Barcelona, Spain; (E.S.); (C.A.C.); (R.R.); (A.P.)
| | - Francesca D’Avanzo
- Department of Translational Medicine, Division of Oncology, University of Piemonte Orientale and Maggiore della Carita’ Hospital, 28100 Novara, Italy; (F.B.); (F.D.); (A.G.)
| | - Joanne S. Evans
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London W12 0HS, UK;
| | - Myria Galazi
- Department of Oncology, University College London Hospitals, London NW1 2PG, UK; (A.J.X.L.); (S.B.); (N.C.); (M.G.); (D.O.); (C.C.T.S.); (Y.N.S.W.)
| | - Isabel Garcia-Fructuoso
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, 17007 Girona, Spain; (A.C.); (C.C.); (I.G.-F.); (J.B.)
| | - Alessia Dalla Pria
- Department of Oncology and National Centre for HIV Malignancy, Chelsea & Westminster Hospital, London SW109NH, UK; (M.B.); (A.D.P.); (T.N.-D.)
| | - Thomas Newsom-Davis
- Department of Oncology and National Centre for HIV Malignancy, Chelsea & Westminster Hospital, London SW109NH, UK; (M.B.); (A.D.P.); (T.N.-D.)
| | - Diego Ottaviani
- Department of Oncology, University College London Hospitals, London NW1 2PG, UK; (A.J.X.L.); (S.B.); (N.C.); (M.G.); (D.O.); (C.C.T.S.); (Y.N.S.W.)
| | - Andrea Patriarca
- Department of Translational Medicine, Division of Haematology, University of Piemonte Orientale and Maggiore della Carita’ Hospital, 28100 Novara, Italy; (R.B.); (A.P.); (R.S.); (G.G.)
| | - Roxana Reyes
- Department of Medical Oncology, Hospital Clinic, 08036 Barcelona, Spain; (E.S.); (C.A.C.); (R.R.); (A.P.)
| | - Rachel Sharkey
- Department of Translational Medicine, Division of Haematology, University of Piemonte Orientale and Maggiore della Carita’ Hospital, 28100 Novara, Italy; (R.B.); (A.P.); (R.S.); (G.G.)
| | - Christopher C. T. Sng
- Department of Oncology, University College London Hospitals, London NW1 2PG, UK; (A.J.X.L.); (S.B.); (N.C.); (M.G.); (D.O.); (C.C.T.S.); (Y.N.S.W.)
| | - Yien Ning Sophia Wong
- Department of Oncology, University College London Hospitals, London NW1 2PG, UK; (A.J.X.L.); (S.B.); (N.C.); (M.G.); (D.O.); (C.C.T.S.); (Y.N.S.W.)
| | - Daniela Ferrante
- Department of Translational Medicine, Unit of Cancer Epidemiology, CPO-Piemonte, University of Piemonte Orientale, 28100 Novara, Italy;
| | - Lorenza Scotti
- Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carita’ Hospital, 28100 Novara, Italy;
| | - Gian Carlo Avanzi
- Department of Translational Medicine, Divisions of Internal and Emergency Medicine, University of Piemonte Orientale and Maggiore della Carita’ Hospital, 28100 Novara, Italy; (G.C.A.); (M.B.); (L.M.C.); (M.P.); (P.P.S.)
| | - Mattia Bellan
- Department of Translational Medicine, Divisions of Internal and Emergency Medicine, University of Piemonte Orientale and Maggiore della Carita’ Hospital, 28100 Novara, Italy; (G.C.A.); (M.B.); (L.M.C.); (M.P.); (P.P.S.)
| | - Luigi Mario Castello
- Department of Translational Medicine, Divisions of Internal and Emergency Medicine, University of Piemonte Orientale and Maggiore della Carita’ Hospital, 28100 Novara, Italy; (G.C.A.); (M.B.); (L.M.C.); (M.P.); (P.P.S.)
| | | | - Meritxell Mollà
- Department of Radiation Oncology, Hospital Clinic, 08035 Barcelona, Spain;
| | - Mario Pirisi
- Department of Translational Medicine, Divisions of Internal and Emergency Medicine, University of Piemonte Orientale and Maggiore della Carita’ Hospital, 28100 Novara, Italy; (G.C.A.); (M.B.); (L.M.C.); (M.P.); (P.P.S.)
| | - Isabel Ruiz-Camps
- Department of Infectious Diseases, Vall d’Hebron University Hospital, 08035 Barcelona, Spain;
| | - Pier Paolo Sainaghi
- Department of Translational Medicine, Divisions of Internal and Emergency Medicine, University of Piemonte Orientale and Maggiore della Carita’ Hospital, 28100 Novara, Italy; (G.C.A.); (M.B.); (L.M.C.); (M.P.); (P.P.S.)
| | - Gianluca Gaidano
- Department of Translational Medicine, Division of Haematology, University of Piemonte Orientale and Maggiore della Carita’ Hospital, 28100 Novara, Italy; (R.B.); (A.P.); (R.S.); (G.G.)
| | - Joan Brunet
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, 17007 Girona, Spain; (A.C.); (C.C.); (I.G.-F.); (J.B.)
| | - Josep Tabernero
- Department of Medical Oncology, Vall d’Hebron University Hospital and Institute of Oncology (VHIO), 08035 Barcelona, Spain; (J.A.-C.); (J.T.)
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic, 08036 Barcelona, Spain; (E.S.); (C.A.C.); (R.R.); (A.P.)
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, 08035 Barcelona, Spain
| | - Alessandra Gennari
- Department of Translational Medicine, Division of Oncology, University of Piemonte Orientale and Maggiore della Carita’ Hospital, 28100 Novara, Italy; (F.B.); (F.D.); (A.G.)
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Gill A, Sharkey R, Simmons J, Bower M, Sita-Lumsden A, Evans J, Newsom-Davis T. Acute diagnostic oncology clinic: A unique primary care-oncology service. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz263.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mccloskey M, Yarr C, Grant K, Doherty M, Sharkey R, Kelly M, Coulter H. Long-term follow-up of patients who had bronchial carcinoid tumours resected in a district general hospital. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30196-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tagawa S, Faltas B, Lam E, Saylor P, Bardia A, Hajdenberg J, Morgans A, Lim E, Kalinsky K, Petrylak D, Guarino M, Galsky M, Maliakal P, Mudenda B, Sharkey R, Wegener W, Goldenberg D. Sacituzumab govitecan (IMMU-132) for patients with pretreated metastatic urothelial uancer (UC): interim results. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx371.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Jones C, Miller R, Sharkey R, Friel A, Clifford D, Darcy C, Moore B, Hall M. P209 Specialist respiratory pharmacist case management copd medicines optimisation clinics: implementation and outcomes. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Newsom-Davis T, Simmons J, Bower M, Cox S, Gill A, Hennah L, Robinson A, Richmond K, Sharkey R. Acute diagnostic oncology clinic: tackling emergency presentations of cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw387.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ocean A, Starodub A, Messersmith W, Picozzi V, Guarino M, Thomas S, Bardia A, Shah M, Govindan S, Maliakal P, Wegener W, Sharkey R, Wilhelm F, Goldenberg D. P-162 Interim Results of IMMU-132 (Sacituzumab Govitecan), an Anti-Trop-2 Antibody-Drug Conjugate (ADC), in Patients (pts) with Metastatic Gastrointestinal (GI) Cancers. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Savage P, Sharkey R, Kua T, Papanastasopoulos P, McDonald-Burrows Z, Hassan S, Probst F, Sanders A, Millington H. Clinical characteristics and outcomes for patients with an initial emergency presentation of malignancy: A 15 month audit of patient level data. Cancer Epidemiol 2015; 39:86-90. [DOI: 10.1016/j.canep.2014.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/30/2014] [Accepted: 11/01/2014] [Indexed: 11/26/2022]
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Savage P, Sharkey R, Kua T, Schofield L, Richardson D, Panchmatia N, Papanastasopoulos P, Williams M, Falconer A, Power D, Arnold F, Ulbricht C. Malignant spinal cord compression: NICE guidance, improvements and challenges. QJM 2014; 107:277-82. [PMID: 24336849 DOI: 10.1093/qjmed/hct244] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND AIM Malignant spinal cord compression (mSCC) is one of the most serious complications of cancer. Recent NICE guidance has aimed to improve patient pathways and outcomes for patients with mSCC. We have examined the current presentations, management and outcomes for patients with mSCC in West London following the implementation of the NICE guidance. MATERIALS AND METHODS The electronic records and clinical notes were reviewed for all patients assessed for confirmed or potential mSCC at Charing Cross Hospital in 2012. Details on the number of referrals, the proportion with confirmed mSCC, the cancer diagnosis, treatment and outcome were analysed. RESULTS 191 patients were reviewed with 127 (66%) cases of confirmed mSCC. The commonest tumour types were prostate cancer (26 cases), lung cancer (26), breast cancer (21) and kidney cancer (15). 21% of the patients had no previous cancer diagnosis; mSCC was their presenting diagnostic event. Radiotherapy was the predominant management, 24% of the patients had first line surgical treatment. At presentation 62% of patients were either chair or bed bound. Treatment brought important mobility benefits to all patients groups with 20% of the initially chair or bed bound patients leaving the hospital with independent mobility. CONCLUSION Enhanced patients pathways with ease of access, rapid assessment and prompt treatment can improve outcomes. Despite these pathways many patients still present with gross motor impairment and over 20% have no previous diagnosis of cancer. Ongoing work to maintain awareness for patients and primary care of the diagnosis and emergency pathways is essential to optimize outcomes.
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Affiliation(s)
- P Savage
- Consultant in Medical Oncology, Imperial Hospitals NHS Trust, Charing Cross Hospital, London W6 8RF, UK.
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Lees C, Tuthill M, Croxford W, Sharkey R, Newsom-Davis T. 42 Lung cancer diagnosis in the acute setting. Lung Cancer 2014. [DOI: 10.1016/s0169-5002(14)70043-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Boerman O, Schoffelen R, Sharkey R, McBride W, van der Graaf W, Goldenberg D, Oyen W. SP-0537 TRANSLATIONAL STUDIES ON PRETARGETED RADIOIMMUNOTHERAPY OF COLORECTAL CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70876-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Weir M, Magowan L, Doherty M, Sharkey R, Mc Closkey M, Kelly M, Daly JG. P194 Why do lung cancer patients still die in hospital? Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054c.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gold D, Karacay H, Chang C, Rossi E, McBride W, Goldenberg D, Sharkey R. A novel bispecific antibody (bsMAb) construct for nuclear imaging of pancreatic cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4564 Background: The initial diagnosis of pancreatic cancer is difficult at best. We developed MAb-PAM4 reactive with a unique epitope within MUC1 that is expressed in most pancreatic cancers, but not in normal or inflammatory pancreas, nor most other normal and neoplastic tissues. Our current focus is the development of a pretargeting procedure that can greatly enhance targeting sensitivity while retaining the MAb’s high specificity. Methods: TF10 is a novel humanized recombinant bsMAb with divalent binding to PAM4-defined MUC1 and monovalent binding to histamine-succinyl-glycine (HSG). TF10 is a 157 kDa protein having >85% binding to MUC1 and >90% with HSG. Athymic nude mice bearing CaPan1, human pancreatic cancer, were injected with 125I-TF10 to assess biodistribution. Other animals were given varying doses of TF10 followed 16 h later with 111In-IMP-288, a divalent-HSG-peptide. These animals were imaged 3 h after the 111In-IMP-288-injection and then necropsied. Results: 125I-labeled TF10 cleared rapidly from the blood, with blood levels <0.25 ± 0.02 %ID/g at 16 h, and no accumulation in any normal tissues. Tumor uptake was 7.16 ± 1.10, 3.47 ± 0.66, and 1.65 ± 0.57 % ID/g at 6, 16, and 48 hrs, respectively. These data confirmed that for a pretargeted imaging study a 16-h interval is sufficient to clear the blood so that 111In-IMP-288 could be administered. At 3 h, the imaging studies showed intense uptake of radiolabeled peptide within the tumors (avg. 0.5 cm3 - 0.3 g at necropsy) with no evidence of uptake in any normal tissues, while no targeting was seen in animals given the 111In-IMP-288 alone. At necropsy, tumor uptake of the 111In-IMP-288 in the TF10 pretargeted animals was 24.3 ± 1.7 % ID/g, while for 111In-IMP-288 alone tumor uptake was only 0.012 ± 0.002 % ID/g. Tumor/blood, liver, lungs, and kidney ratios averaged 2800:1, 139:1, 184:1, and 14.2:1, respectively, in the pretargeted animals. Conclusions: These results demonstrate that this novel PAM4-based pretargeting agent targets and images xenografted human pancreatic cancer with high signal-to-background ratios. In addition to imaging, TF10 may prove useful for pretargeted therapy of pancreas cancer. (Supported in part by grant CA115755 from the NIH.) No significant financial relationships to disclose.
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Affiliation(s)
- D. Gold
- Garden State Cancer Center, Belleville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - H. Karacay
- Garden State Cancer Center, Belleville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - C. Chang
- Garden State Cancer Center, Belleville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - E. Rossi
- Garden State Cancer Center, Belleville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - W. McBride
- Garden State Cancer Center, Belleville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - D. Goldenberg
- Garden State Cancer Center, Belleville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - R. Sharkey
- Garden State Cancer Center, Belleville, NJ; Immunomedics, Inc., Morris Plains, NJ
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Conway J, Sharkey R. Integrating on campus problem based learning and practice based learning: issues and challenges in using computer mediated communication. Nurse Educ Today 2002; 22:552-562. [PMID: 12384036 DOI: 10.1016/s0260-6917(02)90769-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The Faculty of Nursing, University of Newcastle, Australia, has been keen to initiate strategies that enhance student learning and nursing practice. Two strategies are problem based learning (PBL) and clinical practice. The Faculty has maintained a comparatively high proportion of the undergraduate hours in the clinical setting in times when financial constraints suggest that simulations and on campus laboratory experiences may be less expensive.Increasingly, computer based technologies are becoming sufficiently refined to support the exploration of nursing practice in a non-traditional lecture/tutorial environment. In 1998, a group of faculty members proposed that computer mediated instruction would provide an opportunity for partnership between students, academics and clinicians that would promote more positive outcomes for all and maintain the integrity of the PBL approach. This paper discusses the similarities between problem based and practice based learning and presents the findings of an evaluative study of the implementation of a practice based learning model that uses computer mediated communication to promote integration of practice experiences with the broader goals of the undergraduate curriculum.
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Affiliation(s)
- J Conway
- University of Newcastle, Australia.
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Falcone FH, Rossi AG, Sharkey R, Brown AP, Pritchard DI, Maizels RM. Ascaris suum-derived products induce human neutrophil activation via a G protein-coupled receptor that interacts with the interleukin-8 receptor pathway. Infect Immun 2001; 69:4007-18. [PMID: 11349070 PMCID: PMC98463 DOI: 10.1128/iai.69.6.4007-4018.2001] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Infection with tissue-migrating helminths is frequently associated with intense granulocyte infiltrations. Several host-derived factors are known to mediate granulocyte recruitment to the tissues, but less attention has been paid to how parasite-derived products trigger this process. Parasite-derived chemotactic factors which selectively recruit granulocytes have been described, but nothing is known about which cellular receptors respond to these agents. The effect of products from the nematodes Ascaris suum, Toxocara canis, and Anisakis simplex on human neutrophils were studied. We monitored four parameters of activation: chemotaxis, cell polarization, intracellular Ca(2+) transients, and priming of superoxide anion production. Body fluids of A. suum (ABF) and T. canis (TcBF) induced strong directional migration, shape change, and intracellular Ca(2+) transients. ABF also primed neutrophils for production of superoxide anions. Calcium mobilization in response to A. suum-derived products was completely abrogated by pretreatment with pertussis toxin, implicating a classical G protein-coupled receptor mechanism in the response to ABF. Moreover, pretreatment with interleukin-8 (IL-8) completely abrogated the response to ABF, demonstrating desensitization of a common pathway. However, ABF was unable to fully desensitize the response to IL-8, and binding to CXCR1 or CXCR2 was excluded in experiments using RBL-2H3 cells transfected with the two human IL-8 receptors. Our results provide the first evidence for a direct interaction between a parasite-derived chemotactic factor and the host's chemotactic network, via a novel G protein-coupled receptor which interacts with the IL-8 receptor pathway.
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Affiliation(s)
- F H Falcone
- Institute of Cell, Animal and Population Biology, University of Edinburgh, Ashworth Laboratories, United Kingdom
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Weymier J, Daines E, Sharkey R, Foster C. EXERCISE SESSION RPE, HR AND LACTATE IN CARDIAC PATIENTS. Med Sci Sports Exerc 1995. [DOI: 10.1249/00005768-199505001-01224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Feeney T, O’Muire O, Gilmartin JJ, Manning P, Sinclair H, Clancy L, O’Connell F, Springall DR, Polak JM, Thomas VE, Fuller RW, Pride NB, Lyons RA, Leonard C, Faul J, Tormey VJ, Poulter LW, Burke CM, Pathmakanthan S, Barry MC, Wang JH, Kelly CJ, Burke PE, Sheehan SJ, Redmond HP, Bouchier-Hayes D, Abdih H, Watson RWG, Burke P, Egan JJ, Barber L, Lomax J, Fox A, Craske J, Yonan N, Rahman AN, Deiraniya AK, Carroll KB, Turner A, Woodcock AA, McNeill K, Bookless B, Gould K, Corris P, Higgenbottam T, Webb A, Woodcock A, McManus K, Miller D, Allen M, Ilstrup D, Deschamps C, Trastek V, Pairolero P, Cotter TP, Vaughan C, Kealy WP, Duggan PF, Curtain A, Bredin CP, Waite A, Maguire CP, Ryan J, O’Neill D, Coakley D, Walsh JB, Kilgallen I, O’Neill S, Ryan M, O’Connor CM, McDonnell T, Lowry RC, Buick JB, Magee TRA, O’Riordan D, Hayes J, O’Connor C, FitzGerald MX, Cosgrave C, Costello C, Deegan PC, McNicholas WT, Nugent AM, Lyons J, Gleadhill I, MacMahon J, Stevenson EC, Heaney LG, Shields MD, Cadden IS, Taylor R, Ennis M, Kharitonov SA, O’Connor J, Owens WA, O’Kane H, Cleland J, Gladstone DJ, Sarsam M, Graham ANJ, Anikin V, McGuigan JA, Curry RC, Varghese G, Keelan P, Rutherford R, O’Keeffe D, McCarthy P, Gilmartin JJ, Moore H, Balbernie E, Gilmartin JJ, Coakley R, Keane M, Costello R, Byrne P, McKeogh D, McLoughlin P, Finlay G, Concannon D, McKeown D, Kelly P, Tanner WA, Bouchier-Hayes DJ, Arumugasamy M, Yacoub K, O’Leary G, Stokes K, Geraghty J, Osborne H, O’Dwyer R, Gilliland R, Saleem SM, Aherne T, Power CK, Burke CH, Byrne A, Murphy JFA, Sharkey R, Mulloy E, Sharkey K, Long M, Birchall MA, Moorat A, Henderson J, Jacques L, Cahill P, Condron C, Royston D, Murphy J, Neill SO. Irish Thoracic Society. Ir J Med Sci 1995. [DOI: 10.1007/bf02973289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Chan KH, Singh HP, Aherne T, Carabine U, Gilliland H, Johnston JR, Lowry KG, McGuigan J, Cosgrove J, Veerasingham D, McCarthy J, Hurley J, Wood AE, Gilliland R, McGuigan JA, McManus KG, Wilkinson P, Johnston LC, MacMahon J, Wilson D, Austin C, Anikin V, McManus K, McGuigan J, McManus K, Anikin V, Gibbons JRP, McGuigan J, Sharkey R, Long M, Maree A, O’Neill S, Maguire CP, Hayes JP, Masterson J, Fitzgerald MX, Hayes M, Maguire CP, Hayes JP, Masterson J, Fitzgerald MX, Quigley C, Mofidi A, Mofidi R, Fitzgerald MX, O’Neill M, Watson JBG, O’Halloran ET, Shortt C, Taylor M, Holland C, O’Lorcain P, Taylor M, Holland C, O’Lorcain P, Pathmakanthan S, Sreenan S, Power CK, Poulter LW, Burke CM, Reilly D, Pathmakanthan S, Sreenan S, Doyle S, Burke CM, Sreenan S, Power C, Pathmakanthan S, Goggin A, Burke CM, Poulter LW, Sreenan S, Doyle S, Pathmakanthan S, Poulter LW, Burke CM, Sreenan S, Debenham P, Pathmakanthan S, Burke CM, Poulter LW, Southey A, O’Connor CM, Fitzgerald MX, Bourke WJ, McDonnell TJ, Buck JB, Magee TRA, Lowry RC, Graham ANJ, Owens WA, Kelly SB, McGuigan JA, Costelloe RW, Ryan J, Collins J, Guerin D, Rooney D, Long E, O’Donnell M, O’Neill S, Cotter TP, Bredin CP, Buick JB, Lowry RC, MacMahon JJ, Finlay G, Concannon D, McDonnell TJ, Reid PT, Alderdice J, Carson J, Sinnamon DG, Murphy S, Scott T, Keane CT, Walsh JB, Coakley D, McKeown D, Kelly P, Clancy L, Kiely JL, Cryan B, Bredin CP, Killeen P, Farrell S, Kelly P, Clancy L, Kiely JL, O’Riordan DM, Sheehan S, Curtain J, Hogan J, Bredin CP, Malone A, Ahmed S, Watson JBG, Murphy M, Fennell W, Ahmed S, Watson JBG, Aherne T, Keohane C, O’Neill M, Gleeson CM, McGuigan J, Ritchie AJ, Russell SEH, Molloy E, Keane M, Coakley R, Costello R, Condron C, Watson RGW, O’Neill S, Kelly C, Redmond H, Watson W, Burke P, Bouchier-Hayes D, Donnelly SC, Haslett C, Dransfield I, Robertson CE, Carter DC, Ross JA, Grant IS, Tedder TF, Doyle S, Sreenan S, Pathmakanthan S, Burke CM, Heaney LG, Cross LJM, Stanford CF, Ennis M, Sreenan S, Pathmakanthan S, Power C, Goggin A, Poulter LW, Burke CM, Murphy S, Scott T, Keane CT, Walsh JB, Coakley D, O’Riordan DM, Gergely L, Deng N, Rose RM, Hennessy T, Hickey L, Thornton L, Collum C, Durity M, Power J, Johnson H, Lee B, Doherty E, Kelly E, McDonnell T, McKeown D, Kelly P, Clancy L, Wilkinson P, Varghese G, Anikin V, Gibbons J, McManus K, McGuigan J, Reid PT, Gower NH, Rudd RM. Irish thoracic society. Ir J Med Sci 1994. [DOI: 10.1007/bf02967229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Goldenberg D, Sharkey R. Radiolabeled antibodies as in-vivo cancer probes (review). Int J Oncol 1993; 3:5-11. [PMID: 21573317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Cancer imaging with radiolabeled antibodies, or radioimmunodetection (RAID), has undergone a gradual multidisciplinary development over a period of at least 2 decades, resulting in rapid, simple, and accurate targeting agents that are now in final stage evaluation as a new class of cancer imaging and detection reagents. In its development, RAID has focused on different antigen targets, antibodies and antibody forms, radiolabels, and scanning instruments and procedures. Antibodies and imaging agents for a large variety of cancer types have been investigated clinically, and require well controlled, prospective trials to determine clinical applications, utility and safety. At the present time, truly cancer-specific antibodies are not required for successful RAID; many different patients with a similar tumor type can be imaged with a single pancarcinoma antibody; shed tumor antigens do not appear to prevent antibody targeting because of complexation with the administered antibodies; very small doses of antibody, even below 1 mg, can succeed in RAID; few adverse reactions have resulted from RAID, even with the development of human anti-mouse antibodies (HAMA) in patients given high doses of intact immunoglobulin; HAMA can affect monoclonal antibody-based immunoassay results; antibody fragments are less immunogenic and result in a lower incidence of HAMA than intact immunoglobulins; single-photon emission computed tomography (SPECT) usually improves image resolution in RAID, as compared to planar imaging; and RAID can complement conventional imaging agents and can often disclose tumors missed by, conventional scanning methods. A recent advance has been the development of Tc-99m-labeled Fab' fragments by simple and rapid conjugation kits, which enable detection of small lesions, including those in the liver, within a few hours after injection, especially with SPECT scanning.
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Abstract
1. To equip nurses with the skills necessary for working with disturbed people, nurse educators need to be mindful of not watering down the essential skills necessary for nurses to deal with difficult behaviour in all branches of nursing. 2. These components of a mental health clinical experience should equip the graduate to deal with the pressures of dealing with disturbed people in any environment, as the skills learned generalize to any branch of nursing. 3. Universities can combine with traditional hospital services and community mental health services to provide services to clients with mental illness. An additional benefit is in providing students with an intensive clinical learning experience that reinforces the theory taught in the classroom.
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Affiliation(s)
- D Arthur
- Department of Nursing Studies, University of Newcastle, New South Wales, Australia
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Hovell MF, Bursick JH, Sharkey R, McClure J. An evaluation of elementary students' voluntary physical activity during recess. Res Q 1978; 49:460-74. [PMID: 741084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Chynn KY, Sharkey R. Diencephalic syndrome of emaciation. A caase report. Am J Roentgenol Radium Ther Nucl Med 1965; 95:917-20. [PMID: 5294758 DOI: 10.2214/ajr.95.4.917] [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] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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