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Certain cancer treatments may increase the risk of COVID-19

 


Tuesday, September 22, 2020 (Health Day News)-Cancer patients are at increased risk of severe COVID-19. Preliminary studies now suggest that certain cancer treatments may further increase these odds.

Of the 3,600 US cancer patients with COVID-19, the researchers found that those who received cancer treatment within the last three months had the highest risk of death.

And the type of treatment was important. Patients treated with a combination of immunotherapy and chemotherapy had the highest risk of dying after the onset of COVID-19.

Experts emphasized that this finding should not prevent cancer patients from receiving life-saving or life-prolonging treatment.

“We don’t want people to delay treatment,” said Dr. Trishawise Draper, an oncologist and principal investigator at the University of Cincinnati Cancer Center. “Cancer is more deadly than COVID.”

Instead, she said, provide deeper insight into which patients are at greatest risk of becoming severely ill if infected with COVID-19.

Cancer immunotherapy involves a variety of approaches to increasing the ability of the immune system to fight tumors.

On the other hand, severe cases of COVID-19 often have an uncontrolled immune response called a cytokine storm. This raises concerns that cancer patients receiving immunotherapy may be at particular risk of dying if infected.

However, according to Wise-Draper, previous studies did not provide clear evidence that immunotherapy alone exacerbated the complications of COVID-19.

These latest findings suggest that the combination of immunotherapy and chemotherapeutic agents poses the greatest risk, she said.

Of the patients on both therapies infected with the new coronavirus, 29% died. High risk is also associated with chemotherapy alone and “targeted therapies,” especially drugs that deplete B cells in the immune system, Wise-Draper said.

These drugs-including rituximab and obinutuzumab-are used to treat certain cancers that develop on B cells. The problem is that B cells also make antibodies that help the body fight the infection.

Of all patients who received targeted therapy in the past year, 20% died after the onset of COVID-19. This is the same mortality rate as patients with chemotherapy alone. On the other hand, the mortality rate of immunotherapy patients was 18%.

To fit these numbers into several contexts, the researchers also examined COVID-19 patients who had cancer but had not been treated the previous year. Of those patients, 14% died.

The rate is still high, Wise Draper pointed out. She emphasized that it emphasizes the need for vigilance, even among people who are not actively treating cancer: social distance, masking and other precautions are important.

This study found no evidence that current or recent hormone therapy has added to the risk of cancer patients. In fact, these patients had the lowest post-contract mortality rate with COVID-19, at 11%.

The findings were presented on September 19 at the Virtual Annual Meeting of the European Society of Medical Oncology, which was held online for a pandemic. Like most studies presented at conferences, this study is considered preliminary until it is published in a peer-reviewed journal.

But the results are important, said Dr. Joshua Brody, head of the lymphoma immunotherapy program in Mount Sinai, New York City.

The study “reveals important statistics that cancer patients and doctors need to know,” Brody said.

“Fortunately, the results here are very practical,” he added.

According to Brody, cancer patients taking chemotherapy or drugs that deplete B cells need to be closely monitored before and during treatment. And that should include, in addition to regular COVID-19 screening, a prompt response if the patient becomes ill-may mean hospitalization and treatment with the drug dexamethasone.

The findings are based on approximately 3,600 COVID-19 patients nationwide who have previously received systemic cancer treatments (treatments other than surgery and radiation).

More than half of all patients were hospitalized. Overall, patients treated for cancer in the past year were at higher risk of dying than those treated in the past, except with hormone therapy. In general, treatment within the last 3 months was at greatest risk.

According to the American Cancer Society, most people who have been treated for cancer in the past (especially a few years ago) may have normal immune function. However, the group adds that “each person is different,” which encourages cancer patients and survivors to talk to their doctors about their situation.

For more information

The American Cancer Society Cancer and COVID-19..

Source: Trisha Wise-Draper, MD, PhD, Associate Professor, School of Medicine, Hematology and Oncology, Cincinnati University School of Medicine, Cincinnati; Joshua Brody, MD, Director of Lymphoma Immunotherapy Program, Icahn School of Medicine, Mount Sinai, New York City .. Announced on September 19, 2020, Virtual Conference of the European Oncology Society

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