NCI’s Sharpless says COVID-19 may stop streaking rising US cancer mortality

Deferred screening or treatment delays for coronavirus disease (COVID-19) in 2019 reverses improvements in cancer mortality that lasted more than 25 years, according to Dr. Norman E. Nedsharpless, National Cancer Director May be caused. The Institute (NCI) was presented in a virtual format by a pandemic during the American Society of Clinical Oncology (ASCO) 2020 Annual Meeting.

In 2019, tentatively acting as FDA Commissioner Sharpless will hold a virtual session on Cancer and COVID-19 to calmly assess the impact of COVID-19 on both clinical care and cancer research. did.

His speech preceded some presentations on the earliest discoveries of the cancer effects of COVID-19. Patients treated with chemotherapy for lung or breast cancer shortly before being diagnosed with COVID-19 appear to face a higher risk of death. Cancer patients who combined hydroxychloroquine (HCQ) and azithromycin.

The individual data sets help shape the new picture of the situation facing cancer patients at COVID-19. They are more likely to be older or have potential health problems where the virus is known to become more deadly.

Also, as explained by Jeremy L. Warner, MD, an associate professor at Vanderbilt University Medical Center, patients may be immunosuppressed from treatment or the disease itself, and may be in more frequent contact with the medical system than people. There is no cancer.

Deferred care comes at a price

Shavless said that the decision to maintain hospital and clinical capacity was “necessary and important” as COVID-19 peaked this spring. “It may mean more cancer suffering consequences for our patients. What we do not yet know is the scale of these adverse consequences.”

NCI collaborates with the American Cancer Society and others each year to publish an annual report on cancer conditions, which reduces cancer mortality as a “hit” each year for cancer researchers, Charles said. “My concern is that the decline in cancer treatments will have a negative impact on these public health-related cancer statistics, and we expect these trends to continue for years,” he said. “We can’t escape this reality.”

The study is a hit as the number of patients in the NCI trial slows. Sharpless says he heard similar reports on industry-sponsored trials. He said that filling some of the gap was an active effort to initiate trials to understand the effects of COVID-19 on cancer patients. He highlighted two groups presenting results during the ASCO conference and the registries set up by ASCO and the American Society of Hematology.

May 21, 2020, NCI Announces COVID-19 in Cancer Patient Study¹ Enroll 2000 cancer patients diagnosed with COVID-19. “We aim to do research on more than 1000 sites,” Sharpless said. “We need to know as much as we do about the impact of COVID-19 on cancer patients in Montana.
About people in New York. “

He rhetorically said, “What did you learn about the effects of the virus on patients across racial and ethnic groups?” Sharpless said the NCI’s work was “not a directory,” but was approved by the Institutional Review Board. Pointed out that it was a trial. The investigator will seek patient consent for sample collection, biomarker analysis, and development of the patient’s germline sequence.

Participating patients must undergo regular medical visits. Meanwhile, the facility collects blood samples and copies of routine image scans for up to two years. “It is important to note that participation in this study does not require additional visits to hospitals or other facilities,” Sharpless said. “Most of the data is collected electronically and some tests become part of the patient’s daily care.”

Results from TERAVOLT

Past smoking history or lung injury is one of the characteristics that expose breast cancer patients to a particular risk of COVID-19, according to a record of 400 patients in the International Cobid 19 Collaborative Breast Cancer (TERAVOLT) Registry. According to the insights collected,² Breast cancer includes lungs
Tumor, mesothelioma, carcinoid tumor, thymic tumor.

Researchers found that chemotherapy use within 3 months of COVID-19 diagnosis was particularly strongly associated with premature mortality. The risk of death from the virus has increased by 64%. The efficacy of chemotherapy has been shown as a potential risk factor in previous studies, regardless of whether the patient is taking other therapies such as “immunotherapy.”^Three

Of the 400 patients, 144 died. 79.4% (n = 112) due to COVID-19, 10.6% (n = 15) due to cancer, and other causes. Treatment with anticoagulants and corticosteroids has also been associated with an increased risk of death, adding to existing concerns about the use of corticosteroids in patients with chronic illness. More data are needed to reach a firm conclusion about the use of anticoagulants.

Lead authors Leora Horn, MD, and MSc commented on the speed at which research effects materialize. “In less than a week, a study was done to enroll patients,” said Horn, an associate professor of cancer research at Ingram and head of the breast oncology program at Vanderbilt University Medical Center. It was. “We’ve seen clinical trials funded, approved, and enrolled patients within weeks. It often takes months or years to get clinical trial approval.”

Cancer and cocktail

COVID-19 cancer patients treated with both HCQ and azithromycin die within 30 days of being diagnosed with COVID-19, according to a study4 published by Warner, the first author of the study from COVID. 3 times more likely to be-and the Cancer Consortium that started its registration on March 15.
Warner warned that the link was “uncertain justification” and could result from residual confounding. “For example,” he said, “patients receiving this combination are more likely to have severe illness or hospitalized.”

The researchers also reported that neither drug was associated with an increased risk of death when taken alone.

After some statistical adjustment, researchers have a five-fold greater chance of dying patients with worsening cancer within 30 days of COVID-19 diagnosis than patients without remission or evidence of disease I found that.

Of the 928 people with cancer and COVID-19 included in the study, 121 (13%) died within 30 days of being diagnosed with COVID-19, according to a study presented by Warner. There was a slightly different number of written summaries submitted earlier to meet the ASCO deadline, with 1108 and 106 deaths, or 10.4% of all cases.

In an analysis of cases and deaths, the researchers found that factors associated with 30-day mortality risk included cancer progression, progression, or activity. Older age; male sex; former smoker.

Of the 121 deaths Warner discussed in his video presentation, only three were uncomplicated. Of the 466 hospitalized, 106 died.

References

1. NCI COVID-19 (NCCAPS) in cancer patient research. National Cancer Institute. May 21, 2020. Accessed May 30, 2020. https: //www.cancer.
gov / research / keyinitiatives / covid19 / coronavirusresearchinitiatives / nccaps

2. Horn L, Whisenant JG, Torri V etc. Chest Cancer International COVID 19 Collaboration (TERAVOLT): Type of Cancer Treatment and Impact of COVID Treatment on Survival. J Clin Oncol. 2020; 38 (18 suppl; abstr LBA111). doi: 10.1200 / JCO.2020.38.18_suppl.LBA111

3. Dai M, Liu D, Liu M etc. Cancer patients appear to be more vulnerable to SARSCoV2: a multicenter study during the development of COVID19. 2020; 10(6):783791. doi: 10.1158 / 21598290.CD200422

4. Warner JL, Rubinstein S, Grivus P, etc. Clinical Impact of COVID19 on Cancer Patients: Data from COVID19 and Cancer Consortium (CCC19). J Clin Oncol. 2020; 38 (18 suppl; abstr LBA110). doi: 10.1200 / JCO.2020.38.18_suppl.LBA110