Oncologic immunomodulatory agents in patients with cancer and COVID-19 Journal Article


Authors: Jee, J.; Stonestrom, A. J.; Devlin, S.; Nguyentran, T.; Wills, B.; Narendra, V.; Foote, M. B.; Lumish, M.; Vardhana, S. A.; Pastores, S. M.; Korde, N.; Patel, D.; Horwitz, S.; Scordo, M.; Daniyan, A. F.
Article Title: Oncologic immunomodulatory agents in patients with cancer and COVID-19
Abstract: Corticosteroids, anti-CD20 agents, immunotherapies, and cytotoxic chemotherapy are commonly used in the treatment of patients with cancer. It is unclear how these agents affect patients with cancer who are infected with SARS-CoV-2. We retrospectively investigated associations between SARS-CoV-2-associated respiratory failure or death with receipt of the aforementioned medications and with pre-COVID-19 neutropenia. The study included all cancer patients diagnosed with SARS-CoV-2 at Memorial Sloan Kettering Cancer Center until June 2, 2020 (N = 820). We controlled for cancer-related characteristics known to predispose to worse COVID-19 as well as level of respiratory support during corticosteroid administration. Corticosteroid administration was associated with worse outcomes prior to use of supplemental oxygen; no statistically significant difference was observed in sicker cohorts. In patients with metastatic thoracic cancer, 9 of 25 (36%) and 10 of 31 (32%) had respiratory failure or death among those who did and did not receive immunotherapy, respectively. Seven of 23 (30%) and 52 of 187 (28%) patients with hematologic cancer had respiratory failure or death among those who did and did not receive anti-CD20 therapy, respectively. Chemotherapy itself was not associated with worse outcomes, but pre-COVID-19 neutropenia was associated with worse COVID-19 course. Relative prevalence of chemotherapy-associated neutropenia in previous studies may account for different conclusions regarding the risks of chemotherapy in patients with COVID-19. In the absence of prospective studies and evidence-based guidelines, our data may aid providers looking to assess the risks and benefits of these agents in caring for cancer patients in the COVID-19 era. © 2021, The Author(s).
Keywords: aged; middle aged; retrospective studies; mortality; neutropenia; retrospective study; hematologic neoplasms; immunologic factors; corticosteroid; hematologic disease; immunologic factor; respiratory insufficiency; respiratory failure; adrenal cortex hormones; humans; human; male; female; immunological antineoplastic agent; antineoplastic agents, immunological; covid-19; sars-cov-2
Journal Title: Scientific Reports
Volume: 11
ISSN: 2045-2322
Publisher: Nature Publishing Group  
Date Published: 2021-03-01
Start Page: 4814
Language: English
DOI: 10.1038/s41598-021-84137-5
PUBMED: 33649382
PROVIDER: scopus
PMCID: PMC7921444
DOI/URL:
Notes: Article -- Export Date: 1 April 2021 -- Source: Scopus
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MSK Authors
  1. Stephen Pastores
    250 Pastores
  2. Steven M Horwitz
    645 Horwitz
  3. Sean McCarthy Devlin
    602 Devlin
  4. Michael Scordo
    368 Scordo
  5. Neha Sanat Korde
    226 Korde
  6. Melissa Amy Lumish
    39 Lumish
  7. Santosha Adipudi Vardhana
    102 Vardhana
  8. Anthony   Daniyan
    31 Daniyan
  9. Michael Bonner Foote
    42 Foote
  10. Justin Jee
    53 Jee
  11. Dhwani Patel
    41 Patel