Impact of SARS-CoV-2 vaccines and recent chemotherapy on COVID-19 morbidity and mortality in patients with soft tissue sarcoma: an analysis from the OnCovid registry-Reference-Cited by-同舟云学术

Impact of SARS-CoV-2 vaccines and recent chemotherapy on COVID-19 morbidity and mortality in patients with soft tissue sarcoma: an analysis from the OnCovid registry

Published:2024-01 Issue: Volume:16 Page:
ISSN:1758-8359
Container-title:Therapeutic Advances in Medical Oncology
language:en
Short-container-title:Ther Adv Med Oncol

Author:

Vincenzi Bruno¹²,Cortellini Alessio¹³^ORCID,Mazzocca Alessandro¹²^ORCID,Orlando Sarah¹²,Romandini Davide¹²,Aguilar-Company Juan⁴⁵^ORCID,Ruiz-Camps Isabel⁴⁵,Valverde Morales Claudia⁶,Eremiev-Eremiev Simeon⁴⁵,Tondini Carlo⁷,Brunet Joan⁸,Bertulli Rossella⁹,Provenzano Salvatore⁹,Bower Mark¹⁰,Generali Daniele¹¹¹²,Salazar Ramon¹³,Sureda Anna¹⁴,Prat Aleix¹⁵¹⁶,Vasiliki Michalarea¹⁷,Van Hemelrijck Mieke¹⁷¹⁸,Sita-Lumsden Ailsa¹⁷,Bertuzzi Alexia¹⁹,Rossi Sabrina¹⁹,Jackson Amanda²⁰,Grosso Federica²¹,Lee Alvin J. X.²²^ORCID,Murphy Cian²²,Belessiotis Katherine²²,Mukherjee Uma²³,Pommeret Fanny²⁴,Loizidou Angela²⁵,Gaidano Gianluca²⁶,Dettorre Gino M.²⁷,Grisanti Salvatore²⁸,Tucci Marco²⁹³⁰^ORCID,Fulgenzi Claudia A. M.²³¹,Gennari Alessandra³²,Napolitano Andrea³³,Pinato David J.³¹³²

Affiliation:

1. Operative Research Unit of Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy

2. Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy

3. Department of Surgery and Cancer, Imperial College of London, Hammersmith Hospital Campus, Du Cane Road, London, UK

4. Medical Oncology, Vall d’Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain

5. Infectious Diseases, Vall d’Hebron University Hospital, Barcelona, Spain

6. Medical Oncology, Vall d’Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain

7. Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy

8. Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain

9. Medical Oncology 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

10. Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK

11. Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Italy

12. Department of Medical, Surgical and Health Sciences, University of Trieste, Italy

13. Department of Medical Oncology, ICO L’Hospitalet, Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Spain

14. Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain

15. Department of Medical Oncology, Hospital Clinic, Barcelona, Spain

16. Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain

17. Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, UK

18. Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK

19. Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

20. Velindre Cancer Centre, Cardiff, UK

21. Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy

22. Cancer Division, University College London Hospital, London, UK

23. Medical Oncology, Barts Health NHS Trust, London, UK

24. Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France

25. Department of Infectious Diseases, Internal Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium

26. Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Ospedale Maggiore della Carità Hospital, Novara, Italy

27. Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA

28. Medical Oncology Unit, Spedali Civili, Brescia, Italy

29. Section of Medical Oncology, Department of Interdisciplinary Medicine (DIM), University of Bari ‘Aldo Moro’, Bari, Italy

30. IRCCS, Istituto Tumori Giovanni Paolo II, Bari, Italy

31. Department of Surgery and Cancer, Imperial College of London, Hammersmith Hospital Campus, London, UK

32. Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy

33. The Royal Marsden NHS Foundation Trust, London, UK

Abstract

Background: To date, limited evidence exists on the impact of COVID-19 in patients with soft tissue sarcoma (STS), nor about the impact of SARS-CoV-2 vaccines and recent chemotherapy on COVID-19 morbidity and mortality in this specific population. Methods: We described COVID-19 morbidity and mortality among patients with STS across ‘Omicron’ (15 December 2021–31 January 2022), ‘Pre-vaccination’ (27 February 2020–30 November 2020), and ‘Alpha-Delta’ phase (01 December 2020–14 December 2021) using OnCovid registry participants (NCT04393974). Case fatality rate at 28 days (CFR28) and COVID-19 severity were also described according to the SARS-CoV-2 vaccination status, while the impact of the receipt of cytotoxic chemotherapy within 4 weeks prior to COVID-19 on clinical outcomes was assessed with Inverse Probability of Treatment Weighting (IPTW) models adjusted for possible confounders. Results: Out of 3820 patients, 97 patients with STS were included. The median age at COVID-19 diagnosis was 56 years (range: 18–92), with 65 patients (67%) aged < 65 years and most patients had a low comorbidity burden (65, 67.0%). The most frequent primary tumor sites were the abdomen (56.7%) and the gynecological tract (12.4%). In total, 36 (37.1%) patients were on cytotoxic chemotherapy within 4 weeks prior to COVID-19. The overall CFR28 was 25.8%, with 38% oxygen therapy requirement, 34% rate of complications, and 32.3% of hospitalizations due to COVID-19. CFR28 (29.5%, 21.4%, and 12.5%) and all indicators of COVID-19 severity demonstrated a trend toward a numerical improvement across the pandemic phases. Similarly, vaccinated patients demonstrated numerically improved CFR28 (16.7% versus 27.7%) and COVID-19 morbidity compared with unvaccinated patients. Patients who were on chemotherapy experienced comparable CFR28 (19.4% versus 26.0%, p = 0.4803), hospitalizations (50.0% versus 44.4%, p = 0.6883), complication rates (30.6% versus 34.0%, p = 0.7381), and oxygen therapy requirement (28.1% versus 40.0%, p = 0.2755) compared to those who were not on anticancer therapy at COVID-19, findings further confirmed by the IPTW-fitted multivariable analysis. Conclusion: In this study, we demonstrate an improvement in COVID-19 outcomes in patients with STS over time. Recent exposure to chemotherapy does not impact COVID-19 morbidity and mortality and SARS-CoV-2 vaccination confers protection against adverse outcomes from COVID-19 in this patient population.

Funder

NIHR Imperial Biomedical Research Centre

Publisher

SAGE Publications

Link

http://journals.sagepub.com/doi/pdf/10.1177/17588359231225028

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