CLO22-032: Effect of COVID-19 Causing Treatment Delay in Cancer Patients Receiving Immune Checkpoint Inhibitors

Authors:
Anuja Abhyankar University of Louisville, Louisville, KY

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,
Abigail Chan University of Louisville, Louisville, KY

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Ruobing Xue University of Louisville, Louisville, KY

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Vatsala Katiyar University of Louisville, Louisville, KY

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Rohit Kumar University of Louisville, Louisville, KY

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Volume/Issue:
Volume 20: Issue 3.5
Online Publication Date:
31 Mar 2022
DOI:
https://doi.org/10.6004/jnccn.2021.7301
Full access

Background: The onset of the SARS-CoV-2 virus demonstrated an unprecedented challenge in the treatment of cancer patients. Cancer patients were among those at higher risk for contracting the illness, resulting in treatment delays, disease progression, and increased risk of COVID-19 mortality. We conducted a single-center descriptive study with an aim to identify the effect of COVID-19 on treatment delay in patients receiving immune checkpoint inhibitors (ICI). Methods: A retrospective chart review of cancer patients with known diagnosis of COVID-19 receiving ICI as part of their treatment was performed. Baseline characteristics, oncologic history, and treatment course were collected. Descriptive statistics were used to analyze treatment delay and percentage of disease progression. Results: A total of 18 eligible patients were identified, 55% were female, median age was 67.5 years, 83% were Caucasians, and 17% were Black. The most common cancer types included were lung cancer (39%), melanoma (22%), and breast cancer (17%). Majority of the patients had metastatic disease. Pembrolizumab was the most utilized ICI (67%), followed by combination Ipilimumab/Nivolumab (11%), Durvalumab (11%), and single agent Nivolumab or Atezolizumab. Chemotherapy was used in combination in more than half of the cases. Twelve of the 18 patients required hospitalization for COVID-19 and 2 required intensive care unit stays. Eleven were treated with supportive care, 6 received corticosteroids, and 4 had Remdesivir infusions. The median treatment delay was 56 days among 11 patients, while 5 permanently discontinued ICIs. Two patients started ICI treatment after diagnosis of COVID-19. Six (33%) patients experienced disease progression with treatment interruption. There were no reported severe immune related Adverse Events among the cohort. On last follow up, 3 patients were deceased. Conclusion: The COVID-19 pandemic had led to significant treatment delays and discontinuation in our cohort of patients. There is paucity of data regarding recommendations for cancer ICI in patients with COVID-19 and a wide scope and need for further research regarding the same.

Corresponding Author: Anuja Abhyankar, MD
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Copyright:
Copyright © 2022 by the National Comprehensive Cancer Network 2022
Article Category:
Abstract
Print Publication Date:
31 Mar 2022
Online Publication Date:
31 Mar 2022
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