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. 2020 Jul 31;10(10):1465-1474.
doi: 10.1158/2159-8290.CD-20-0773. Online ahead of print.

Clinical portrait of the SARS-CoV-2 epidemic in European cancer patients

David J Pinato  1 , Alberto Zambelli  2 , Juan Aguilar-Company  3 , Mark Bower  4 , Christopher Sng  5 , Ramon Salazar  6 , Alexia Bertuzzi  7 , Joan Brunet  8 , Ricard Mesia  9 , Elia Segui  10 , Federica Biello  11 , Daniele Generali  12 , Salvatore Grisanti  13 , Gianpiero Rizzo  14 , Michela Libertini  15 , Antonio Maconi  16 , Nadia Harbeck  17 , Bruno Vincenzi  18 , Rossella Bertulli  19 , Diego Ottaviani  20 , Anna Carbo  21 , Riccardo Bruna  22 , Sarah Benafif  23 , Andrea Marrari  7 , Rachel Wuerstlein  24 , M Carmen Carmona-Garcia  25 , Neha Chopra  20 , Carlo Tondini  26 , Oriol Mirallas  27 , Valeria Tovazzi  28 , Marta Betti  29 , Salvatore Provenzano  30 , Vittoria Fotia  26 , Claudia Andrea Cruz  10 , Alessia Dalla Pria  31 , Francesca D'Avanzo  32 , Joanne S Evans  33 , Nadia Saoudi-Gonzalez  34 , Eudald Felip  35 , Myria Galazi  20 , Isabel Garcia-Fructuoso  36 , Alvin J X Lee  37 , Thomas Newsom-Davis  38 , Andrea Patriarca  22 , David Garcia-Illescas  39 , Roxana Reyes  40 , Palma Dileo  20 , Rachel Sharkey  31 , Yien Ning Sophia Wong  20 , Daniela Ferrante  41 , Javier Marco-Hernandez  10 , Anna Sureda  42 , Clara Maluquer  43 , Isabel Ruiz-Camps  44 , Gianluca Gaidano  45 , Lorenza Rimassa  46 , Lorenzo Chiudinelli  47 , Macarena Izuzquiza  48 , Alba Cabirta  48 , Michela Franchi  49 , Armando Santoro  50 , Aleix Prat  51 , Josep Tabernero  52 , Alessandra Gennari  53
Affiliations

Clinical portrait of the SARS-CoV-2 epidemic in European cancer patients

David J Pinato et al. Cancer Discov. .

Abstract

The SARS-Cov-2 pandemic significantly impacted on oncology practice across the globe. There is uncertainty as to the contribution of patients' demographics and oncological features on severity and mortality from Covid-19 and little guidance as to the role of anti-cancer and anti-Covid-19 therapy in this population. In a multi-center study of 890 cancer patients with confirmed Covid-19 we demonstrated a worsening gradient of mortality from breast cancer to haematological malignancies and showed that male gender, older age, and number of co-morbidities identifies a subset of patients with significantly worse mortality rates from Covid-19. Provision of chemotherapy, targeted therapy and immunotherapy did not worsen mortality. Exposure to antimalarials was associated with improved mortality rates independent of baseline prognostic factors. This study highlights the clinical utility of demographic factors for individualized risk-stratification of patients and support further research into emerging anti-Covid-19 therapeutics in SARS-Cov-2 infected cancer patients.

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Conflict of interest statement

D.J. Pinato reports personal fees from ViiV Healthcare (Lecture Fees), personal fees from Bayer Healthcare (Lecture Fees), other from BMS (Travel Fees), other from Bayer Healthcare (Travel Fees), personal fees from Mina Therapeutics (Consultancy), personal fees from EISAI (Consultancy), personal fees from Roche (Consultancy), personal fees from AstraZeneca (Consultancy), grants from MSD (Grant to institution), and grants from BMS (Grant to institution) outside the submitted work. A. Zambelli reports personal fees from Roche (For occasional advisory board), personal fees from Pfizer (For occasional advisory board), personal fees from Novartis (For occasional advisory board), personal fees from Lilly (For occasional advisory board), personal fees from AstraZeneca (For occasional advisory board), personal fees from Merck (For occasional advisory board), and personal fees from Exact Science GH (For occasional advisory board) outside the submitted work. M. Bower reports Speaker honoraria received from ViiV, Gilead Sciences, BMS, Janssen, and MSD. R. Mesia reports grants and personal fees from Merck KgA, personal fees from MSD, personal fees from BMS, personal fees from AstraZeneca, personal fees from Nanobiotics, personal fees from Seattle Genetics, and personal fees from Roche outside the submitted work. D. Generali reports personal fees from Novartis, personal fees from Pfizer, and personal fees from Lilly outside the submitted work. R. Bertulli reports other from Advenchen Laboratories (research funding), other from Amgen Dompe (research funding), other from AROG Pharmaceuticals (research funding), other from Bayer (research funding), other from Blueprint Medicine (research funding), other from Daiichi Sankyo (research funding), other from Deciphera (research funding), other from Eisai (research funding), other from Eli Lilly (research funding), other from Epizime Inc. (research funding), other from Glaxo (research funding), other from Karyopharm Pharmaceuticals (research funding), other from Novartis (research funding), other from Pfizer (research funding), and other from Pharmamar (research funding) outside the submitted work. C. Tondini reports grants from Roche (clinical trial), grants from Novartis (clinical trial), grants from BMS (clinical trial), personal fees from Myriad Genetics (Consulting or Advisory Role), personal fees from Amgen (Speakers' Bureau), personal fees from Celgene (Travel/Accommodations, Expenses), personal fees from Novartis (Travel/Accommodations, Expenses), and personal fees from Roche/Genentech (Travel/Accommodations, Expenses) outside the submitted work. O. Mirallas reports personal fees from Kyowa Kirin (Travel) outside the submitted work. S. Provenzano reports other from Eli Lilly (research funding), other from Novartis (research funding), other from Pfizer (research funding), other from Pharmamar (research funding), other from Karyopharm (research funding), other from GSK (research funding), other from Epizime (research funding), and other from Eisai (research funding) outside the submitted work; and spouse working for AstraZeneca. J.S. Evans reports grants from Takeda and personal fees from Roche outside the submitted work. T. Newsom-Davis reports personal fees and non-financial support from AstraZeneca, personal fees and non-financial support from Boehringer Ingelheim, personal fees from Amgen, personal fees and non-financial support from BMS, personal fees and non-financial support from MSD, personal fees and non-financial support from Eli Lilly, personal fees from Novartis, personal fees and non-financial support from Roche, personal fees from Bayer, personal fees from Pfizer, and personal fees and non-financial support from Takeda outside the submitted work. A. Sureda reports personal fees from Takeda, personal fees from Celgene-BMS, personal fees from Novartis, personal fees from Kite Gilead, personal fees from Sanofi, personal fees from Janssen, and personal fees from Roche outside the submitted work. G. Gaidano reports personal fees from Janssen (Advisory Board, Speaker' Bureau), personal fees from AbbVie (Advisory Board, Speakers' Bureau), personal fees from Sunesys (Advisory Board), and personal fees from AstraZeneca (Advisory Board) outside the submitted work. L. Rimassa reports personal fees from Amgen; ArQule; AstraZeneca; Basilea; Bayer; Celgene; Eisai; Eli Lilly; Exelixis; Hengrui; Incyte; Ipsen; Merck Sharp & Dohme; Nerviano Medical Sciences; Roche; and Sanofi (Advisor or consultant); personal fees from AbbVie; Amgen; Eisai; Eli Lilly; Gilead; Incyte; Ipsen; Roche; and Sanofi (Lecture fees); grants from Agios; ARMO BioSciences; AstraZeneca; BeiGene; Eisai; Eli Lilly; Exelixis; FibroGen; Incyte; Ipsen; Merck Sharp & Dohme; and Roche (Research grants to Institution), and non-financial support from Ipsen (Travel expenses) outside the submitted work. A. Prat reports personal fees from Roche, personal fees from Novartis, personal fees from Pfizer, personal fees from Daiichi Sankyo, personal fees from Oncolytics Biotech, personal fees from AstraZeneca, personal fees from NanoString Technologies, and personal fees from Seattle Genetics outside the submitted work. J. Tabernero reports personal fees from Array Biopharma, AstraZeneca, Bayer, BeiGene, Boehringer Ingelheim, Chugai, Genentech, Inc., Genmab A/S, Halozyme, Imugene Limited, Inflection Biosciences Limited, Ipsen, Kura Oncology, Lilly, MSD, Menarini, Merck Serono, Merrimack, Merus, Molecular Partners, Novartis, Peptomyc, Pfizer, Pharmacyclics, ProteoDesign SL, Rafael Pharmaceuticals, F. Hoffmann-La Roche Ltd., Sanofi, SeaGen, Seattle Genetics, Servier, Symphogen, Taiho, VCN Biosciences, Biocartis, Foundation Medicine, HalioDX SAS, and Roche Diagnostics (scientific consultancy role) outside the submitted work. No potential conflicts of interest were disclosed by the other authors.

Figures

Figure 1.
Figure 1.
The relationship between mortality from COVID-19 and clinicopathologic features of patients with cancer. Unadjusted mortality rates stratified by type (A) and number (B) of complications from COVID-19, primary tumor site (C), type (D) and number (E) of comorbid conditions, and anticancer therapy (F) and anti–COVID-19 therapy (G) received. *, P < 0.05; **, P < 0.01; ***, P < 0.001; ****, P < 0.0001. DIC, disseminated intravascular coagulation.
See this image and copyright information in PMC

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