. 2021 Jun;32(6):787-800.

doi: 10.1016/j.annonc.2021.02.024. Epub 2021 Mar 19.

Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium

P Grivas¹, A R Khaki², T M Wise-Draper³, B French⁴, C Hennessy⁴, C-Y Hsu⁴, Y Shyr⁴, X Li⁵, T K Choueiri⁶, C A Painter⁷, S Peters⁸, B I Rini⁴, M A Thompson⁹, S Mishra⁴, D R Rivera¹⁰, J D Acoba¹¹, M Z Abidi¹², Z Bakouny⁶, B Bashir¹³, T Bekaii-Saab¹⁴, S Berg¹⁵, E H Bernicker¹⁶, M A Bilen¹⁷, P Bindal¹⁸, R Bishnoi¹⁹, N Bouganim²⁰, D W Bowles¹², A Cabal²¹, P F Caimi²², D D Chism²³, J Crowell²⁴, C Curran⁶, A Desai²⁵, B Dixon²⁴, D B Doroshow²⁶, E B Durbin²⁷, A Elkrief²⁰, D Farmakiotis²⁸, A Fazio²⁹, L A Fecher³⁰, D B Flora²⁴, C R Friese³⁰, J Fu²⁹, S M Gadgeel³¹, M D Galsky²⁶, D M Gill³², M J Glover³³, S Goyal³⁴, P Grover³, S Gulati³, S Gupta³⁵, S Halabi³⁶, T R Halfdanarson²⁵, B Halmos³⁷, D J Hausrath⁵, J E Hawley³⁸, E Hsu³⁹, M Huynh-Le³⁴, C Hwang³¹, C Jani⁴⁰, A Jayaraj⁴¹, D B Johnson⁴, A Kasi⁴², H Khan²⁸, V S Koshkin⁴³, N M Kuderer⁴⁴, D H Kwon⁴³, P E Lammers⁴⁵, A Li⁴⁶, A Loaiza-Bonilla⁴⁷, C A Low³², M B Lustberg⁴⁸, G H Lyman⁴⁹, R R McKay²¹, C McNair¹³, H Menon⁵⁰, R A Mesa⁵¹, V Mico¹³, D Mundt⁹, G Nagaraj⁵², E S Nakasone⁴⁹, J Nakayama⁵³, A Nizam³⁵, N L Nock²², C Park³, J M Patel¹⁸, K G Patel⁵⁴, P Peddi⁵⁵, N A Pennell³⁵, A J Piper-Vallillo¹⁸, M Puc⁵⁶, D Ravindranathan¹⁷, M E Reeves⁵², D Y Reuben⁵⁷, L Rosenstein⁵⁸, R P Rosovsky⁵⁹, S M Rubinstein⁶⁰, M Salazar⁵¹, A L Schmidt⁶, G K Schwartz³⁸, M R Shah⁶¹, S A Shah³³, C Shah¹⁹, J A Shaya²¹, S R K Singh³¹, M Smits⁶², K E Stockerl-Goldstein⁶³, D G Stover⁴⁸, M Streckfuss⁹, S Subbiah⁶⁴, L Tachiki⁴⁹, E Tadesse⁹, A Thakkar³⁷, M D Tucker⁴, A K Verma³⁷, D C Vinh²⁰, M Weiss⁶², J T Wu³³, E Wulff-Burchfield⁴⁰, Z Xie²⁵, P P Yu⁴¹, T Zhang³⁶, A Y Zhou⁶³, H Zhu⁶⁵, L Zubiri⁵⁹, D P Shah⁵¹, J L Warner⁴, GdL Lopes⁶⁶

Affiliations

¹ University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, USA. Electronic address: pgrivas@uw.edu.
² University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, USA; Stanford University, Stanford, USA.
³ University of Cincinnati Cancer Center, Cincinnati, USA.
⁴ Vanderbilt University Medical Center, Nashville, USA.
⁵ Vanderbilt University School of Medicine, Nashville, USA.
⁶ Dana-Farber Cancer Institute, Boston, USA.
⁷ Broad Institute, Cancer Program, Cambridge, USA.
⁸ Lausanne University, Lausanne, Switzerland.
⁹ Advocate Aurora Health, Milwaukee, USA.
¹⁰ Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, USA.
¹¹ University of Hawaii Cancer Center, Honolulu, USA.
¹² University of Colorado School of Medicine, Aurora, USA.
¹³ Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, USA.
¹⁴ Mayo Clinic Cancer Center, Phoenix, USA.
¹⁵ Cardinal Bernardin Cancer Center, Loyola University Medical Center, Maywood, USA.
¹⁶ Houston Methodist Cancer Center, Houston, USA.
¹⁷ Winship Cancer Institute of Emory University, Atlanta, USA.
¹⁸ Beth Israel Deaconess Medical Center, Boston, USA.
¹⁹ University of Florida, Gainesville, USA.
²⁰ McGill University Health Centre, Montréal, Canada.
²¹ University of California San Diego, Moores Cancer Center, La Jolla, USA.
²² University Hospitals Seidman Cancer Center, Cleveland, USA; Case Western Reserve University, Cleveland, USA.
²³ Thompson Cancer Survival Center, Knoxville, USA.
²⁴ St. Elizabeth Healthcare, Edgewood, USA.
²⁵ Mayo Clinic Cancer Center, Rochester, USA.
²⁶ Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA.
²⁷ Markey Cancer Center, University of Kentucky, Lexington, USA.
²⁸ The Warren Alpert Medical School of Brown University, Providence, USA.
²⁹ Tufts Medical Center Cancer Center, Boston and Stoneham, USA.
³⁰ University of Michigan Rogel Cancer Center, Ann Arbor, USA.
³¹ Henry Ford Cancer Institute/Henry Ford Health System, Detroit, USA.
³² Intermountain Healthcare, Salt Lake City, USA.
³³ Stanford University, Stanford, USA.
³⁴ George Washington University, Washington DC, USA.
³⁵ Cleveland Clinic Taussig Cancer Institute, Cleveland, USA.
³⁶ Duke University, Durham, USA.
³⁷ Albert Einstein Cancer Center/Montefiore Medical Center, Bronx, USA.
³⁸ Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, USA.
³⁹ Hartford HealthCare, Hartford, USA; University of Connecticut, Farmington, USA.
⁴⁰ Mount Auburn Hospital, Cambridge, USA.
⁴¹ Hartford HealthCare, Hartford, USA.
⁴² University of Kansas Medical Center, Kansas City, USA.
⁴³ University of California, San Francisco, San Francisco, USA.
⁴⁴ Advanced Cancer Research Group, LLC, Kirkland, USA.
⁴⁵ Baptist Cancer Center, Memphis, USA.
⁴⁶ Baylor College of Medicine, Houston, USA.
⁴⁷ Cancer Treatment Centers of America, Philadelphia, USA.
⁴⁸ The Ohio State University, Columbus, USA.
⁴⁹ University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, USA.
⁵⁰ Penn State Health/Penn State Cancer Institute/St. Joseph Cancer Center, Hershey, USA.
⁵¹ Mays Cancer Center at UT Health San Antonio MD Anderson, San Antonio, USA.
⁵² Loma Linda University Cancer Center, Loma Linda, USA.
⁵³ Case Western Reserve University, Cleveland, USA; University Hospitals Cleveland Medical Center, Cleveland, USA.
⁵⁴ University of California Davis Comprehensive Cancer Center, Sacramento, USA.
⁵⁵ Willis-Knighton Cancer Center, Shreveport, USA.
⁵⁶ Virtua Health, Marlton, USA.
⁵⁷ Medical University of South Carolina, Charleston, USA.
⁵⁸ Gunderson Health System, La Crosse, USA.
⁵⁹ Massachusetts General Hospital, Harvard Medical School, Boston, USA.
⁶⁰ University of North Carolina, Chapel Hill, USA.
⁶¹ Rutgers Cancer Institute of New Jersey, New Brunswick, USA.
⁶² ThedaCare Regional Cancer Center, Appleton, USA.
⁶³ Siteman Cancer Center, Washington University School of Medicine, St. Louis, USA.
⁶⁴ Stanley S. Scott Cancer Center, LSU Health Sciences Center, New Orleans, USA.
⁶⁵ Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, USA.
⁶⁶ University of Miami/Sylvester Comprehensive Cancer Center, Miami, USA.

PMID: 33746047
PMCID: PMC7972830
DOI: 10.1016/j.annonc.2021.02.024

Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium

P Grivas et al. Ann Oncol. 2021 Jun.

. 2021 Jun;32(6):787-800.

doi: 10.1016/j.annonc.2021.02.024. Epub 2021 Mar 19.

Authors

Affiliations

¹ University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, USA. Electronic address: pgrivas@uw.edu.
² University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, USA; Stanford University, Stanford, USA.
³ University of Cincinnati Cancer Center, Cincinnati, USA.
⁴ Vanderbilt University Medical Center, Nashville, USA.
⁵ Vanderbilt University School of Medicine, Nashville, USA.
⁶ Dana-Farber Cancer Institute, Boston, USA.
⁷ Broad Institute, Cancer Program, Cambridge, USA.
⁸ Lausanne University, Lausanne, Switzerland.
⁹ Advocate Aurora Health, Milwaukee, USA.
¹⁰ Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, USA.
¹¹ University of Hawaii Cancer Center, Honolulu, USA.
¹² University of Colorado School of Medicine, Aurora, USA.
¹³ Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, USA.
¹⁴ Mayo Clinic Cancer Center, Phoenix, USA.
¹⁵ Cardinal Bernardin Cancer Center, Loyola University Medical Center, Maywood, USA.
¹⁶ Houston Methodist Cancer Center, Houston, USA.
¹⁷ Winship Cancer Institute of Emory University, Atlanta, USA.
¹⁸ Beth Israel Deaconess Medical Center, Boston, USA.
¹⁹ University of Florida, Gainesville, USA.
²⁰ McGill University Health Centre, Montréal, Canada.
²¹ University of California San Diego, Moores Cancer Center, La Jolla, USA.
²² University Hospitals Seidman Cancer Center, Cleveland, USA; Case Western Reserve University, Cleveland, USA.
²³ Thompson Cancer Survival Center, Knoxville, USA.
²⁴ St. Elizabeth Healthcare, Edgewood, USA.
²⁵ Mayo Clinic Cancer Center, Rochester, USA.
²⁶ Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA.
²⁷ Markey Cancer Center, University of Kentucky, Lexington, USA.
²⁸ The Warren Alpert Medical School of Brown University, Providence, USA.
²⁹ Tufts Medical Center Cancer Center, Boston and Stoneham, USA.
³⁰ University of Michigan Rogel Cancer Center, Ann Arbor, USA.
³¹ Henry Ford Cancer Institute/Henry Ford Health System, Detroit, USA.
³² Intermountain Healthcare, Salt Lake City, USA.
³³ Stanford University, Stanford, USA.
³⁴ George Washington University, Washington DC, USA.
³⁵ Cleveland Clinic Taussig Cancer Institute, Cleveland, USA.
³⁶ Duke University, Durham, USA.
³⁷ Albert Einstein Cancer Center/Montefiore Medical Center, Bronx, USA.
³⁸ Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, USA.
³⁹ Hartford HealthCare, Hartford, USA; University of Connecticut, Farmington, USA.
⁴⁰ Mount Auburn Hospital, Cambridge, USA.
⁴¹ Hartford HealthCare, Hartford, USA.
⁴² University of Kansas Medical Center, Kansas City, USA.
⁴³ University of California, San Francisco, San Francisco, USA.
⁴⁴ Advanced Cancer Research Group, LLC, Kirkland, USA.
⁴⁵ Baptist Cancer Center, Memphis, USA.
⁴⁶ Baylor College of Medicine, Houston, USA.
⁴⁷ Cancer Treatment Centers of America, Philadelphia, USA.
⁴⁸ The Ohio State University, Columbus, USA.
⁴⁹ University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, USA.
⁵⁰ Penn State Health/Penn State Cancer Institute/St. Joseph Cancer Center, Hershey, USA.
⁵¹ Mays Cancer Center at UT Health San Antonio MD Anderson, San Antonio, USA.
⁵² Loma Linda University Cancer Center, Loma Linda, USA.
⁵³ Case Western Reserve University, Cleveland, USA; University Hospitals Cleveland Medical Center, Cleveland, USA.
⁵⁴ University of California Davis Comprehensive Cancer Center, Sacramento, USA.
⁵⁵ Willis-Knighton Cancer Center, Shreveport, USA.
⁵⁶ Virtua Health, Marlton, USA.
⁵⁷ Medical University of South Carolina, Charleston, USA.
⁵⁸ Gunderson Health System, La Crosse, USA.
⁵⁹ Massachusetts General Hospital, Harvard Medical School, Boston, USA.
⁶⁰ University of North Carolina, Chapel Hill, USA.
⁶¹ Rutgers Cancer Institute of New Jersey, New Brunswick, USA.
⁶² ThedaCare Regional Cancer Center, Appleton, USA.
⁶³ Siteman Cancer Center, Washington University School of Medicine, St. Louis, USA.
⁶⁴ Stanley S. Scott Cancer Center, LSU Health Sciences Center, New Orleans, USA.
⁶⁵ Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, USA.
⁶⁶ University of Miami/Sylvester Comprehensive Cancer Center, Miami, USA.

PMID: 33746047
PMCID: PMC7972830
DOI: 10.1016/j.annonc.2021.02.024

Abstract

Background: Patients with cancer may be at high risk of adverse outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We analyzed a cohort of patients with cancer and coronavirus 2019 (COVID-19) reported to the COVID-19 and Cancer Consortium (CCC19) to identify prognostic clinical factors, including laboratory measurements and anticancer therapies.

Patients and methods: Patients with active or historical cancer and a laboratory-confirmed SARS-CoV-2 diagnosis recorded between 17 March and 18 November 2020 were included. The primary outcome was COVID-19 severity measured on an ordinal scale (uncomplicated, hospitalized, admitted to intensive care unit, mechanically ventilated, died within 30 days). Multivariable regression models included demographics, cancer status, anticancer therapy and timing, COVID-19-directed therapies, and laboratory measurements (among hospitalized patients).

Results: A total of 4966 patients were included (median age 66 years, 51% female, 50% non-Hispanic white); 2872 (58%) were hospitalized and 695 (14%) died; 61% had cancer that was present, diagnosed, or treated within the year prior to COVID-19 diagnosis. Older age, male sex, obesity, cardiovascular and pulmonary comorbidities, renal disease, diabetes mellitus, non-Hispanic black race, Hispanic ethnicity, worse Eastern Cooperative Oncology Group performance status, recent cytotoxic chemotherapy, and hematologic malignancy were associated with higher COVID-19 severity. Among hospitalized patients, low or high absolute lymphocyte count; high absolute neutrophil count; low platelet count; abnormal creatinine; troponin; lactate dehydrogenase; and C-reactive protein were associated with higher COVID-19 severity. Patients diagnosed early in the COVID-19 pandemic (January-April 2020) had worse outcomes than those diagnosed later. Specific anticancer therapies (e.g. R-CHOP, platinum combined with etoposide, and DNA methyltransferase inhibitors) were associated with high 30-day all-cause mortality.

Conclusions: Clinical factors (e.g. older age, hematological malignancy, recent chemotherapy) and laboratory measurements were associated with poor outcomes among patients with cancer and COVID-19. Although further studies are needed, caution may be required in utilizing particular anticancer therapies.

Clinical trial identifier: NCT04354701.

Keywords: SARS-CoV2; anticancer therapy; cancer; laboratory measurements; neoplasm; outcomes.

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Conflict of interest statement

Disclosure JDA reports research funding to the institution from Tesaro, outside the submitted work. ZB reports nonfinancial support from Bristol Myers Squibb and grants from Genentech/imCORE, outside the submitted work. BB reports research funding to the institution from Boehringer Ingelheim, Bicycle Therapeutics, Syros Pharmaceuticals, and Ikena Oncology, all outside the submitted work. TB-S reports research funding to the institution from Agios, Arys, Boston Biomedical, Bayer, Amgen, Merck, Celgene, Lilly, Ipsen, Clovis, Seattle Genetics, Array Biopharma, Genentech, Novartis, Mirati, Merus, AbGenomics, Incyte, Pfizer, BMS; consulting (to institution) for Ipsen, Array Biopharma, Pfizer, Seattle Genetics, Bayer, Genentech, Incyte, and Merck; consulting (to self) for AbbVie, Boehringer Ingelheim, Janssen, Eisai, Daiichi Sankyo, Natera, Treos Bio, Celularity, Exact Science, Sobi, BeiGene, Xilis, Astra Zeneca, and Foundation Medicine; serving on Independent Data Monitoring Committee/Data and Safety Monitoring Board (to self) for AstraZeneca, Exelixis, Lilly, PanCAN, and 1Globe; positions on Scientific Advisory Board for Imugene, Immuneering, and Sun Biopharma; and inventions/patents (WO/2018/183488 and WO/2019/055687), all outside the submitted work. SB reports being on advisory boards for Bristol Meyers Squibb and Seattle Genetics. MAB reports personal fees from Exelixis, Bristol-Myers Squibb, Bayer, Eisai, Pfizer, AstraZeneca, Janssen, Genomic Health, Nektar, and Sanofi; grants from Xencor, Bayer, Bristol-Myers Squibb, Genentech/Roche, Seattle Genetics, Incyte, Nektar, AstraZeneca, Tricon Pharmaceuticals, Peloton Therapeutics, and Pfizer, outside the submitted work. NB reports honoraria from Novartis, Pfizer, Roche, and Lilly, outside the submitted work. DWB reports research funding to the institution from Exelixis, Ayala, Merck, and Elevar, all outside the submitted work. DDC declares consulting or advisory role with Exelixis, outside the submitted work. TKC reports institutional and personal research support from Alexion, Analysis Group, AstraZeneca, Aveo, Bayer, Bristol Myers-Squibb/ER Squibb and sons LLC, Calithera, Cerulean, Corvus, Eisai, Exelixis, F. Hoffmann-La Roche, Foundation Medicine Inc., Genentech, GlaxoSmithKline, Ipsen, Lilly, Merck, Novartis, Peloton, Pfizer, Prometheus Labs, Roche, Roche Products Limited, Sanofi/Aventis, Takeda, Tracon; consulting/honoraria or advisory role with Alexion, Analysis Group, AstraZeneca, Aveo, Bayer, Bristol Myers-Squibb/ER Squibb and sons LLC, Cerulean, Corvus, Eisai, EMD Serono, Exelixis, Foundation Medicine Inc., Genentech, GlaxoSmithKline, Heron Therapeutics, Infinity Pharma, Ipsen, Jansen Oncology, IQVIA, Lilly, Merck, NCCN, Novartis, Peloton, Pfizer, Pionyr, Prometheus Labs, Roche, Sanofi/Aventis, Surface Oncology, Tempest, Up-to-Date; CME-related events (e.g. OncLive, PVI, MJH Life Sciences); stock ownership in Pionyr, Tempest; patents filed, royalties, or other intellectual properties related to biomarkers of immune checkpoint blockers; fees for travel, accommodations, expenses, medical writing in relation to consulting, advisory roles, or honoraria; and no speaker's bureau; also supported in part by the Dana-Farber/Harvard Cancer Center Kidney SPORE and Program, the Kohlberg Chair at Harvard Medical School and the Trust Family, Michael Brigham, and Loker Pinard Funds for Kidney Cancer Research at DFCI. DBD reports consulting for Ipsen, Boehringer Ingelheim; ASCO Young Investigator Award from Conquer Cancer Foundation, outside the submitted work. AE reports grant support from AstraZeneca, outside the submitted work. DF reports research funding to the institution from Viracor-Eurofins and Astellas, all outside the submitted work. LAF reports clinical trial funding to the institution from BMS, EMD Serono, Pfizer, Merck KGaA, Array, Kartos, Merck, and Incyte, ECOG-ACRIN study funding from Array; and personal fees from Elsevier and Via Oncology, outside the submitted work. DBF reports honoraria from Castle Biosciences. SMG reports Honoraria from AstraZeneca, Merck, Genentech/Roche; consulting or advisory role with Genentech/Roche, AstraZeneca, Bristol-Myers Squibb, Takeda, Xcovery, Boehringer Ingelheim, Novocure, Daiichi Sankyo, Novartis, Jazz Pharmaceuticals, Blueprint Medicines, Eli Lilly, Pfizer, Janssen Oncology; research funding (to self) from Merck, AstraZeneca; research funding (to institution) from Genentech/Roche, Merck, Blueprint Medicines, ARIAD/Takeda, Astellas Pharma, Lycera, Daiichi Sankyo, IMAB, Nektar, AstraZeneca, Pfizer, Amgen; travel, accommodations, expenses from Genentech/Roche, Merck; and other relationship from AstraZeneca, all outside the submitted work. MDG reports personal fees from Genentech, Pfizer, Astra Zeneca, Merck, Bristol Myers Squib, Dragonfly, Dracen, Seattle Genetics, and Astellas, outside the submitted work. PG reports consulting fees from AstraZeneca, Bayer, Bristol-Myers Squibb, Clovis Oncology, Dyania Health, Driver, EMD Serono, Exelixis, Foundation Medicine, Genentech/Roche, Genzyme, GlaxoSmithKline, Heron Therapeutics, Immunomedics, Infinity Pharmaceuticals, Janssen, Merck, Mirati Therapeutics, Pfizer, Seattle Genetics, QED Therapeutics; research funding to institution from Merck, Mirati Therapeutics, Pfizer, Clovis Oncology, Bavarian Nordic, Immunomedics, Debiopharm, Bristol-Myers Squibb, QED Therapeutics, GlaxoSmithKline, and Kure It Cancer Research, all outside the submitted work. SG reports research funding to the institution from AstraZeneca and consulting/advisory role with Puma Biotechnology. SG reports consultancy fees from BMS, Merck, AstraZeneca, Seattle Genetics, Pfizer; and speaker fees from Seattle Genetics and Janssen, all outside the submitted work. 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DCV reports honoraria and speakers' bureau fees from CSL Behring, Merck Canada, Novartis Canada, Takeda, and UCB Biosciences GmbH, and travel accommodations from CSL Behring, and Avir Pharma, all outside the submitted work. He is supported by the Fonds de la recherche en santé du Québec (FRQS) Clinician-Scientist Junior 2 program. JLW reports grants from the National Cancer Institute during the conduct of the study; personal fees from Westat and IBM Watson Health; and other from HemOnc.org LLC, outside the submitted work. TMW-D reports stock and other ownership interests in High Enroll; honoraria from Physicians' Education Resource; consulting or advisory roles with Shattuck Labs, Rakuten Medical, Exicure; research funding from Merck, AstraZeneca/MedImmune, Bristol-Myers Squibb, GlaxoSmithKline, Caris Life Sciences, GlaxoSmithKline; travel, accommodations, expenses from Merck, Bristol-Myers Squibb, Bexion, AstraZeneca/MedImmune, Caris Life Sciences, Lilly, and Tesaro, all outside the submitted work. EW-B reports work in a consultant/advisor role for Astellas and BMS; funding support from Pfizer Global Medical Grants; other for Exelixis; and an immediate family member with stock ownership in Immunomedics and Nektar, all outside the submitted work. TZ reports research funding (to Duke) from Pfizer, Janssen, Acerta, AbbVie, Novartis, Merrimack, OmniSeq, PGDx, Merck, Mirati, Astellas, and Regeneron; consulting/speaking role with Genentech Roche, Exelixis, Genomic Health, and Sanofi Aventis; and serves on the consulting/advisory board for AstraZeneca, Bayer, Pfizer, Foundation Medicine, Janssen, Amgen, BMS, Calithera, Dendreon, and MJH Associates; stock ownership/employment (spouse) from Capio Biosciences, Archimmune Therapeutics, and Nanorobotics. AYZ has currently or during the past 2 years owned stock or held an ownership interest in Gilead Sciences. LZ reports personal fees from MERCK, outside the submitted work. All others have declared no conflicts of interest.

Figures

**Figure 1**
Adjusted odds ratios and 95% confidence intervals for laboratory measurements obtained from multivariable models for COVID-19 severity and 30-day all-cause mortality among hospitalized patients. Odds ratios >1 indicate higher COVID-19 severity or higher odds of 30-day all-cause mortality. Adjusted for age, sex, race/ethnicity, country of patient residence, month of COVID-19 diagnosis, type of malignancy, cancer status, and active anticancer therapy. COVID-19, coronavirus disease 2019.

**Figure 2**
Visualization of the most prevalent cancer therapies and associated 30-day all-cause mortality. Individual anticancer drug exposures and their combinations are shown in an UpSet plot, which is an alternative to the Venn diagram for the visualization of high-dimensional data. Each row represents the individual anticancer therapies recorded as being given within 3 months of COVID-19 diagnosis that were present in ≥10 cases; rows are colored by treatment modality. Each column represents the intersection of one or more drugs given in combination (i.e. as a regimen) in ≥10 cases. A column with a single dark circle represents a monotherapy regimen; columns with multiple dark circles connected by dark lines represent multiagent regimens. Bars are colored by mortality for the patients receiving the drug or the combination, with darker hues representing higher mortality. This information is also shown in tabular format in Supplementary Table 9, available at https://doi.org/10.1016/j.annonc.2021.02.024. ADT, androgen-deprivation therapy; BCR-ABLi, BCR-ABL tyrosine kinase inhibitor; BRAFi, serine/threonine-protein kinase B-Raf inhibitor; BTKi, Bruton tyrosine kinase inhibitor; CDK4/6i, cyclin-dependent kinase 4 and 6 inhibitor; COVID-19, coronavirus disease 2019; DNMTi, DNA methyltransferase inhibitor; EGFRi, epidermal growth factor receptor tyrosine kinase inhibitor; ERBB2i, epidermal growth factor receptor 2 tyrosine kinase inhibitor; IMiD, immunomodulator; JAKi, Janus kinase inhibitor; MEKi, mitogen-activated protein kinase kinase inhibitor; NSAA, nonsteroid antiandrogen; OFS, ovarian function suppression; PARPi, poly (ADP-ribose) polymerase inhibitor; VEGFRi, vascular endothelial growth factor receptor inhibitor.

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References

1. World Health Organization (WHO) WHO Coronavirus Disease (COVID-19) Dashboard. https://covid19.who.int/table Available at: Accessed November 24, 2020.
1. Johns Hopkins Coronavirus Resource Center https://coronavirus.jhu.edu/ Available at: Accessed December 9, 2020.
1. Liang W., Guan W., Chen R. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335–337. - PMC - PubMed
1. Yu J., Ouyang W., Chua M.L.K., Xie C. SARS-CoV-2 transmission in patients with cancer at a Tertiary Care Hospital in Wuhan, China. JAMA Oncol. 2020;6(7):1108–1110. - PMC - PubMed
1. Wang Q., Berger N.A., Xu R. Analyses of risk, racial disparity, and outcomes among US patients with cancer and COVID-19 infection. JAMA Oncol. 2021;7(2):220–227. - PMC - PubMed

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Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium

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Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium

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