Abstract S12-02: Comprehensive meta-analysis of COVID-19 mortality rates for 22 cancer subtypes from the Reboot: COVID-Cancer Project, an interactive resource with aggregated data from 21,839 cancer patients

Abstract Background Cancer patients with COVID-19 disease have been reported to have double the case fatality rate of the general population. Methods A systematic search of PubMed, Embase, and Cochrane Central was done for studies on cancer patients with COVID-19. Pooled proportions were calculated for categorical variables. Odds ratio (OR) and forest plots (Random-effects model) were constructed for both primary and secondary outcomes. Results This systematic review of 38 studies and meta-analysis of 181,323 patients from 26 studies included 23,736 cancer patients. Our meta-analysis shows that cancer patients with COVID-19 have a higher likelihood of death (n = 165,980, OR = 2.54, 95% confidence interval [CI] = 1.47 to 4.42), which was largely driven by mortality among patients in China. Cancer patients were more likely to be intubated. Among cancer subtypes, the mortality was highest in hematological malignancies (n = 878, OR = 2.39, 95% CI = 1.17 to 4.87) followed by lung cancer (n = 646, OR = 1.83, 95% CI = 1.00 to 3.37). There was no association between receipt of a particular type of oncologic therapy and mortality. Our study showed that cancer patients affected by COVID-19 are a decade older than the normal population and have a higher proportion of co-morbidities. There was insufficient data to assess the association of COVID-directed therapy and survival outcomes in cancer patients. Conclusion Cancer patients with COVID-19 disease are at increased risk of mortality and morbidity. A more nuanced understanding of the interaction between cancer-directed therapies and COVID-19-directed therapies is needed. This will require uniform prospective recording of data, possibly in multi-institutional registry databases.

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Mortality in Cancer Patients With COVID-19 Who Are Admitted to an ICU or Who Have Severe COVID-19: A Systematic Review and Meta-Analysis

JCO Global Oncology ◽

10.1200/go.21.00072 ◽

2021 ◽

pp. 1286-1305

Author(s):

Amogh Rajeev Nadkarni ◽

Swapna C. Vijayakumaran ◽

Sudeep Gupta ◽

Jigeeshu V. Divatia

Keyword(s):

Systematic Review ◽

Cancer Patients ◽

Critically Ill ◽

Odds Ratio ◽

Hematologic Malignancy ◽

Meta Analysis ◽

Risk Of Bias ◽

Cancer Subtypes ◽

Newcastle Ottawa Scale ◽

Random Effects Modeling

PURPOSE There are scarce data to aid in prognostication of the outcome of critically ill cancer patients with COVID-19. In this systematic review and meta-analysis, we investigated the mortality of critically ill cancer patients with COVID-19. METHODS We searched online databases and manually searched for studies in English that reported on outcomes of adult cancer patients with COVID-19 admitted to an intensive care unit (ICU) or those with severe COVID-19 between December 2019 and October 2020. Risk of bias was assessed by the Modified Newcastle-Ottawa Scale. The primary outcome was all-cause mortality. We also determined the odds of death for cancer patients versus noncancer patients, as also outcomes by cancer subtypes, presence of recent anticancer therapy, and presence of one or more comorbidities. Random-effects modeling was used. RESULTS In 28 studies (1,276 patients), pooled mortality in cancer patients with COVID-19 admitted to an ICU was 60.2% (95% CI, 53.6 to 6.7; I2 = 80.27%), with four studies (7,259 patients) showing higher odds of dying in cancer versus noncancer patients (odds ratio 1.924; 95% CI, 1.596 to 2.320). In four studies (106 patients) of patients with cancer and severe COVID-19, pooled mortality was 59.4% (95% CI, –39.4 to 77.5; I2 = 72.28%); in one study, presence of hematologic malignancy was associated with significantly higher mortality compared with nonhematologic cancers (odds ratio 1.878; 95% CI, 1.171 to 3.012). Risk of bias was low. CONCLUSION Most studies were reported before the results of trials suggesting the benefit of dexamethasone and tocilizumab, potentially overestimating mortality. The observed mortality of 60% in cancer patients with COVID-19 admitted to the ICU is not prohibitively high, and admission to the ICU should be considered for selected patients (registered with PROSPERO, CRD42020207209).

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Immune checkpoint inhibitors use and effects on prognosis of COVID-19 infection: a systematic review and meta-analysis

Immunotherapy ◽

10.2217/imt-2021-0007 ◽

2021 ◽

Author(s):

Wenwei Qian ◽

Ying Ye ◽

Lugen Zuo ◽

Ting Song ◽

Qing Xu ◽

...

Keyword(s):

Systematic Review ◽

Cancer Patients ◽

Immune Checkpoint ◽

Odds Ratio ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Meta Analysis ◽

Severe Disease ◽

Mortality Rates ◽

Prior Exposure

Aim: We aimed to quantify the effects of immune checkpoint inhibitors (ICIs) on the prognosis of COVID-19. Materials & methods: A meta-analysis was conducted and the hospitalization, severe disease and mortality rates were assessed. Thirteen studies comprising of 4614 cancer patients with COVID-19 were included. Results: When compared with cancer patients without prior ICI exposure, patients with prior ICI treatment exhibited a higher rate of hospitalization (odds ratio [OR] 2.0, 95% CI 1.19–3.38, p = 0.01). However, the OR of severe disease and mortality in ICI exposed cases was similar to non-ICI exposed patients (OR 1.55, 95% CI 0.69–3.51, p = 0.29; OR 1.12, 95% CI 0.85–1.48, p = 0.42, respectively). Conclusion: It is uncertain whether prior exposure to ICIs increases the risk of severe disease and death, however the observed OR suggest a higher rate of hospitalization.

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A systematic review and meta-analysis of cancer patients affected by a novel coronavirus

10.1101/2020.05.27.20115303 ◽

2020 ◽

Cited By ~ 3

Author(s):

Bhanu Prasad Venkatesulu ◽

Viveksandeep Thoguluva Chandrasekar ◽

Prashanth Giridhar ◽

Pragati Advani ◽

Amrish Sharma ◽

...

Keyword(s):

Systematic Review ◽

Cancer Patients ◽

Odds Ratio ◽

Normal Population ◽

Meta Analysis ◽

Case Fatality ◽

Categorical Variables ◽

Mortality And Morbidity ◽

Cancer Subtypes ◽

Increased Risk

Background Cancer patients with COVID-19 disease have been reported to have double the case fatality rate of the general population. Materials and methods A systematic search of PubMed/MEDLINE, Embase, Cochrane Central, Google Scholar, and MedRxiv was done for studies on cancer patients with COVID-19. Pooled proportions were calculated for categorical variables. Odds ratio and forest plots were constructed for both primary and secondary outcomes. The random-effects model was used to account for heterogeneity between studies. Results This systematic review of 31 studies and meta-analysis of 181,323 patients from 26 studies involving 23,736 cancer patients is the largest meta-analysis to the best of our knowledge assessing outcomes in cancer patients affected by COVID-19. Our meta-analysis shows that cancer patients with COVID-19 have a higher likelihood of death (odds ratio, OR 2.54), which was largely driven by mortality among patients in China. Cancer patients were more likely to be intubated, although ICU admission rates were not statistically significant. Among cancer subtypes, the mortality was highest in hematological malignancies (OR 2.43) followed by lung cancer (OR 1.8). There was no association between receipt of a particular type of oncologic therapy and mortality. Our study showed that cancer patients affected by COVID-19 are a decade older than the normal population and have a higher proportion of co-morbidities. There was insufficient data to assess the association of COVID-directed therapy and survival outcomes in cancer patients. Despite the heterogeneity of studies and inconsistencies in reported variables and outcomes, these data could guide clinical practice and oncologic care during this unprecedented global health pandemic. Conclusion Cancer patients with COVID-19 disease are at increased risk of mortality and morbidity. A more nuanced understanding of the interaction between cancer-directed therapies and COVID-19-directed therapies is needed. This will require uniform prospective recording of data, possibly in multi-institutional registry databases.

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Associations between coping strategies and well-being among breast cancer patients: A meta-analysis

PsycEXTRA Dataset ◽

10.1037/e546872013-011 ◽

2013 ◽

Author(s):

Richard Branstrom ◽

Pia Kvillemo

Keyword(s):

Breast Cancer ◽

Coping Strategies ◽

Cancer Patients ◽

Meta Analysis ◽

Well Being ◽

Breast Cancer Patients

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Thrombosis in Cancer Patients Treated with Hematopoietic Growth Factors - A Meta-Analysis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1650276 ◽

1996 ◽

Vol 75 (02) ◽

pp. 368-371 ◽

Cited By ~ 51

Author(s):

T Barbul ◽

G Finazzi ◽

A Grassi ◽

R Marchioli

Keyword(s):

Cancer Patients ◽

Case Reports ◽

Meta Analysis ◽

Case Series ◽

Hematopoietic Growth Factors ◽

Patients With Cancer ◽

Cytotoxic Treatment ◽

Pertinent Data ◽

Thrombotic Complications ◽

Vascular Occlusions

SummaryHematopoietic colony-stimulating factors (CSFs) are largely used in patients with cancer undergoing cytotoxic treatment to accelerate neutrophil recovery and decrease the incidence of febrile neutropenia. Clinical practice guidelines for their use have been recently established (1), taking into account clinical benefit, but also cost and toxicity. Vascular occlusions have been recently reported among the severe reactions associated with the use of CSFs, in anedoctal case reports (2, 3), consecutive case series (4) and randomized clinical trial (5, 6). However, the role of CSFs in the pathogenesis of thrombotic complications is difficult to ascertain, because pertinent data are scanty and widely distributed over a number of heterogenous investigations. We report here a systematic review of relevant articles, with the aims to estimate the prevalence of thrombosis associated with the use of CSFs and to assess if this rate is significantly higher than that observed in cancer patients not receiving CSFs.

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