Utilization of COVID-19 Treatments and Clinical Outcomes among Patients with Cancer: A COVID-19 and Cancer Consortium (CCC19) Cohort Study

被引：109

作者：

Rivera, Donna R. ^{[1
]}

Peters, Solange ^{[2
]}

Panagiotou, Orestis A. ^{[3
]}

Shah, Dimpy P. ^{[4
]}

Kuderer, Nicole M. ^{[5
]}

Hsu, Chih-Yuan ^{[6
]}

Rubinstein, Samuel M. ^{[7
]}

Lee, Brendan J. ^{[7
]}

Choueiri, Toni K. ^{[8
]}

Lopes, Gilberto de Lima, Jr. ^{[9
]}

Grivas, Petros ^{[10
,11
]}

Painter, Corrie A. ^{[12
]}

Rini, Brian, I ^{[7
]}

Thompson, Michael A. ^{[13
]}

Arcobello, Jonathan ^{[14
]}

Bakouny, Ziad ^{[6
]}

Doroshow, Deborah B. ^{[15
,16
]}

Egan, Pamela C. ^{[17
]}

Farmakiotis, Dimitrios ^{[18
]}

Fecher, Leslie A. ^{[19
]}

Friese, Christopher R. ^{[20
]}

Galsky, Matthew D. ^{[15
,16
]}

Goel, Sanjay ^{[21
]}

Gupta, Shilpa ^{[22
]}

Halfdanarson, Thorvardur R. ^{[23
]}

Halmos, Balazs ^{[21
]}

Hawley, Jessica E. ^{[24
]}

Khaki, Ali Raza ^{[10
]}

Lemmon, Christopher A. ^{[22
]}

Mishra, Sanjay ^{[25
]}

Olszewski, Adam J. ^{[17
]}

Pennell, Nathan A. ^{[22
]}

Puc, Matthew M. ^{[26
]}

Revankar, Sanjay G. ^{[14
]}

Schapira, Lidia ^{[27
]}

Schmidt, Andrew ^{[8
]}

Schwartz, Gary K. ^{[24
]}

Shah, Sumit A. ^{[27
]}

Wu, Julie T. ^{[27
]}

Xie, Zhuoer ^{[23
]}

Yeh, Albert C. ^{[10
]}

Zhu, Huili ^{[15
]}

Shyr, Yu ^{[6
]}

Lyman, Gary H. ^{[11
]}

Warner, Jeremy L. ^{[7
,28
]}

机构：

[1] NCI, Div Canc Control & Populat Sci, Rockville, MD USA

[2] Univ Lausanne, Dept Oncol, Lausanne, Switzerland

[3] Brown Univ, Dept Hlth Serv Policy & Practice, Providence, RI 02912 USA

[4] UT Hlth San Antonio MD Anderson, Dept Populat Hlth Sci, Mays Canc Ctr, San Antonio, TX USA

[5] Adv Canc Res Grp LLC, Kirkland, WA USA

[6] Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN 37232 USA

[7] Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol & Oncol, Nashville, TN USA

[8] Dana Farber Canc Inst, Dept Med Oncol, Boston, MA 02115 USA

[9] Univ Miami, Sylvester Comprehens Canc Ctr, Miami, FL USA

[10] Univ Washington, Dept Med, Div Oncol, Seattle, WA 98195 USA

[11] Fred Hutchinson Canc Res Ctr, 1124 Columbia St, Seattle, WA 98104 USA

[12] Count Me In, Cambridge, MA USA

[13] Advocate Aurora Hlth, Milwaukee, WI USA

[14] Karmanos Canc Inst, Detroit, MI USA

[15] Icahn Sch Med Mt Sinai, Dept Med, New York, NY 10029 USA

[16] Icahn Sch Med Mt Sinai, Tisch Canc Inst, New York, NY 10029 USA

[17] Brown Univ, Dept Med, Div Hematol Oncol, Warren Alpert Med Sch, Providence, RI 02912 USA

[18] Brown Univ, Dept Med, Div Infect Dis, Warren Alpert Med Sch, Providence, RI 02912 USA

[19] Univ Michigan, Dept Internal Med, Rogel Canc Ctr, Ann Arbor, MI 48109 USA

[20] Univ Michigan, Sch Nursing, Ann Arbor, MI 48109 USA

[21] Montefiore Med Ctr, Albert Einstein Coll Med, Bronx, NY 10467 USA

[22] Cleveland Clin, Dept Hematol & Med Oncol, Cleveland, OH 44106 USA

[23] Mayo Clin, Dept Med Oncol, Rochester, MN USA

[24] Columbia Univ, Dept Med, Herbert Irving Comprehens Canc Ctr, Irving Med Ctr, New York, NY USA

[25] Vanderbilt Ingram Canc Ctr, Nashville, TN USA

[26] Virtua Hlth, Sect Thorac Surg, Dept Surg, Marlton, NJ USA

[27] Stanford Univ, Dept Med, Div Oncol, Palo Alto, CA USA

[28] Vanderbilt Univ, Dept Biomed Informat, Med Ctr, Nashville, TN 37232 USA

来源：

CANCER DISCOVERY | 2020年 / 10卷 / 10期

关键词：

RISK-FACTORS; MULTICENTER; DISEASE; MODELS; CHINA;

D O I：

10.1158/2159-8290.CD-20-0941

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Among 2,186 U.S. adults with invasive cancer and laboratory-confirmed SARS-CoV-2 infection, we examined the association of COVID-19 treatments with 30-day all-cause mortality and factors associated with treatment. Logistic regression with multiple adjustments (e.g., comorbidities, cancer status, baseline COVID-19 severity) was performed. Hydroxychloroquine with any other drug was associated with increased mortality versus treatment with any COVID-19 treatment other than hydroxychloroquine or untreated controls; this association was not present with hydroxychloroquine alone. Remdesivir had numerically reduced mortality versus untreated controls that did not reach statistical significance. Baseline COVID-19 severity was strongly associated with receipt of any treatment. Black patients were approximately half as likely to receive remdesivir as white patients. Although observational studies can be limited by potential unmeasured confounding, our findings add to the emerging understanding of patterns of care for patients with cancer and COVID-19 and support evaluation of emerging treatments through inclusive prospective controlled trials. SIGNIFICANCE: Evaluating the potential role of COVID-19 treatments in patients with cancer in a large observational study, there was no statistically significant 30-day all-cause mortality benefit with hydroxychloroquine or high-dose corticosteroids alone or in combination; remdesivir showed potential benefit. Treatment receipt reflects clinical decision-making and suggests disparities in medication access.

引用

页码：1514 / 1527

页数：14

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