Immune checkpoint inhibitor therapy and outcomes from SARS-CoV-2 infection in patients with cancer: a joint analysis of OnCovid and ESMO-CoCARE registries

被引：5

作者：

Cortellini, Alessio ^{[1
,2
]}

Dettorre, Gino M. ^{[3
]}

Dafni, Urania ^{[4
]}

Aguilar-Company, Juan ^{[5
,6
]}

Castelo-Branco, Luis ^{[7
,8
]}

Lambertini, Matteo ^{[9
,10
]}

Gennatas, Spyridon ^{[11
]}

Angelis, Vasileios ^{[11
]}

Sita-Lumsden, Ailsa ^{[12
]}

Rogado, Jacobo ^{[13
]}

Pedrazzoli, Paolo ^{[14
,15
,23
]}

Vinal, David ^{[16
]}

Prat, Aleix ^{[17
,18
]}

Rossi, Maura ^{[19
]}

Berardi, Rossana ^{[20
]}

Alonso-Gordoa, Teresa ^{[21
]}

Grisanti, Salvatore ^{[22
]}

Dimopoulou, Georgia

Queirolo, Paola

Pradervand, Sylvain ^{[24
]}

Bertuzzi, Alexia ^{[25
]}

Bower, Mark ^{[26
,27
]}

Arnold, Dirk ^{[28
]}

Salazar, Ramon ^{[29
]}

Tucci, Marco ^{[30
,31
]}

Harrington, Kevin J. ^{[32
,33
]}

Mazzoni, Francesca ^{[34
]}

Mukherjee, Uma ^{[35
]}

Tsourti, Zoi ^{[36
]}

Michielin, Olivier ^{[24
]}

Pommeret, Fanny ^{[37
]}

Brunet, Joan ^{[38
]}

Vincenzi, Bruno ^{[2
]}

Tonini, Giuseppe ^{[2
]}

Patriarca, Andrea ^{[39
,40
]}

Biello, Federica ^{[40
,41
]}

Krengli, Marco ^{[40
]}

Tabernero, Josep

Pentheroudakis, George ^{[7
]}

Gennari, Alessandra

Peters, Solange ^{[7
,24
]}

Romano, Emanuela

Pinato, David J. ^{[1
,40
,41
]}

机构：

[1] Imperial Coll London, Dept Surg & Canc, Hammersmith Hosp Campus, London, England

[2] Fdn Policlin Univ Campus Biomed, Med Oncol, Via Alvaro Portillo,200, I-00128 Rome, Italy

[3] Washington Univ, Dept Internal Med, Sch Med, St Louis, MO USA

[4] Natl & Kapodistrian Univ Athens, Sch Hlth Sci, Lab Biostat, Athens, Greece

[5] Vall dHebron Univ Hosp & Inst Oncol VHIO, Med Oncol, Barcelona, Spain

[6] Vall dHebron Univ Hosp, Infect Dis, Barcelona, Spain

[7] ESMO European Soc Med Oncol, Sci & Med Div, Lugano, Switzerland

[8] NOVA Univ, NOVA Natl Sch Publ Hlth, Lisbon, Portugal

[9] Univ Genoa, Sch Med, Dept Internal Med & Med Specialties DiMI, Genoa, Italy

[10] IRCCS Osped Policlin San Martino, Med Oncol Dept, UO Clin Oncol Med, Genoa, Italy

[11] Royal Marsden Hosp & NHS Fdn Trust, Med Oncol Dept, IOB Quiron, UVic UCC, London, England

[12] Guys & St ThomasNHS Fdn Trust GSTT, Med Oncol, Ctr Canc Immunotherapy, Dept Oncol, London, England

[13] Hosp Univ Infanta Leonor, Med Oncol Dept, Madrid, Spain

[14] Fdn IRCCS Policlin San Matteo, Med Oncol, Pavia, Italy

[15] Univ Pavia, Dept Internal Med & Med Therapy, Pavia, Italy

[16] Hosp Univ La Paz, Med Oncol Dept, Madrid, Spain

[17] Hosp Clin Barcelona, Dept Med Oncol, Barcelona, Spain

[18] Inst Invest Biomed August Pi i Sunyer IDIBAPS, Translat Genom & Targeted Therapies Solid Tumors, Barcelona, Spain

[19] ASO SS Antonio Biagio & Cesare Arrigo, Oncol Dept, Alessandria, Italy

[20] Polytech Univ Marche Reg, Med Oncol, AOU Ospedali Riuniti, Ancona, Italy

[21] Hosp Univ Ramon & Cajal, Med Oncol Dept, Madrid, Spain

[22] Spedali Civil Brescia, Med Oncol Unit, Brescia, Italy

[23] European Inst Oncol IRCCS, Melanoma Sarcoma & Rare Tumors, IEO, Milan, Italy

[24] Ctr Hosp Univ Vaudois CHUV, Oncol Dept, Lausanne, Switzerland

[25] IRCCS Humanitas Res Hosp, Human Canc Ctr, Med Oncol & Hematol Unit, Milan, Italy

[26] Chelsea & Westminster Hosp, Dept Oncol, London, England

[27] Chelsea & Westminster Hosp, Natl Ctr HIV Malignancy, London, England

[28] Asklepios Klin Altona Asklepios Kliniken, Oncol Haematol Palliat Care Dept, Hamburg, Germany

[29] CIBERONC, Dept Med Oncol, Oncobell Program IDIBELL, ICO LHosp, Barcelona, Spain

[30] Univ Bari Aldo Moro, Dept Interdisciplinary Med DIM, Sect Med Oncol, Bari, Italy

[31] IRCCS Ist Tumori Giovanni Paolo II, Bari, Italy

[32] Royal Marsden Hosp, Div Radiotherapy & Imaging, London, England

[33] Inst Canc Res NIHR Biomed Res Ctr, London, England

[34] Careggi Univ Hosp, Med Oncol, Florence, Italy

[35] Barts Hlth NHS Trust, Med Oncol, London, England

[36] Frontier Sci Fdn Hellas, Athens, Greece

[37] Univ Paris Saclay, Inst Gustave Roussy, Dept Canc Med, 114 rue Edouard Vaillant, Villejuif, France

[38] Univ Hosp Josep Trueta, Catalan Inst Oncol, Dept Med Oncol, Girona, Spain

[39] Univ Piemonte Orientale, Dept Translat Med, Div Haematol, Novara, Italy

[40] Azienda Ospedaliera Maggiore Car, Novara, Italy

[41] Univ Piemonte Orientale, Dept Translat Med, Div Oncol, Novara, Italy

来源：

JOURNAL FOR IMMUNOTHERAPY OF CANCER | 2022年 / 10卷 / 11期

关键词：

COVID-19; Vaccination; Immunogenicity; Vaccine; Cytotoxicity; Immunologic; Immunotherapy; COVID-19; BNT162B2; SAFETY;

D O I：

10.1136/jitc-2022-005732

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BackgroundAs management and prevention strategies against COVID-19 evolve, it is still uncertain whether prior exposure to immune checkpoint inhibitors (ICIs) affects COVID-19 severity in patients with cancer.MethodsIn a joint analysis of ICI recipients from OnCovid (NCT04393974) and European Society for Medical Oncology (ESMO) CoCARE registries, we assessed severity and mortality from SARS-CoV-2 in vaccinated and unvaccinated patients with cancer and explored whether prior immune-related adverse events (irAEs) influenced outcome from COVID-19.FindingsThe study population consisted of 240 patients diagnosed with COVID-19 between January 2020 and February 2022 exposed to ICI within 3 months prior to COVID-19 diagnosis, with a 30-day case fatality rate (CFR30) of 23.6% (95% CI 17.8 to 30.7%). Overall, 42 (17.5%) were fully vaccinated prior to COVID-19 and experienced decreased CFR30 (4.8% vs 28.1%, p=0.0009), hospitalization rate (27.5% vs 63.2%, p<0.0001), requirement of oxygen therapy (15.8% vs 41.5%, p=0.0030), COVID-19 complication rate (11.9% vs 34.6%, p=0.0040), with a reduced need for COVID-19-specific therapy (26.3% vs 57.9%, p=0.0004) compared with unvaccinated patients. Inverse probability of treatment weighting (IPTW)-fitted multivariable analysis, following a clustered-robust correction for the data source (OnCovid vs ESMO CoCARE), confirmed that vaccinated patients experienced a decreased risk of death at 30 days (adjusted OR, aOR 0.08, 95% CI 0.01 to 0.69).Overall, 38 patients (15.8%) experienced at least one irAE of any grade at any time prior to COVID-19, at a median time of 3.2 months (range 0.13-48.7) from COVID-19 diagnosis. IrAEs occurred independently of baseline characteristics except for primary tumor (p=0.0373) and were associated with a significantly decreased CFR30 (10.8% vs 26.0%, p=0.0462) additionally confirmed by the IPTW-fitted multivariable analysis (aOR 0.47, 95% CI 0.33 to 0.67). Patients who experienced irAEs also presented a higher median absolute lymphocyte count at COVID-19 (1.4 vs 0.8 10(9) cells/L, p=0.0098).ConclusionAnti-SARS-CoV-2 vaccination reduces morbidity and mortality from COVID-19 in ICI recipients. History of irAEs might identify patients with pre-existing protection from COVID-19, warranting further investigation of adaptive immune determinants of protection from SARS-CoV-2.

引用

页数：10

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