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COVID-19 infections in cancer patients


(Annalisa) #1

Wenhua Liang and colleagues were the first to focus on COVID-19 infection in patients with cancer (DOI:https://doi.org/10.1016/S1470-2045(20)30096-6). They reported that 18 (1%; 95% CI 0·61–1·65) of 1590 COVID-19 cases had a history of cancer and they showed that patients with cancer had poorer outcomes from COVID-19 than those without cancers. Furthermore, they showed that patients who underwent chemotherapy or surgery in the past month had a numerically higher risk of clinically severe events than did those not receiving chemotherapy or surgery also after adjustment for major prognostic factors. Based on these results, they proposed an intentional postponing of adjuvant chemo therapy or elective surgery for stable cancer in endemic areas.

Italy is currently among the most affected countries and major questions oncologists are confronted with follows:

  1.  what you have chosen to do with new patients or patients on treatment who are infected?
    
  2.  What are you doing with patients planned for surgery?
    
  3.  In what circumstances do you continue or hold therapy?
    
  4.  In what circumstances do you restart therapy?
    
  5.  Particularly those on cytotoxic chemotherapy or immunotherapy?
    

    What is the decision we are trying to inform?
    decision about whether to treat (in case how) or not to treat a cancer patients with CPVID-19
    Who is the decision-maker?
    health care professionals dealing with cancer patients
    What type of real-world data is needed to generate reliable evidence?
    prevalence of cancer patients among patients COVID-19 positive ?
    description of cancer treatments in the last 3 months before COVID-19 infection (chemotherapy, surgery, radiotherapy, concomitant chemo-radiotherapy, immuno check point inhibitors)
    major clinical features of cancer patients (age, type of comorbidities, cancer stage etc.)
    |cancer patients experiences a severe events or death in active treatment (admission to Intensive care unit, requiring ventilation, death. specifically, how many of those experiencing severe event or dying had received surgery, had received cytotoxic chemotherapy or immunotherap,had received concomitant chemo-radio therapy in the last month? to what extend treatment impacted on the outcomes considering also prognostic factors?

How will reliable real-world evidence inform the decision?
(we’ll presume we know the answer to ‘When is the evidence needed?’ = as soon as possible!)
there are no data about COVID-19 impact on cancer patients but 18 cases described in China. The oncological community is taken decision based on expert opinion and are in great need of data to support their choice


Covid19 PLP OC definition - Question on access-to-intensive-care data in the HIRA db
OHDSI virtual study-a-thon to support COVID-19 response, to take place 26-29Mar2020...Collaborators wanted!
(Jeremy Warner) #2

Hello Annalisa,

We have launched the COVID-19 and Cancer Consortium (CCC19). This national collaborative effort began organically, primarily through social media channels like Twitter. Membership has quickly grown to over 65 physicians and nurses representing over 30 institutions and organizations in the United States. Most institutional members are large NCI-designated Comprehensive Cancer Centers, although large networks of community practices are also represented. The driving goal of the consortium is to collect prospective, granular, uniformly organized information on cancer patients infected with COVID-19 as rapidly as possible.

The primary means of collecting information is through an online REDCap survey, which is live and accessible through https://www.ccc19us.org. We are seeking to expand internationally as soon as is feasible.

We hope to work closely with the OHDSI community both on the front-end (through data donations) and the back-end (through data harmonization). Please help us spread the word!

Sincerely,
Jeremy Warner


(Laura Hester) #3

I don’t have COVID-19 data in cancer patients to contribute to the registry at the moment, but I also have questions that are in line with those Annalisa proposed to help inform our clinical trials and physicians who are prescribing our treatments. At this early stage, we are interested in characterizing patients who are diagnosed with COVID-19 within cancer site subgroups and by the treatments they were on at the time of infection (especially immunotherapies). If there is any way I could help with this effort, please let me know.


(Mark Shapiro) #4

We’re working on collecting this information for patients with brain tumors.


(Chiara Attanasio) #5

Hi Laura! Thanks a lot for dropping a comment.

If you please send me your e-mail in a private message, I can forward you information on the goals of Wed use case session of the Oncology WG (so far 17-19 CET) along with the invite in case you’re interested to join actively or not (:

Cheers,
Chiara


(Chiara Attanasio) #6

Hi Mark! That’s very nice to hear!

Could you please send me your e-mail in a private message? I believe it would be nice to get in touch. Possibly at the Wed use case session of the Oncology WG (so far 17-19 CET)?

Let me know,
Cheers,
Chiara


(Michael Gurley) #7

Chiara,

Can you send me meeting deatils of Wed use case session? I would like to join.

Thanks!


(Paul Fitz) #8

Hi Chiara,

I’m part of Cancer Research Manchester Institute I would like to contribute to this topic and the WG in general. If possible please add me to the meeting

All the very best
Paul


(Chiara Attanasio) #9

Hi Paul, I apologize for the late reply, I did not see the notification of this message in time to add you to the call.

However, you are still on time to get on board as we are currently defining the strategy/studies to perform, who-does-what and in which priority, if you send me an email at c.attanasio@iknl.nl I can tell you more! :slight_smile:

Ps: we are also working on getting more transparent/how to better reach-out and link with OHDSI in general, soon updates on that!


(Aedin Culhane) #10

Will use be using the OHDSI MsTeams account that was used during the study-a-thon?
Aedin


(Christian Reich) #11

Friends:

You will probably notice some lack of immediate action. Reason is to finish the first round of thestudy-a-thon: fixing data and cohort definitions, collecting results, writing it up. The cancer stuff will start right after that. Don’t slow down.


#12

Hi Chiara, I will also like to participate in the meeting if it is not too late. I was part of the Stanley Scott Cancer Center research team at LSU in New Orleans, LA and did my entire dissertation work on prostate cancer. Tontel


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