@article{bea52fcd77e145a0aa9ecd88798ddb5a,
title = "COVID-19 in patients with thoracic malignancies (TERAVOLT): first results of an international, registry-based, cohort study: The Lancet Oncology",
abstract = "Background: Early reports on patients with cancer and COVID-19 have suggested a high mortality rate compared with the general population. Patients with thoracic malignancies are thought to be particularly susceptible to COVID-19 given their older age, smoking habits, and pre-existing cardiopulmonary comorbidities, in addition to cancer treatments. We aimed to study the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on patients with thoracic malignancies. Methods: The Thoracic Cancers International COVID-19 Collaboration (TERAVOLT) registry is a multicentre observational study composed of a cross-sectional component and a longitudinal cohort component. Eligibility criteria were the presence of any thoracic cancer (non-small-cell lung cancer [NSCLC], small-cell lung cancer, mesothelioma, thymic epithelial tumours, and other pulmonary neuroendocrine neoplasms) and a COVID-19 diagnosis, either laboratory confirmed with RT-PCR, suspected with symptoms and contacts, or radiologically suspected cases with lung imaging features consistent with COVID-19 pneumonia and symptoms. Patients of any age, sex, histology, or stage were considered eligible, including those in active treatment and clinical follow-up. Clinical data were extracted from medical records of consecutive patients from Jan 1, 2020, and will be collected until the end of pandemic declared by WHO. Data on demographics, oncological history and comorbidities, COVID-19 diagnosis, and course of illness and clinical outcomes were collected. Associations between demographic or clinical characteristics and outcomes were measured with odds ratios (ORs) with 95% CIs using univariable and multivariable logistic regression, with sex, age, smoking status, hypertension, and chronic obstructive pulmonary disease included in multivariable analysis. This is a preliminary analysis of the first 200 patients. The registry continues to accept new sites and patient data. Findings: Between March 26 and April 12, 2020, 200 patients with COVID-19 and thoracic cancers from eight countries were identified and included in the TERAVOLT registry; median age was 68·0 years (61·8–75·0) and the majority had an Eastern Cooperative Oncology Group performance status of 0–1 (142 [72%] of 196 patients), were current or former smokers (159 [81%] of 196), had non-small-cell lung cancer (151 [76%] of 200), and were on therapy at the time of COVID-19 diagnosis (147 [74%] of 199), with 112 (57%) of 197 on first-line treatment. 152 (76%) patients were hospitalised and 66 (33%) died. 13 (10%) of 134 patients who met criteria for ICU admission were admitted to ICU; the remaining 121 were hospitalised, but were not admitted to ICU. Univariable analyses revealed that being older than 65 years (OR 1·88, 95% 1·00–3·62), being a current or former smoker (4·24, 1·70–12·95), receiving treatment with chemotherapy alone (2·54, 1·09–6·11), and the presence of any comorbidities (2·65, 1·09–7·46) were associated with increased risk of death. However, in multivariable analysis, only smoking history (OR 3·18, 95% CI 1·11–9·06) was associated with increased risk of death. Interpretation: With an ongoing global pandemic of COVID-19, our data suggest high mortality and low admission to intensive care in patients with thoracic cancer. Whether mortality could be reduced with treatment in intensive care remains to be determined. With improved cancer therapeutic options, access to intensive care should be discussed in a multidisciplinary setting based on cancer specific mortality and patients' preference. Funding: None. {\textcopyright} 2020 Elsevier Ltd",
keywords = "adult, age, aged, Article, cancer chemotherapy, cancer staging, chronic obstructive lung disease, clinical feature, cohort analysis, controlled study, coronavirus disease 2019, cross-sectional study, disease association, disease registry, female, follow up, histopathology, human, hypertension, intensive care unit, major clinical study, male, medical history, medical record, mortality risk, non small cell lung cancer, observational study, pandemic, priority journal, reverse transcription polymerase chain reaction, sex, smoking habit, symptom, thorax cancer, virus pneumonia, Betacoronavirus, cause of death, clinical trial, Coronavirus infection, hospitalization, longitudinal study, middle aged, mortality, multicenter study, pathology, register, risk factor, thorax tumor, Aged, Cause of Death, Coronavirus Infections, Cross-Sectional Studies, Female, Hospitalization, Humans, Longitudinal Studies, Male, Middle Aged, Pandemics, Pneumonia, Viral, Registries, Risk Factors, Thoracic Neoplasms",
author = "M.C. Garassino and J.G. Whisenant and L.-C. Huang and A. Trama and V. Torri and F. Agustoni and J. Baena and G. Banna and R. Berardi and A.C. Bettini and E. Bria and M. Brighenti and J. Cadranel and {De Toma}, A. and C. Chini and A. Cortellini and E. Felip and G. Finocchiaro and P. Garrido and C. Genova and R. Giusti and V. Gregorc and F. Grossi and F. Grosso and S. Intagliata and {La Verde}, N. and S.V. Liu and J. Mazieres and E. Mercadante and O. Michielin and G. Minuti and D. Moro-Sibilot and G. Pasello and A. Passaro and V. Scotti and P. Solli and E. Stroppa and M. Tiseo and G. Viscardi and L. Voltolini and Y.-L. Wu and S. Zai and V. Pancaldi and A.-M. Dingemans and {Van Meerbeeck}, J. and F. Barlesi and H. Wakelee and S. Peters and L. Horn and TERAVOLT investigators",
note = "Cited By :115 Export Date: 11 March 2021 CODEN: LOANB Correspondence Address: Garassino, M.C.; Thoracic Oncology Unit, Italy; email: marina.garassino@istitutotumori.mi.it Funding details: Otsuka Pharmaceutical, OPC Funding details: Merck Sharp and Dohme, MSD Funding details: Exelixis Funding details: Takeda Pharmaceutical Company Funding details: Roche Italia Funding details: AstraZeneca Funding details: Clovis Oncology Funding details: Celgene Funding details: GlaxoSmithKline, GSK Funding details: Novartis Funding details: Bristol-Myers Squibb Canada, BMS Funding details: Les Laboratories Pierre Fabre Funding details: AbbVie Funding details: Spectrum Pharmaceuticals Funding details: Pfizer Funding details: Amgen Funding details: Stanford University, SU Funding details: Bayer Funding details: Eli Lilly and Company Funding details: Merck Funding text 1: All declarations of interest are outside of the submitted work, unless stated otherwise. MCG received grants, personal fees, and other financial support from Merck Sharp & Dohme, AstraZeneca, Novartis, Roche, Pfizer, Celgene; grants and other financial support from Tiziana Sciences, Clovis, GlaxoSmithKline, Spectrum, and Blueprint; personal fees and other financial support from Eli Lilly and Bristol Myers Squibb; grants from Merck and Bayer; personal fees from Boheringer, Otsuka Pharma, Incyte, Inivata, Takeda, Bayer, Sanofi, Seattle Genetics, and Daichii Sankyo; and other financial support from Merck Serono. GLB received personal fees from Jannsen-Cilag, Boheringer/Ingelheim, and Roche; and non-financial support from Bristol Myers Squibb, AstraZeneca/medimmune, Pierre Fabre, and Ipsen. RB has been on the advisory board for AstraZeneca, Boerhinger/Ingelherim, Lilly, Merck Sharp & Dohme, and Otsuka and has received institutional funding from Novartis, Lilly, and AstraZeneca. EB has received personal fees and grants from AstraZeneca and Roche; and personal fees from Pfizer, Merck Sharp & Dohme, Helssin, Eli-Lilly, Bristol Myers Squibb, and Novartis. AC has received grants Merck Sharp & Dohme, Roche, Bristol Myers Squibb, AstraZeneca, and Novartis; and personal fees from Merck Sharp & Dohme, AstraZeneca, and Astellas. A-MD has received grants from Abbvie and Bristol Myers Squibb and personal fees from Roche, Lilly Boheringer/Ingelheim, Takeda, and Pharmamar. EF has had an advisory role or been on a speakers bureau for Abbvie, AstraZeneca, Blue Print Medicine, Boheringer/Ingelheim, Bristol Myers Squibb, GlaxoSmithKline, Eli Lilly, Guardant Health, Janssen, Medscape, Merck, Merck Sharp & Dohme, Novartis, Pfizer, Prime Oncology, Roche, Samsung, Springer, Takeda, Touchime, and Grifols; and has received research funding from Grant for Oncology Innovation and Fundacion Merck salud. PG has received personal fees from Roche, Merck Sharp & Dohme, Bristol Myers Squibb, Boheringer, Pfizer, Abbvie, Novartis, Lilly, AstraZeneca, Jannsen, Blueprint, Takeda, Gilead, and Rovi. CG has received personal fees from AstraZeneca, Boheringer, Bristol Myers Squibb, Merck Sharp & Dohme, and Roche. SVL has received grants, personal fees, and non-financial support from AstraZeneca, Merck Sharpe & Dohme, and Roche; grants and personal fees from Bristol Myers Squibb, and Pfizer; grants from Alkermes, Bayer, Blueprint, Corvus, Merus, Molecular Partners, Rain Therapeutics, Rapt, Spectrum, and Turning Point Therapeutics; personal fees from Catalyst, Cellgene, G1 Therapeutics, Guardant Health, Jannsen, Lilly, LOXO, Pharmamar, Regeneron, and Takeda; and non-financial support from Boheringer. NLV received grants from EISAI; had an advisory role for Roche, Pfizer, Novartis, Cellgene, and Merck Sharp & Dohme; received travel and accomodation from Roche, Gentili, and Pfizer; and been on a speakers bureau from Roche and Gentili. JM has been on the advisory board for Merck, Roche, AstraZeneca, Merck Sharp & Dohme, Bristol Myers Squibb, Pfizer, Hengruii, Daichii, Boheringer, and Pierre Fabre; and has received research grants from Roche, AstraZeneca, and Pierre Fabre. OM has received grants and personal fees from Bristol Myers Squibb, Merck Sharp & Dohme, Roche, and Amgen; and personal fees from Novartis. DM-S has received grants, personal fees, and non-financial support from AstraZeneca, Bristol Myers Squibb; grants and personal fees from Pfizer, AbbVie, and Boheringer; personal fees and non-financial support from Merck Sharp & Dohme and Roche; and personal fees from Takeda, Amgen, Novartis, and Lilly. AP has received personal fees from AstraZeneca, Agilent/Dako, Bristol Myers Squibb, Merck Sharp & Dohme, Eli-Lilly, and Roche. MT has received grants and personal fees from AstraZeneca and Boheringer; and personal fees from Novartis, Merck Sharp & Dohme, Takeda, and Bristol Myers Squibb. Y-LW received personal fees from AstraZeneca, Lilly, Roche, Pfizer, Sanofi, Boheringer, Merck Sharp & Dohme, and Bristol Myers Squibb, during the conduct of the study. VP has received grants from Institute De Recherche Pierre Fabre, Fondation Toulouse Cancer Sante', Inserm. FB has received personal fees from AstraZeneca, Bayer, Bristol Myers Squibb, Boheringer/Ingelheim, Ely Lilly, F Hoffman/La Roche, Novartis, Merck, Merck Sharp & Dohme, Pierre Fabre, Pfizer, and Takeda. HW has received grants from Gilead; personal fees from AstraZeneca, Xcovery, Jannsen, Daichii, Helssin, and Mirati; non-financial support from AstraZeneca, Takeda, Cellworks, Roche, Merck, Fishawak, Medscape, Onclive, Phillips Gillmore Oncology, Physician Education resource, Potomac Centre, Prime Oncology, Primo, Research to Practice, Uptodate, WebMDHealth, Novartis, Rgcon, Japanese Lung Cancer Society, Korean Society of Medical Oncology, Stanford University, and International Thymic Malignancies Interest Group; and other financial support from Xcovery, Roche, Merck, Acea Therapeutics, Arrys Therapeutics, AstraZeneca, Bristol Myers Squibb, Celgene, Clovis, Exelixis, Lilly, Pfizer, and Pharmacyclis. SP has received personal fees and non-financial support from Amgen, AstraZeneca, Boheringer, Bristol Myers Squibb, Clovis, Illumina, Roche, Merck Sharpe & Dohme, Novartis, Pfizer, and Sanofi; personal fees from Abbvie, Bayer, Biocartis, Daichii, Debiofarm, Eli Lilly, Foundation Medicine, Jannsen, Merck, Merrimack, Pharma Mar, Bioinvent, Regeneron, Seattle Genetics, and Takeda; and non-financial support from Merck Serono. LH has received grants, personal fees, and travel reimbursement from Xcovery; grants and travel reimbursement from Bristol Myers Squibb; grants from Boheringer/Ingelherim; and personal fees from AstraZeneca, Roche, Incyte, Merck, Pfizer, Xcovery, EMD, Tesaro, AbbVie, Medscape, Physicians Education Resource, Research to practice, Onclive, Amgen, and Bayer. All remaining authors declare no competing interests.",
year = "2020",
doi = "10.1016/S1470-2045(20)30314-4",
language = "English",
volume = "21",
pages = "914--922",
journal = "Lancet Oncol.",
issn = "1470-2045",
publisher = "Lancet Publishing Group",
number = "7",
}