Abstract PO-056: Using MammaPrint to reduce the need for chemotherapy in early breast cancer during the COVID-19 pandemic

Abstract

Abstract Introduction: With the recent worldwide outbreak of COVID-19, it became clear that certain comorbidities are associated with an increased risk of complications and death. Several publications have reported an increased rate of ICU admission and mortality in cancer patients. This has led to guidelines advising more conservative approaches to cancer therapy, including chemotherapy. In the absence of prospective, disease-specific outcome data, there is a risk of overestimating the risk of COVID-19 and thus increasing cancer-specific mortality or of underestimating. MammaPrint has been validated for selecting clinically high-risk breast cancer patients in whom chemotherapy can be avoided safely. Methods: We evaluated the current published literature related to the potential risk of breast cancer and chemotherapy in association with COVID-19. We estimated the potential risk of severe events in COVID-19 breast cancer patients receiving adjuvant chemotherapy to assess whether MammaPrint could help us further in making chemotherapy decisions specific to an infectious epidemic risk. Results: The risk of COVID-19 morbidity and mortality in patients receiving chemotherapy could be greater than 1.5 to 2 times higher than usual. However, other associated conditions frequently found in the breast cancer population seem to still play a significant role in a worse outcome. We found no data to quantify the effect of chemotherapy or data allowing us to adapt the MammaPrint Score to risk in an infectious epidemic. Conclusion: Adjuvant chemotherapy carries a potential risk for morbidity and mortality. Data from the current literature do not show the magnitude of the added risk for breast cancer patients on adjuvant chemotherapy in association with SARS Cov-2 infection. By using MammaPrint in hormone receptor-positive patients with up to three nodes in whom chemotherapy is considered, the treatment-related risk can be limited, allowing safe de-escalation of therapy without increased cancer-specific mortality. We plan to pursue the statistical question of how the level of risk at any of the sites on the spectrum relates to distant metastasis-free survival so that mortality risks can be better estimated during an infection. Citation Format: Elizabeth M. Murray, Ettienne J. Myburgh, Ersan Lujinovic, Lorenza Mittempergher, Duncan J. Robertson, Josephus J. de Jager, Maritha J. Kotze. Using MammaPrint to reduce the need for chemotherapy in early breast cancer during the COVID-19 pandemic [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-056.