Abstract
Abstract Background: At the last update of the TERAVOLT registry, patients with thoracic malignancies and COVID-19 showed a high mortality rate (35.5% overall and 31% due to COVID-19) compared to the general population and to other solid tumors. Major determinants of mortality were age, Eastern Cooperative Oncology Group Performance Status (ECOG-PS), and previous administration of chemotherapy. No cancer-specific data are available with respect to small-cell lung cancer (SCLC) and other rare thoracic malignancies. Methods: TERAVOLT is an international, multicenter observational registry launched to collect data on patients with thoracic malignancies diagnosed with COVID-19 infection. Risk factors for hospitalization and mortality were identified by Wilcoxon rank sum tests (continuous variables) or χ2 tests (categorical variables). Here we present the subgroup analyses of SCLC and other rare thoracic malignancies, including malignant pleural mesothelioma (MPM), thymic carcinoma/thymoma, and carcinoid/neuroendocrine lung tumors. Results: As of June 4th, 2020, a total of 581 patients with COVID-19 and thoracic cancers have been entered; among them, 66 (11%) were SCLC, 22 (4%) were MPM, 18 (3%) were thymic carcinoma/thymoma, 12 (2%) were carcinoid/neuroendocrine lung tumors, and 442 (76%) NSCLC; 21 were an unknown type. Among SCLC patients, 54% were > 65 years old, 56% were males, 98% were current/former smokers, 31% had an ECOG-PS ≥ 2, 67% had stage IV disease, 82% were on current oncologic treatment at the COVID-19 diagnosis, and 58% were receiving chemotherapy alone or in combination with immune checkpoint inhibitors. Among other non-NSCLC patients, 56% were > 65 years old, 56% were males, 69% were current/former smokers, 24% had an ECOG-PS ≥ 2, 50% had stage IV disease, 52% were on current oncologic treatment at the COVID-19 diagnosis, and 37% were receiving chemotherapy alone or in combination with immune checkpoint inhibitors. Overall, 79.7% of the patients required hospitalization, 15.4% were admitted to an ICU, and 39.8% died (36.2% due to COVID-19). Among SCLC patients, 74.2% required hospitalization, 14.3% were admitted to an ICU, and 42.2% died (37.5% due to COVID-19). Among SCLC patients, age > 65 years old (p=0.81), gender (p=0.71), smoking status (p=1.0), ECOG-PS ≥ 2(p=0.17), disease stage of IV (p=0.37), and having received chemotherapy alone or with checkpoint inhibitors (p=0.84) were not associated with mortality. Conclusions: This analysis confirmed that patients with thoracic malignancies have a high mortality and risk for hospitalization due to COVID-19 overall. SCLC patients showed the highest mortality rate among thoracic cancer patients. Citation Format: Alessio Cortellini, Anne-Marie C. Dingemans, Oscar Arrieta, Javier Baena, Matteo Brighenti, Enriqueta Felip, Marina Chiara Garassino, Pilar Garrido, Carlo Genova, Federica Grosso, Leora Horn, Li-Ching Huang, Jan Van Meerbeeck, Solange Peters, Ernest Nadal, Jacobo Rogado, Yu Shyr, Marcello Tiseo, Valter Torri, Annalisa Trama, Heather Wakelee, Jennifer G Whisenant, Giuseppe Viscardi, Fabrice Barlesi, Sanjay Popat. Thoracic cancers international COVID-19 collaboration (TERAVOLT): Small-cell lung cancer and other rare thoracic malignancies [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 S12-03.
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