A new study led by the Universities of Birmingham and Oxford has found the mortality rate in cancer patients who are assessed or treated in hospital with COVID-19 is not significantly affected by chemotherapy or other anti-cancer treatments.
Published in The Lancet, the study was devised by steering committee of the UK Coronavirus Cancer Monitoring Project (UKCCMP) which launched in March, and collects information on UK cancer patients who are diagnosed with COVID-19. The UKCCMP forms the largest prospective database and analysis of COVID-19 in this group of patients.
The project was set up to rapidly assimilate and disseminate data about the course of COVID-19 in cancer patients, and to evaluate whether recent (within 4 weeks) or current chemotherapy or other active cancer treatment (radiotherapy, immunotherapy or hormonal therapy) impacted upon this trajectory in terms of morbidity and mortality.
Local clinicians at each participating centre reported the clinical outcome of the inputted patients, recording whether they died or were discharged, and also detailing other important risk factors such as age, gender, and the presence of comorbidities.
Fifty-five cancer centres across the UK reported into the UKCCMP, analysing the outcomes of the first 800 COVID19-positive cancer patients.
Results found 169 of the 800 were reported as having no comorbidities other than cancer. In the remaining 631 patients, other comorbidities included hypertension, diabetes, cardiovascular disease and chronic obstructive pulmonary disease.
In terms of COVID-19 disease trajectory, over half of patients followed a mild disease course. As in the general population, patients who were older and suffered other co-morbidities were at increased risk of death compared to younger patients without any other underlying comorbidities. The overall mortality rate was 28%. Recent receipt (within 4 weeks) of chemotherapy was not associated with an increased risk of death.
Joint-lead author Dr Lennard Lee, Medical Oncology Clinical Academic from the University of Birmingham’s Institute of Cancer and Genomic Sciences said: “This project is a great illustration of what can be achieved by the UK oncology community. We have joined forces to learn from each other and answer the most pressing questions for cancer patients. The UKCCMP projects will be crucial in providing the necessarily tools to enable to identify and mitigate risks to cancer patients now and in any possible pandemic phases. This will ensure the highest levels of cancer care will continue to be provided across the UK.”
Joint-lead author Professor Jean-Baptiste Cazier, Director of the Centre for Computational Biology at the University of Birmingham said: “This study demonstrates the power of the rapid integration of data from across the country to deliver actionable knowledge in near-real-time and inform clinicians and cancer patients, enabling them to make critical decisions in these challenging times. This close collaboration between oncologists and data scientists through the Centre for Computational Biology illustrates how expert use of data can have an immediate impact on patients’ lives.”
Joint-senior author, Professor Gary Middleton from the University of Birmingham's Institute of Immunology and Immunotherapy said: “We hope this study will be reassuring for cancer patients, as to whether chemotherapy or anti-cancer treatments will increase their risk of dying from COVID-19. Including their increased risk due to their cancer, our answer is not necessarily so. Our data strongly shows that cancer COVID-19 mortality is principally driven by advancing age and the presence of other non-cancer co-morbidities”.
Joint senior author Professor Rachel Kerr, Associate Professor of Gastrointestinal Oncology and Consultant Medical Oncologist from the University of Oxford said: “I am incredibly proud of how hard my colleagues have worked to deliver this hugely important and timely study. The team comprises a wealth of expertise from consultant oncologists to computational data scientists, but actually also could not have been delivered without the dedication of our junior doctors and medical and biological science undergraduates. Sterling team work which has produced a really critical answer for our understandably concerned cancer patients and community.”