Patients with sarcoma have high rates of complications from COVID-19, according to a presentation at the Connective Tissue Oncology Society (CTOS) 2021 Annual Meeting.
However, the data also suggest that recent anticancer treatment does not increase the risk of complications in these patients.
Many treatments for sarcoma are “highly immunosuppressive, which, in some other studies, have been associated with adverse outcomes in patients with cancer and COVID-19,” said Michael J. Wagner, MD, of the University of Washington in Seattle, when giving the presentation at the meeting.
To gain insight into COVID-19 outcomes in sarcoma patients, Dr Wagner and colleagues analyzed data from the COVID-19 and Cancer Consortium (CCC19) Registry (ClinicalTrials.gov Identifier: NCT04354701).
The researchers analyzed 222 adults with sarcoma and lab-confirmed COVID-19 who were entered into the CCC19 registry between March 17, 2020, and June 13, 2021. The median age of the cohort was 56 years, and 48% were women. Most patients had a performance status of 0-1, with 13% having a status of 2 or higher.
The most common types of sarcoma were soft tissue (n=126), bone (n=40), and gastrointestinal stromal tumor (n=36). Active cancer was present in 54% of patients, and 19% had lung metastases. Less than half of patients had received cytotoxic chemotherapy (31%) or targeted therapy (17%) within 3 months of their COVID-19 diagnosis.
The median follow-up was 56 days. The hospitalization rate was 49% and was similar across sarcoma subtypes. Of the patients hospitalized, 32% required supplemental oxygen, 12% were admitted to the ICU, and 6% required mechanical ventilation.
Death within 30 days occurred in 9% of patients, and death at any time after COVID-19 diagnosis occurred in 16%.
In a multivariable analysis, several factors were associated with the primary outcome, which was ordinal outcome of COVID-19 severity, including hospitalization with and without oxygen use, ICU admittance, need for mechanical ventilation, and all-cause death.
Factors associated with the primary outcome included age older than 40 years, performance status of 2 or higher, lung metastases, male sex, and renal disease. Recent cancer therapy was associated with the primary outcome in an unadjusted model but not in an adjusted model.
Dr Wagner concluded that patients with sarcoma have high rates of complications from COVID-19, and there are minimal differences between the sarcoma subtypes. He also noted future directions for this research, including accounting for the risk of death from sarcoma, the effect of vaccination status, and the effect of the Delta wave on the outcomes of patients with sarcoma and COVID-19.
Disclosures: Dr Wagner disclosed affiliations with Adaptimmune, Deciphera, Epizyme, Athenex, Incyte, and GlaxoSmithKline.
Wagner MJ, Ingham M, Painter CA, et al. Demographics, prognosis factors, and outcomes for patients (pts) with sarcoma and COVID-19: A CCC19-registry based retrospective cohort analysis. Presented at CTOS 2021; November 10-13, 2021. Paper 09.
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