背景:癌症是发生严重COVID19的危险因素。此外,SARS-CoV2对肾细胞具有特殊的向性,并且可以通过肾癌的标准治疗来增强血栓形成或细胞因子风暴等并发症(即,抗血管生成或免疫疗法)。因此,了解COVID19对该肿瘤患者的影响是他们正确处理的关键。
方法:我们设计了一项回顾性病例对照研究,比较了三组接受全身治疗的晚期肾癌患者的结局:队列A(抗血管生成药物时开发的COVID19),队列B(免疫治疗时出现COVID19)和队列C(未感染)。匹配因素是年龄,性别,和治疗。
结果:从2020年9月至2021年5月,在西班牙的16个中心招募了95名患者。最后,85人被认为是合格的(23个队列A,21队列B,41队列C)。COVID患者需要更多的剂量中断(25vs.6)和住院(10vs.没有)比没有COVID的人(两者p=0.001)。在住院或住院时间方面,队列A和B之间没有观察到差异。没有登记入住ICU,队列B中的一名患者因COVID19死亡。关于癌症的进化,队列A中有3例患者在COVID19后出现进行性疾病,而队列B中有2例患者出现进行性疾病。最初被认为是稳定的疾病,COVID19后获得部分响应。
结论:在全身治疗期间发生COVID19的肾癌患者比未感染的患者需要更多的治疗中断和住院治疗。然而,未观察到对癌症结局的显著影响.此外,抗血管生成素或免疫治疗的病例间无差异.
BACKGROUND: Cancer is a risk factor for developing severe
COVID19. Additionally, SARS-CoV2 has a special tropism for renal cells and complications like thrombosis or cytokine storm could be enhanced by standard treatments in kidney cancer (i.e., antiangiogenics or immunotherapy). Thus, understanding the impact of COVID19 in patients with this tumor is key for their correct management.
METHODS: We designed a retrospective
case-control study comparing the outcome of three groups of advanced kidney cancer patients on systemic treatment: cohort A (developed COVID19 while on antiangiogenics), cohort B (developed
COVID19 while on immunotherapy) and cohort C (non-infected). Matching factors were age, gender, and treatment.
RESULTS: 95 patients were recruited in 16 centers in Spain from September 2020 to May 2021. Finally, 85 were deemed as eligible (23 cohort A, 21 cohort B, 41 cohort C). Patients with COVID required more dose interruptions (25 vs. six) and hospitalizations (10 vs. none) than those without COVID (both p = 0.001). No difference between cohorts A and B was observed regarding hospitalization or length of stay. No ICU admission was registered and one patient in cohort B died due to
COVID19. Regarding cancer evolution, three patients in cohort A presented progressive disease after COVID19 compared to two in cohort B. One
case in cohort B, initially deemed as stable disease, achieved a partial response after
COVID19.
CONCLUSIONS: Kidney cancer patients who developed COVID19 while on systemic therapy required more treatment interruptions and hospitalizations than those non-infected. However, no significant impact on cancer outcome was observed. Also, no difference was seen between cases on antiangiogenics or immunotherapy.