First results from the TERAVOLT (Thoracic cancERs international coVid 19 cOLlaboraTion) registry for thoracic cancers—presented by Marina C. Garassino, MD, at the American Association for Cancer Research (AACR) Virtual Annual Meeting in the COVID-19 and Cancer Session—indicate a high mortality rate in patients with thoracic malignancies who are infected with COVID-19.
Marina C. Garassino, MD
The data include the results for the first 200 patients enrolled in the registry up to April 12, 2020, and represent the first large dataset for patients with thoracic cancers infected with COVID-19.
Previously published data in JAMA Oncology suggested a higher prevalence of COVID-19 in patients with lung cancer compared to other cancers. That analysis, as well as one published in JCO Oncology Practice, also indicated that patients with cancer and survivors may be at a higher risk of COVID-19 infection compared to the general population.
TERAVOLT Registry Details
The TERAVOLT registry was launched in March 2020 with the aim of gathering information on patients with thoracic cancer infected with COVID-19, regardless of therapies administered. This global collaboration involves 21 countries worldwide and is endorsed by a number of international oncology societies. Any patients with thoracic cancer also diagnosed with COVID-19 infection through laboratory tests, or with suspected COVID-19 infection based on exposure and symptoms, are eligible for inclusion in the registry.
For the first 200 patients in the registry, the median age was 68 years, with the majority of patients being male and current/former smokers; 73.5% had stage IV disease and 75.5% had non–small cell lung cancer. Patients with small cell lung cancer (14.5%) and rare thoracic malignancies were also included in the registry. At least one comorbidity was observed in 83.8% of patients, with hypertension being the most common comorbidity (47%), followed by chronic obstructive pulmonary disease (25.8%).
Most patients were receiving treatment (73.9%), mainly chemotherapy alone (32.7%), immunotherapy alone (23.1%), or a tyrosine kinase inhibitor alone (19%). The clinical presentation of COVID-19 showed a similar profile to lung cancer symptoms, with the most common symptoms being fever, cough, and dyspnea, making diagnosis of the virus challenging. The most common complications were pneumonia/pneumonitis (79.6%) and acute respiratory distress syndrome (26.8%).
The majority of patients were hospitalized (76%), and 33.3% of these patients died. Most patients were not admitted to intensive care units, although the reasons for this remain unclear. Univariate analysis did not show an association with any specific cancer treatment and an increased risk of death. Multivariate analysis adjusted for the most important risk factors in the general population did not identify a risk profile for COVID-19 mortality in patients with thoracic cancer.
Dr. Garassino concluded that although the mortality rate of COVID-19 in patients with thoracic cancer was unexpectedly high, this does not appear to be associated with any specific type of treatment or comorbidity. Most of these deaths were caused by SARS-CoV2 infection and not cancer, and no risk profile was identified for death in patients with thoracic cancer diagnosed with COVID-19 infection.
Major limitations of the study include the short follow-up and selected patient population, but Dr. Garassino highlighted the strong, united response from the international thoracic community which allowed activation of the registry and generation of data in a short period of time.
Disclosure: For full disclosures of the study authors, visit abstractsonline.com.The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.