In a study led by researchers at NYU Langone Health and its Perlmutter Cancer Center involving more than 3,000 women treated for breast cancer at the height of the COVID-19 pandemic in New York City, only 64 patients, or 2% of the total study population, contracted the virus. Of this group, 10 died of COVID-19, a number the study authors say is low and expected for this age group, regardless of cancer. Notably, those receiving cytotoxic chemotherapy were at about the same risk from coronavirus infection as those taking other classes of drugs, with minimal impact on the immune system defenses. These findings were presented by Budhathoki et al during the 2021 ASCO Annual Meeting (Abstract 1513).
“Our results show that patients can safely receive breast cancer therapy, including chemotherapy, during the pandemic,” said lead study investigator and Perlmutter Cancer Center medical oncologist Douglas K. Marks, MD.
“As long as patients continue to take reasonable precautions such as wearing masks and social distancing, they should feel confident in continuing the treatment plan they have chosen with their physicians,” added senior study investigator and Perlmutter Cancer Center medical oncologist Sylvia Adams, MD.
Hesitation Surrounding Standard Chemotherapy During the Pandemic
At the onset of the coronavirus pandemic in the spring of 2020, lack of information regarding the risk factors for COVID-19 infection for patients with breast cancer led to delays in treatment. Many physicians, the study authors said, were particularly concerned about giving standard chemotherapy regimens, potentially making patients more vulnerable to the virus. As a result, some delayed or even avoided treatment.
The recent analysis is believed to be the first large investigation to directly evaluate whether breast cancer therapies affect the risk of coronavirus infection and death, according to Dr. Adams.
For the investigation, the study researchers reviewed medical records for patients with breast cancer receiving either chemotherapy or other drug therapies from February to May 2020 at Perlmutter Cancer Center in New York City and on Long Island. The investigators then analyzed information including COVID-19 testing results, the extent of cancer, the presence of other illnesses, and survival.
Risk of COVID-19 Infection
Among the study results, the risk of coronavirus infection among patients with breast cancer who received chemotherapy was not greater than the risk for those who received treatments that were not expected to hinder their immune systems. Treatment also did not seem to increase their risk of death from COVID-19. The weighted risk of infection was 3.5% in the cytotoxic chemotherapy group vs 2.7% in the group receiving endocrine and/or HER2-directed therapy (P = .523).
In addition, the study showed that older and overweight patients remained at increased risk of dying from coronavirus infection, a finding in line with previous research on COVID-19 mortality, according to the researchers.
Dr. Adams cautioned that the coronavirus pandemic is rapidly evolving and that enhanced infection precautions should remain in place at cancer centers. Dr. Marks added that it remains unclear whether these findings will hold true in the case of newly emerging variants of the coronavirus, which the research team has yet to investigate.
Disclosure: Study funding was provided by NYU Langone and its Perlmutter Cancer Center. For full disclosures of the study authors, visit coi.asco.org.
