Outcomes of Breast Cancer Patients Treated with Chemotherapy, Biologic Therapy, Endocrine Therapy, or Active Surveillance During the COVID-19 Pandemic

Douglas K. Marks, Nibash Budhathoki, John Kucharczyk, Faisal Fa’ak, Nina D’Abreo, Maryann Kwa, Magdalena Plasilova, Shubhada Dhage, Phyu Phyu Soe, Daniel Becker, Alexander Hindenburg, Johanna Lee, Megan Winner, Chinyere Okpara, Alison Daly, Darshi Shah, Angela Ramdhanny, Marleen Meyers, Ruth Oratz, James SpeyerYelena Novik, Freya Schnabel, Simon A. Jones, Sylvia Adams

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Provide real-world data regarding the risk for SARS-CoV-2 infection and mortality in breast cancer (BC) patients on active cancer treatment. Methods: Clinical data were abstracted from the 3778 BC patients seen at a multisite cancer center in New York between February 1, 2020 and May 1, 2020, including patient demographics, tumor histology, cancer treatment, and SARS-CoV-2 testing results. Incidence of SARS-CoV-2 infection by treatment type (chemotherapy [CT] vs endocrine and/or HER2 directed therapy [E/H]) was compared by Inverse Probability of Treatment Weighting. In those diagnosed with SARS-CoV-2 infection, Mann–Whitney test was used to a assess risk factors for severe disease and mortality. Results: Three thousand sixty-two patients met study inclusion criteria with 641 patients tested for SARS-COV-2 by RT-PCR or serology. Overall, 64 patients (2.1%) were diagnosed with SARS-CoV-2 infection by either serology, RT-PCR, or documented clinical diagnosis. Comparing matched patients who received chemotherapy (n = 379) with those who received non-cytotoxic therapies (n = 2343) the incidence of SARS-CoV-2 did not differ between treatment groups (weighted risk; 3.5% CT vs 2.7% E/H, P = .523). Twenty-seven patients (0.9%) expired over follow-up, with 10 deaths attributed to SARS-CoV-2 infection. Chemotherapy was not associated with increased risk for death following SARS-CoV-2 infection (weighted risk; 0.7% CT vs 0.1% E/H, P = .246). Advanced disease (stage IV), age, BMI, and Charlson’s Comorbidity Index score were associated with increased mortality following SARS-CoV-2 infection (P ≤ .05). Conclusion: BC treatment, including chemotherapy, can be safely administered in the context of enhanced infectious precautions, and should not be withheld particularly when given for curative intent.

Original languageEnglish
Pages (from-to)89-96
Number of pages8
JournalOncologist
Volume27
Issue number2
DOIs
StatePublished - Feb 2022

Keywords

  • breast cancer
  • cancer treatment
  • COVID-19
  • SARS-CoV-2

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