TERAVOLT registry tracks outcomes among thoracic cancer patients
sickened by COVID-19

Date:
June 16, 2020
Source:
Vanderbilt University Medical Center
Summary:
New data from TERAVOLT, a global consortium that tracks outcomes
of people with thoracic cancers affected by COVID-19, offers clues
as to why they experienced a high death rate of 33 percent when
the coronavirus swept across Europe.



FULL STORY ==========================================================================
New data from TERAVOLT, a global consortium that tracks outcomes of
people with thoracic cancers affected by COVID-19, offers clues as to
why they experienced a high death rate of 33% when the coronavirus swept
across Europe.


========================================================================== While the majority of those who died were hospitalized, only 9% were
admitted to intensive care units, according to a study published in The
Lancet Oncology.

Most died from complications of COVID-19, not the progression of cancer.

"Just having a lung cancer diagnosis in and of itself shouldn't exclude patients from care," said Leora Horn, MD, MSc, Ingram Associate Professor
of Cancer Research at Vanderbilt-Ingram Cancer Center, who is a senior
author of the study and a TERAVOLT consortium steering committee member.

The study is based on the first 200 patients for which TERAVOLT received outcomes data. Of the 152 hospitalized patients, 134 or 88% met the
criteria for ICU admission, but only 13 of those patients were admitted
to an ICU. Only 5 were mechanically ventilated.

Most of the patients were hospitalized in Italy, France and Spain, which
were "particularly hard hit" by the pandemic, the study noted. The
study's lead author, Marina Garassino, MD, of the National Cancer
Institute of Milan, Italy, initiated the idea for the registry, which
led to the TERAVOLT consortium (Thoracic cancERs InterAtional coVid
19 cOLlobaraTion).

"We tried to capture the reasons for the lack of ICU admission," the
authors noted in the study. "Difficult decisions were made limiting
ICU admissions to cancer patients and others with terminal illness
due to equipment and personnel shortages. However, we are aware that
behind these choices there may also be patients' decisions, cultural
and institutional choices that our work is unable to properly capture."
"Not all lung cancer patients are at risk for hospitalization," Horn said.

Initial data indicated that patients on tyrosine kinase inhibitors
appeared to be at decreased risk for hospital admission. This remained
true when Horn presented updated data from the TERAVOLT registry last
month at ASCO20 Virtual, the annual meeting of the American Society of
Clinical Oncology. The data presented at the ASCO meeting were based on
those first 200 patients in The Lancet Oncology study, plus an additional
200, including many from the United States.

That data revealed that patients treated with chemotherapy within three
months of a COVID-19 diagnosis had a significantly increased risk of 64%
of dying from the coronavirus. Patients treated with anticoagulants to
prevent blood clots and corticosteroids to reduce inflammation also had
a greater mortality risk.

Patients treated with immunotherapies had no increased risk of mortality.

In The Lancet Oncology paper, the authors noted that at this point it
remains unclear if intubation and more aggressive care could improve
survival for people with thoracic cancers sickened by COVID-19, but
the integration of patients' preferences could provide guidance for
clinicians while uncertainty is high.

The TERAVOLT registry is an ongoing longitudinal study. Data collected
from consortium participants across the globe are entered on a REDCap
database hosted by Vanderbilt. The registry recently received $95,000
in funding support from the International Association for the Study of
Lung Cancer on behalf of the Lung Ambition Alliance.


========================================================================== Story Source: Materials provided by
Vanderbilt_University_Medical_Center. Original written by Tommy
Wilemon. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Marina Chiara Garassino, Jennifer G Whisenant, Li-Ching Huang,
Annalisa
Trama, Valter Torri, Francesco Agustoni, Javier Baena, Giuseppe
Banna, Rossana Berardi, Anna Cecilia Bettini, Emilio Bria, Matteo
Brighenti, Jacques Cadranel, Alessandro De Toma, Claudio Chini,
Alessio Cortellini, Enriqueta Felip, Giovanna Finocchiaro,
Pilar Garrido, Carlo Genova, Raffaele Giusti, Vanesa Gregorc,
Francesco Grossi, Federica Grosso, Salvatore Intagliata, Nicla La
Verde, Stephen V Liu, Julien Mazieres, Edoardo Mercadante, Olivier
Michielin, Gabriele Minuti, Denis Moro- Sibilot, Giulia Pasello,
Antonio Passaro, Vieri Scotti, Piergiorgio Solli, Elisa Stroppa,
Marcello Tiseo, Giuseppe Viscardi, Luca Voltolini, Yi-Long Wu,
Silvia Zai, Vera Pancaldi, Anne-Marie Dingemans, Jan Van Meerbeeck,
Fabrice Barlesi, Heather Wakelee, Solange Peters, Leora Horn.

COVID-19 in patients with thoracic malignancies (TERAVOLT): first
results of an international, registry-based, cohort study. The
Lancet Oncology, 2020; DOI: 10.1016/S1470-2045(20)30314-4 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/06/200616135754.htm

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