Tumori Journal Abstract Book - October 2020 - 88

Tumori Journal 106(2S)

during the hospitalization (mean time of symptoms onset
4 days + 4). C-reactive protein increase was detected in
15 (75%) patients, high lactate dehydrogenase levels in
13 (65%), lymphocytopenia and thrombocytopenia in 6
(30%) and 4 (20%), respectively. Seven patients (35%)
were on active anti-tumor treatment, 3 (43%) received
anti-tumor therapy within two weeks before SARSCoV-2 positivity, and 2 (29%) continued oncological
treatment (TKIs and chemotherapy) after the infection
diagnosis. Nine (45%) patients were prescribed hydroxychloroquine and 5 (25%) antiviral therapy with lopinavir/
ritonavir or darunavir/ritonavir. Ten (50%) patients died
within a mean of 11 days (+ 8) from the diagnosis of
COVID-19 infection. Five patients (25%) have been discharged from the hospital, 4 (20%) of them with the indication to best supportive care and 1(5%) to active
antitumor treatment.
Conclusions: Our series confirms the high mortality rate
among cancer patients with COVID-19. The presence of
asymptomatic cases suggests that typical symptoms and
fever may not be the only useful parameters to suspect
COVID-19 in oncological patients.
Our Onco-Covid unit suggests the importance of a tailored
and holistic approach for cancer patients, even in a challenging situation like SARS-CoV-2 pandemic.

D44
Impact of immunotherapy in
hospitalization of COVID-19
infected cancer patients. First
results of an Italian Study in the
Province of Modena and Reggio
Emilia during SARS-CoV-2 outbreak
Spallanzani A.1, Damato A.2, Rovesti G.1, Benatti S.1, Berselli A.2,
Luppi G.1, Pinto C.2
1

Division of Oncology, University Hospital of Modena, Modena; 2Medical
Oncology Unit, AUSL-IRCCS Reggio Emilia, Reggio Emilia

Background: Recent reports highlight the higher incidence of severe events in cancer patients (pts) affected by
COVID-19, although, insufficient data are available about
the association with immunotherapy. Italian scientific
society and colleges (AIOM, CIPOMO, COMU) released
shared recommendations according to pts risk of infection
and tumor characteristics, demanding for telephone consultations and, if suitable, treatments delay.
Material and Methods: In Modena and Reggio Emilia
Cancer Centers, medical reports of pts undertaking immunotherapy between January 1st 2020 and April 30th 2020
were collected. For those pts infected with COVID-19,
identified by thoracic computerized tomography criteria
and RT-PCR of nasopharyngeal specimens according to
WHO indications, we estimated the risk of infection and
related complications that lead to hospitalization.
Results: A total of 337 pts with solid tumors treated with
anti-PD1 and anti-PDL-1 antibody regardless the line of
treatment was identified. Cancer diagnosis included 156
(46,3%) lung cancer, 74 (22%) melanoma, 36 (10,7%) kidney, 23 (7%) colorectal, 12 (3,4%) head and neck, and, 36
(10,6%) miscellaneous. Only 3 pts (0.9%), all with metastatic disease and during first line therapy were hospitalized
for COVID-19 infection (Table1). The median age was 57
years. 2 pts have been treated with immunotherapy in combination with chemotherapy, and 1 patient with anti-PD1
and anti-CTLA-4. The onset symptom was fever in 2 pts,
while 1 patient had subjective dyspnea. Subsequently, they
develop respiratory distress and underwent to non-invasive
assisted ventilation, receiving treatments with hydroxychloroquine, steroids, low molecular weight heparin.
Tocilizumab was administered only in 1 patient according to
progressive increase of serum IL-6 values. Nobody was
admitted in Intensive Care Unit (ICU). Since the last update,
May 15th 2020, 1 patient died while the others have recovered resulting COVID-19 negative to nasopharyngeal swab.
Conclusions: Although not conclusive, in our series, cancer pts infected by COVID-19 receiving immunotherapy
do not appear to be exposed to greater risk of recovery.

Table 1. Characteristics of three metastatic cancer pts hospitalized with COVID-19 infection.
Primary tumor

Age (ys)

Gender

Regimens

Hospitalization
(days)

Pulmonary infection
involvement (%)

Death

Colon

20-40

Kidney

Yes

Pleura

Atezolizumab
FOLFOXIRI
Bevacizumab
Nivolumab
Ipilimumab
Pembrolizumab
Cisplatin
Pemetrexed

Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020