by Tom Wilemon
People with thoracic cancers sickened by COVID-19 were especially vulnerable to deaths, with a 35% mortality rate, according to early results from TERAVOLT, a global consortium that tracks outcomes among this vulnerable patient population.
Much of the early data was accumulated when the pandemic was first sweeping through Italy and other European nations. Updated data from the registry, including outcomes from the United States, will be presented as part of the official press program at ASCO20 Virtual, the annual meeting of the American Society of Clinical Oncology.
TERAVOLT consortium (Thoracic cancERs international coVid 19 cOLloboraTion) steering committee member, Leora Horn, MD, MSc, Ingram Associate Professor of Cancer Research at Vanderbilt-Ingram Cancer Center, will present the abstract. The additional data follows a prior report to the American Association for Cancer Research by Marina Garassino, MD, of the National Cancer Institute of Milan, Italy, who initiated the idea of the registry.
“The data on the first 200 patients was primarily from France, Italy and Spain,” Horn said. “The outcomes were pretty shocking. There was 35% mortality in patients with a thoracic malignancy. Almost three-quarters of the patients required hospital admission.
“We also found that the majority of patients were not admitted to an ICU even though they may have required ICU admission, primarily due to institutional policies or lack of resources or physicians determining it would be futile to admit a patient with stage IV cancer to the ICU,” Horn said.
The origin of the TERAVOLT consortium began with an email from Garassino, who specializes in lung cancer and other thoracic cancers.
“Marina Garassino sent an email to a number of oncologists about COVID-19 and what was happening in Italy,” Horn said. “In that email, she said that it was terrible, that it is a war and that we needed to collect data and survivor outcomes, not only to see what is happening with patients but with delays to their therapies. At the time, we were preparing for COVID-19 here, but there were not that many cases in Nashville.
“I offered, in collaboration with Jennifer Whisenant, PhD, research assistant professor of Medicine at VUMC, to develop the database and Vanderbilt could host it on REDCap. We sent out an email asking about 75 oncologists to join, and we have since had interest from more than 200 cancer centers in more than 22 countries.
“This started as a small project among friends emailing one another as we were concerned about our patients. It’s been amazing to watch the lung cancer community come together globally to help our patients,” Horn said.
Within three days, a database had been built, and within a week, data collection began.
The updated analysis to be presented at ASCO20 Virtual encompasses data on 400 patients with thoracic cancers.
“We now have an updated analysis with another 200 patients, including sites in the United States,” Horn said. “We’re looking to present at ASCO the impact of comorbidities, medications and cancer-specific therapies on patient outcomes.”
Data will be presented on how patients on chemotherapy, immunotherapy and tyrosine kinase inhibitors fared and the effect of comorbidities, steroids and anticoagulation on outcome. Another focus will be outcomes of patients admitted to the hospital.
“Are we going to see different outcomes in the U.S. compared to Europe where physicians are a little clearer in goals of care discussions up front and where many hospital systems were at capacity and difficult decisions had to made and patients with thoracic cancers or stage IV disease were not offered ICU care,” Horn said.
The TERAVOLT consortium, which has generated interest from thoracic oncologists located across the globe, will continue to track long-term outcomes of people with lung cancer sickened by COVID-19.