Study Finds Risk of Death Due to COVID-19 Not Raised by Recent Chemotherapy, Immunotherapy for Gynecologic Cancer

A new study finds that recent chemotherapy or immunotherapy for gynecologic cancer does not raise the risk of hospitalization or death due to COVID-19, according to results presented at the Society of Gynecologic Oncology 2021 Annual Meeting on Women’s Cancer.

“We can reassure women with gynecologic cancer that they can continue anticancer therapy,” said the study’s presenting author, Olivia Lara, MD, MS, gynecologic oncology fellow, New York University (NYU) Langone Health, New York City, in a press release.

Lara and her colleagues conducted the study due to the underrepresentation of gynecologic cancer in past studies of COVID-19 outcomes in patients with cancer. Additionally, she added that some of her patients were concerned that chemotherapy, which can weaken the immune system, would increase their risk of more severe illness if they became infected with COVID-19.

The researchers analyzed data from 193 patients with COVID-19 at 8 NYC area hospitals treated between March 2020 and May 2020. All patients had gynecologic cancer, primarily endometrial/uterine, ovarian, and cervical cancers, and overall 54.9% required hospitalization.

When analyzing the odds of death or hospitalization due to COVID-19, the researchers found that use of cytotoxic chemotherapy did not predict increased risk for either. The same held true for immunotherapy, or drugs that help the immune system fight cancer. Although Lara and her team reported last year that immunotherapy was a risk factor for increased COVID-19-related deaths in women with gynecologic cancer, that was not the case in the new, larger study.

However, the researchers found that greater odds of death due to COVID-19 among current or former smokers versus nonsmokers, as smoking is a known risk factor for severe COVID-19 infection.

The need for hospitalization due to COVID-19 was reportedly associated with ages 65 years and older, Black race, and having 3 or more additional coexisting long-term health conditions. Furthermore, women who had a low performance status score, indicating their ability to independently perform activities of daily living, had increased odds of hospitalization compared with those with better performance statuses.

In the study, 34 of 193 patients died of COVID-19. Lara added that this fatality rate is similar to that of age-matched women with COVID-19 who did not have cancer. The fatality rates may be lower now than early in the pandemic when their study took place, according to the authors.

REFERENCE

Recent chemotherapy or immunotherapy for gynecologic cancer does not raise risk of death due to COVID-19. March 20, 2021. Accessed March 22, 2021. SGO [press release].