While patients with cancer are at an increased risk of experiencing poor outcomes from COVID-19, there is significant variability in COVID-19 risk and mortality among patients with different tumor types and demographics such as age and sex, with those with hematologic malignancies facing the highest risk. In this interview with i3 Health, Lennard Lee, DPhil, MRCP, BMBCh, an Honorary Research Fellow at the University of Birmingham's Institute of Cancer and Genomic Sciences, discusses the significance of this finding and shares advice for personalizing treatment and minimizing COVID-19 risk in patients with different types of cancer.
Can you comment on the significance of your findings regarding COVID-19 risk and outcomes in patients with cancer according to tumor subtype and patient demographics?
Lennard Lee, DPhil, MRCP, BMBCh: The cancer community needs to make contingency plans and be prepared for a rise in COVID-19 cases. To help us achieve this, we need the latest information regarding how COVID-19 affects patients with cancer. Because of this study, we now know for the first time that the risk of contracting COVID-19 in patients with cancer does vary, and we can now tailor recommendations to each individual patient to reduce that risk.
To what do you attribute your finding that patients with hematologic malignancies experienced the highest rate of mortality from COVID-19?
Dr. Lee: Blood cancers appear to pose a much higher risk of COVID-19 infection in patients with cancer. It is likely that these cancers, which often affect white blood cells, may also be impairing patients' ability to fight COVID-19. It is also possible that treatments for blood cancers are making them more vulnerable. Either way, it is important that COVID-19 risk in patients with blood cancers be minimized, and that there is a general awareness that these patients have the highest risk of experiencing poor outcomes if they were to contract COVID-19.
What further research needs to be done regarding the effect of tumor subtype and patient demographics on COVID-19 risk and outcomes?
Dr. Lee: We need more granular information. Our study was the first to identify COVID-19 risk based on tumor subtype and patient age and sex. What we need to do now is combine our findings with other results from American, French, and Italian datasets. This will give us the power to identify a patient's personal risk, taking into account exactly which treatment they are receiving, their stage of disease, or even their histological subsets.
How do you think that your results should impact the treatment and management of patients with cancer during the COVID-19 pandemic?
Dr. Lee: No patient that needs treatment for their cancer during the COVID-19 pandemic should be denied it. We now know that most patients with cancer will recover from COVID-19, and in many cancer types, their risk of infection and mortality is much lower.
About Dr. Lee
Lennard Lee, DPhil, MRCP, BMBCh, is an Honorary Research Fellow at the Institute of Cancer and Genomic Sciences at the University of Birmingham in the United Kingdom. His research focuses on COVID-19 risk and outcomes in patients with cancer. Dr. Lee is currently leading the UK Coronavirus Cancer Monitoring Project (UKCCMP), a national project tracking disease-specific mortality, age-specific cancer mortality, treatment impact, and efficacy of public health interventions among patients with COVID-19 and cancer.
For More Information
Lee LYW, Cazier JB, Starkey T, et al (2020). COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study. Lancet Oncol. [Epub ahead of print] DOI:10.1016/S1470-2045(20)30442-3
Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of i3 Health.