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Journal of Zhejiang University SCIENCE B

ISSN 1673-1581(Print), 1862-1783(Online), Monthly

Impact of antitumor regimens on the outcomes of cancer patients with COVID-19: a pooled analysis

Abstract: Since the outbreak of coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) discovered in December 2019, the disease has emerged as a global pandemic (Shi et al., 2020; World Health Organization, 2020). Several studies have shown a higher incidence of COVID-19, as well as related poor outcomes in patients with malignancies as compared with those without them (Liang et al., 2020; Tian et al., 2020). The impact of cancer on COVID-19 may be attri‑buted to the use of antitumor treatments that may disturb the host response to SARS-CoV-2 infection (Wang et al., 2020), while the current studies on this topic have drawn controversial conclusions. Some implied that anticancer treatments might elevate the risk of death (García-Suárez et al., 2020; Liu et al., 2020). On the contrary, others pointed out that this association is not significant (Brar et al., 2020; Lee et al., 2020a). Although previous systematic reviews have investigated this important issue (Wang and Huang, 2020), the heterogeneity of findings is obvious and the general conclusion has remained unclear. Considering this ambiguity, it is difficult for clinicians to make therapeutic decisions when facing patients with both cancer and COVID-19; therefore, a high-quality and accurate evaluation of the impact of anticancer treatments on COVID-19 patients is necessary. Accordingly, we conducted a pooled analysis with the original data of each patient for the first time to provide a comprehensive perspective into the association between anticancer regimens and the outcomes of cancer patients with COVID-19.

Key words: COVID-19; Cancer; Anti-tumor regimens; Pooled analysis

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概è¦ï¼šä¸åŒçš„肿瘤治疗方案å¯èƒ½æ˜¯è‚¿ç˜¤åˆå¹¶æ–°åž‹å† çŠ¶ç—…毒肺炎(COVID-19)患者预åŽè¾ƒå·®çš„原因之一,但是目å‰ç›¸å…³ç ”究å´ä»æœªæœ‰å®šè®ºã€‚因此,全é¢æ·±å…¥çš„分æžå¯ä»¥è¾…助临床医生选择和制定新型冠状病毒æµè¡ŒæœŸé—´çš„抗肿瘤治疗方案。我们通过从PubMedã€Embaseå’ŒCochraneæ•°æ®åº“检索得到的æ供了æ¯ä¸ªæ‚£è€…临床信æ¯çš„11项相关研究展开汇总分æžã€‚本研究å‘现化疗是这些COVID-19åˆå¹¶è‚¿ç˜¤çš„患者中最常è§çš„抗肿瘤治疗。ç»è¿‡å¯¹æ··æ‚因素的调整,抗肿瘤治疗方案对患者结局的影å“并ä¸æ˜¾è‘—。值得关注的是,在对于化疗和激素治疗的研究中,高龄(≥65å²ï¼‰ä¼šå¢žåŠ è¿™ç±»æ‚£è€…å‘生死亡(化疗的研究中比值比(OR)=2.36,95%的置信区间(95% CI)=1.11~5.01,P=0.025;激素治疗的研究中OR=2.29ï¼›95% CI=1.08~4.85,P=0.03)åŠä¸¥é‡äº‹ä»¶ï¼ˆOR=2.72,95% CI=1.45~5.10,P=0.002)的å¯èƒ½æ€§ï¼Œå¿ƒè„‘血管疾病病å²åˆ™ä¼šå¢žåŠ è¿™ç±»æ‚£è€…å‘生严é‡äº‹ä»¶çš„å¯èƒ½æ€§ï¼ˆOR=1.91ï¼›95% CI=1.02~3.57,P=0.043)。在进一步的亚组分æžä¸­ï¼Œæˆ‘们å‘现å…疫治疗å¯èƒ½ä¼šæ˜¾è‘—增加患有实体肿瘤的新型冠状病毒患者死亡(OR=2.66,95% CI=1.07~6.64,P=0.03)和å‘生严é‡äº‹ä»¶ï¼ˆOR=5.04,95% CI=1.02~24.86,P=0.039)的å¯èƒ½æ€§ï¼Œè€ŒåŒ–疗则å¯èƒ½æ˜¾è‘—增加患有血液系统肿瘤的新型冠状病毒患者死亡的å¯èƒ½æ€§ï¼ˆOR=4.11,95% CI=1.59~10.6,P=0.003)。综上所述,在多因素模型中,相较于ä¸åŒçš„肿瘤治疗方案,影å“肿瘤åˆå¹¶COVID-19患者预åŽçš„关键临床因素如年龄ã€å¿ƒè„‘血管病等,å¯èƒ½æ›´ä¸ºå…³é”®ã€‚在亚组分æžä¸­ï¼Œå…疫治疗和化疗则å¯èƒ½åˆ†åˆ«å¯¹å®žä½“肿瘤患者和血液肿瘤患者有较为显著的影å“。

关键è¯ç»„:COVID-19;肿瘤治疗方案;化疗,å…疫治疗;汇总分æž


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DOI:

10.1631/jzus.B2100151

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On-line Access:

2021-10-12

Received:

2021-02-10

Revision Accepted:

2021-07-19

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