A North west London experience of use of Immunotherapeutic drugs in advanced renal cancer during COVID-19 pandemic


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Session type:

Anand Sharma1, Salma Alam1, Joanne Kwa2, Yatri Shah1, Rebecca Devine1, Andrew Gogbashian3, Paul Nathan1
1Mount Vernon Cancer Centre, 2East and North Hertfordshire NHS Trust, 3Paul Strickland Scanner Centre

Abstract

Background

Advanced renal cell carcinoma (aRCC) is amongst the few cancers, which is treated by either an oral anti-angiogenic agent, antiPD1/PDL1 or anti-CTLA-4 agent or a combination of the two. Data of COVID-19 outcomes in this cancer is sparse.

Method

Patients who were treated at 2 large north west london cancer centres (Mount Vernon cancer centre and Lister hospital), covering a population of 2 million were analysed. 209 patients with aRCC were treated at these centres and all patients had either received an oral tyrosine kinase inhibitor (TKI’S-pazopanib, sunitinib, cabozantinib, tivozanib) or levantinib/ everolimus combination, or ipilimumab/ nivolumab or axitinib/avelumab or nivolumab single agent. Only patients with PCR positive COVID-19 throat swab were included.

Results

Between March 2020 and March 2021, 209 patients were treated for aRCC, of which 143 were male (68%) and 66 females (32%). During this period the treatment given were as follows- 51 patients were on Avelumab and axitinib (25%), 30 were on Ipilimumab/nivolumab (14%), 113 on TKI’s (54%) and 15 were on single agent Nivolumab (7%).  Amongst these patients- 15 patients (7%) were diagnosed with COVID-19 infection. 5 patients were on avelumab/axitinib and 1 on ipilimumab/ nivolumab, and patients on sunitinib, cabozantinib, levantinib/ everolimus were 3 each. 9 patients (60%) of those infected, died as a result of COVID-19 infection. All 9 patients who died were on oral therapy (TKI’s).

Conclusion

Treatment for aRCC doesn’t increase your risk of severity of COVID-19 infection or affect mortality. Use of Immunotherapy agents in aRCC, doesn’t adversely affect, your outcome in COVID-19 infection. In the COVID-19 pandemic, eligible patients with aRCC, should not be denied an immunotherapy combination, as this offers them the best outcomes. Our centre was able to provide optimum therapy to all patients with aRCC during the COVID-19 pandemic.

Impact statement

Patients with aRCC should not be denied novel immunotherapy combinations in 1st line setting, during the COVID-19 pandemic.