V. Aggelis (London, United Kingdom)
Author Of 1 Presentation
97P - Is continuing CDK4-6 inhibitor therapy safe during the COVID-19 pandemic? A UK Cancer Centre Experience
Abstract
Background
CDK4-6 inhibitors are now considered the standard of care for advanced ER-positive HER2-negative advanced breast cancer (ABC) in combination with endocrine therapy (ET). During the first wave of the COVID-19 pandemic, clinicians were uncertain what impact CDK4-6 inhibitor-induced immunosuppression may have on the risk of contracting COVID-19 or the severity of infection. Some clinicians pre-emptively reduced doses, altered schedules, or even withheld treatment, continuing ET alone. There is currently no evidence that CDK4-6 inhibitors increase the risk or severity of COVID-19 infection, although there have reports of protracted illness. We describe our experience of 203 patients receiving CDK4-6 inhibitors during the first wave and demonstrate the safety of continuing treatment during this period.
Methods
Epidemiological and clinical data were collected prospectively for patients at the Royal Marsden Hospital (RMH) and one network hospital with a ER-positive HER2-negative ABC that were receiving a CDK4-6 inhibitor between April 1st and June 30th 2020.
Results
200 patients received a CDK4-6 inhibitor in combination with ET, of which of 65/200 fulfilled local criteria to be screened with COVID-19 PCR testing and 6/65 were swab-positive. Two patients required hospital admission but there were no ICU admissions or COVID-19-associated deaths. Only 12 patients (6%) had treatment adjustments in the form of dose reduction (3/12), regime adjustment (2/12), or temporary interruption (7/12). In 9/12 cases this was a prophylactic measure due to additional risk factors; age (n=1), co-morbidities(n=3), patient choice (n=1) or overall concerns (n=4) to reduce the risk of contracting COVID-19. Results on dispensing >2 cycles at a time, telephone clinics, deferred CT scans and complications relating due to remote monitoring will also be reported.
Conclusions
Based on this snapshot during the first wave of the COVID-19 pandemic, we conclude that continuation of CDK4-6 inhibitors appears safe. This project is helping to drive a UK-wide review of CDK4-6 inhibitor treatment continuation, adjustment during the pandemic, assessing the risk of acquiring clinically severe COVID-19 infection, and subsequent cancer-related outcomes for these patients.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
S.R.D. Johnston: Advisory/Consultancy: Eli Lilly; Advisory/Consultancy, Speaker Bureau/Expert testimony: AstraZeneca; Advisory/Consultancy, Research grant/Funding (institution): Puma Biotechnology; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (institution): Pfizer; Advisory/Consultancy, Speaker Bureau/Expert testimony: Novartis; Speaker Bureau/Expert testimony: Eisai; Research grant/Funding (institution), Clinical Trials: Roche/Genentech; Research grant/Funding (institution), Clinical Trials: Eli Lilly; Research grant/Funding (institution), Clinical Trials: Pfizer; Research grant/Funding (institution), Clinical Trials: AstraZeneca; Research grant/Funding (institution), Clinical Trials: Novartis; Research grant/Funding (institution), Laboratory studies: Pfizer; Research grant/Funding (institution), Laboratory studies: Puma Biotechnology. A. Okines: Research grant/Funding (self): Pfizer; Honoraria (self): Leo Pharma; Speaker Bureau/Expert testimony: Seagen; Advisory/Consultancy: Roche; Research grant/Funding (self): Roche; Honoraria (self): AstraZeneca; Advisory/Consultancy: Seagen. S. McGrath: Speaker Bureau/Expert testimony: Pfizer. All other authors have declared no conflicts of interest.
Presenter Of 1 Presentation
97P - Is continuing CDK4-6 inhibitor therapy safe during the COVID-19 pandemic? A UK Cancer Centre Experience
Abstract
Background
CDK4-6 inhibitors are now considered the standard of care for advanced ER-positive HER2-negative advanced breast cancer (ABC) in combination with endocrine therapy (ET). During the first wave of the COVID-19 pandemic, clinicians were uncertain what impact CDK4-6 inhibitor-induced immunosuppression may have on the risk of contracting COVID-19 or the severity of infection. Some clinicians pre-emptively reduced doses, altered schedules, or even withheld treatment, continuing ET alone. There is currently no evidence that CDK4-6 inhibitors increase the risk or severity of COVID-19 infection, although there have reports of protracted illness. We describe our experience of 203 patients receiving CDK4-6 inhibitors during the first wave and demonstrate the safety of continuing treatment during this period.
Methods
Epidemiological and clinical data were collected prospectively for patients at the Royal Marsden Hospital (RMH) and one network hospital with a ER-positive HER2-negative ABC that were receiving a CDK4-6 inhibitor between April 1st and June 30th 2020.
Results
200 patients received a CDK4-6 inhibitor in combination with ET, of which of 65/200 fulfilled local criteria to be screened with COVID-19 PCR testing and 6/65 were swab-positive. Two patients required hospital admission but there were no ICU admissions or COVID-19-associated deaths. Only 12 patients (6%) had treatment adjustments in the form of dose reduction (3/12), regime adjustment (2/12), or temporary interruption (7/12). In 9/12 cases this was a prophylactic measure due to additional risk factors; age (n=1), co-morbidities(n=3), patient choice (n=1) or overall concerns (n=4) to reduce the risk of contracting COVID-19. Results on dispensing >2 cycles at a time, telephone clinics, deferred CT scans and complications relating due to remote monitoring will also be reported.
Conclusions
Based on this snapshot during the first wave of the COVID-19 pandemic, we conclude that continuation of CDK4-6 inhibitors appears safe. This project is helping to drive a UK-wide review of CDK4-6 inhibitor treatment continuation, adjustment during the pandemic, assessing the risk of acquiring clinically severe COVID-19 infection, and subsequent cancer-related outcomes for these patients.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
S.R.D. Johnston: Advisory/Consultancy: Eli Lilly; Advisory/Consultancy, Speaker Bureau/Expert testimony: AstraZeneca; Advisory/Consultancy, Research grant/Funding (institution): Puma Biotechnology; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (institution): Pfizer; Advisory/Consultancy, Speaker Bureau/Expert testimony: Novartis; Speaker Bureau/Expert testimony: Eisai; Research grant/Funding (institution), Clinical Trials: Roche/Genentech; Research grant/Funding (institution), Clinical Trials: Eli Lilly; Research grant/Funding (institution), Clinical Trials: Pfizer; Research grant/Funding (institution), Clinical Trials: AstraZeneca; Research grant/Funding (institution), Clinical Trials: Novartis; Research grant/Funding (institution), Laboratory studies: Pfizer; Research grant/Funding (institution), Laboratory studies: Puma Biotechnology. A. Okines: Research grant/Funding (self): Pfizer; Honoraria (self): Leo Pharma; Speaker Bureau/Expert testimony: Seagen; Advisory/Consultancy: Roche; Research grant/Funding (self): Roche; Honoraria (self): AstraZeneca; Advisory/Consultancy: Seagen. S. McGrath: Speaker Bureau/Expert testimony: Pfizer. All other authors have declared no conflicts of interest.