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Research Paper|Volume 14, Issue 5|pp 2062—2080

Association of active immunotherapy with outcomes in cancer patients with COVID-19: a systematic review and meta-analysis

Chang Cao1, Xinyan Gan1, Xiaolin Hu2, Yonglin Su3, Yu Zhang4, Xingchen Peng3
  • 1State Key Laboratory of Oral Diseases, West China Hospital of Stomatology/Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P.R. China
  • 2Department of Nursing, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P.R. China
  • 3Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P.R. China
  • 4Affiliated Hospital of Chengdu University, Chengdu 610041, Sichuan, P.R. China
* Equal contribution
Received: November 13, 2021Accepted: January 25, 2022Published: March 10, 2022
https://doi.org/10.18632/aging.203945

Copyright: © 2022 Cao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: During the COVID-19 pandemic, there are growing concerns about the safety of administering immunotherapy in cancer patients with COVID-19. However, current clinical guidelines provided no clear recommendation.

Methods: Studies were searched and retrieved from electronic databases. The meta-analysis was performed by employing the generic inverse-variance method. A random-effects model was used to calculate the unadjusted odds ratios (ORs) and adjusted ORs with the corresponding 95% CIs.

Results: This meta-analysis included 20 articles with 6,042 cancer patients diagnosed with COVID-19. According to the univariate analysis, the acceptance of immunotherapy within 30 days before COVID-19 diagnosis did not increase the mortality of cancer patients (OR: 0.92; 95% CI: 0.68-1.25; P=0.61). Moreover, after adjusting for confounders, the adjusted OR for mortality was 0.51, with borderline significance (95% CI: 0.25-1.01; P=0.053). Similarly, the univariate analysis showed that the acceptance of immunotherapy within 30 days before COVID-19 diagnosis did not increase the risk of severe/critical disease in cancer patients (OR: 1.07; 95% CI: 0.78-1.47; P=0.66). No significant between-study heterogeneity was found in these analyses.

Conclusions: Accepting immunotherapy within 30 days before the diagnosis of COVID-19 was not significantly associated with a higher risk of mortality or severe/critical disease of infected cancer patients. Further prospectively designed studies with large sample sizes are required to evaluate the present results.