Abstract PO-030: Outcome of older cancer patients infected with Covid19 at Gustave Roussy Cancer Center
Authors: Hauchecorne Mathilde , Baldini Capucine , Foulon Stéphanie , Bayle Arnaud , Gachot Bertrand , Pommeret Fanny , Vincent Helene , Lamy Tina , Nagera Celine , Willekens Christophe , Griscelli Franck , Netzer Florence , Balleyguier Corinne , Ammari Samy , André Fabrice , Scotte Florian , Besse Benjamin , Soria Jean-Charles , Barlési Fabrice , Albigès Laurence 
Published: December 2020

Background: The SARS-CoV-2 outbreak in Paris’s region significantly affected Gustave Roussy Cancer Center. Previous analyses showed that mortality rate increases with age in the general population. Here, we report the Gustave Roussy experience on older patients (OP) with cancer during the SARS-CoV-2 outbreak.

Methods: Cancer pts with suspected SARS-CoV-2 infection were admitted at Gustave Roussy starting March 12th. Screening indications have been adapted over the time. All the COVID19 pts positively tested and managed at Gustave Roussy between March 14th (1st positive case) and April 15th have been included in a REDCap database. Pts and underlying oncologic and COVID19 diseases characteristics have been collected. Cancer and COVID-19 managements and outcomes have been assessed. The primary endpoint of this analysis was the clinical deterioration, defined as the need for O2 supplementation of 6l/min, or death of any cause.

Results: Among the first 137 cancer pts diagnosed with SARS-CoV-2, 36 patients were aged 70 years (26%). Most of them were female (61%) with a median age of 75.5 years old. Most frequent underlying cancers were solid tumors (92%) including GI (19%), lung (17%), GYN (14%), and head and neck (14%). Most OP (36%) were ECOG performance status 2 versus 24% in younger patients (YP). The diagnosis of SARS-CoV-2 infection was made by RT-PCR or thoracic CT scan alone in 97% and 3% of the cases, respectively, in OP and in 92% and 8% in YP. Most OP experienced symptoms prior to testing (92%) compared to YP (80%). Symptoms differed according to age with more cough with sputum production in OP (14% versus 5%), dyspnea (39% versus 31%), diarrhea (17% versus 9%), shivers (8% versus 0%), sore throat (8% versus 4%), and no anosmia or agueusia. The majority of OP were hospitalized (81%) compared to 72% of YP and treated with HCQ/AZI (15; 52%) with inclusion in the ONCOVID trial (EudraCT: 2020-01250-21) compared to 25 (35%) YP. They did not receive any IL-6 inhibitor. Only one OP was admitted in the ICU (3%). Clinical deterioration occurred in 10 OP (29%). There was no impact of age on clinical worsening (HR=1.157; 95%CI 0.55-2.42; p=0.7). However, age was associated with worse overall survival (OS) (HR=2.45 95%CI 1.02-5.92 ; p=0.0463). Results will be updated at the meeting.

Conclusions: OP with cancer had a different disease presentation, same rate of clinical worsening, but worse OS in SARS-CoV-2 infection.

Citation Format: Mathilde Hauchecorne, Capucine Baldini, Stéphanie Foulon, Arnaud Bayle, Bertrand Gachot, Fanny Pommeret, Helene Vincent, Tina Lamy, Celine Nagera, Christophe Willekens, Franck Griscelli, Florence Netzer, Corinne Balleyguier, Samy Ammari, Fabrice André, Florian Scotte, Benjamin Besse, Jean-Charles Soria, Fabrice Barlési, Laurence Albigès. Outcome of older cancer patients infected with Covid19 at Gustave Roussy Cancer Center [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-030.