Impact of COVID-19 in patients on active melanoma therapy and with history of melanoma

Abstract

Introduction COVID-19 particularly impacted patients with co-morbid conditions, including cancer. Patients with melanoma have not been specifically studied in large numbers. Here, we sought to identify factors that associated with COVID-19 severity among patients with melanoma, particularly assessing outcomes of patients on active targeted or immune therapy. Methods Using the COVID-19 and Cancer Consortium (CCC19) registry, we identified 307 patients with melanoma diagnosed with COVID-19. We used multivariable models to assess demographic, cancer-related, and treatment-related factors associated with COVID-19 severity on a 6-level ordinal severity scale. We assessed whether treatment was associated with increased cardiac or pulmonary dysfunction among hospitalized patients and assessed mortality among patients with a history of melanoma compared with other cancer survivors. Results Of 307 patients, 52 received immunotherapy (17%), and 32 targeted therapy (10%) in the previous 3 months. Using multivariable analyses, these treatments were not associated with COVID-19 severity (immunotherapy OR 0.51, 95% CI 0.19 – 1.39; targeted therapy OR 1.89, 95% CI 0.64 – 5.55). Among hospitalized patients, no signals of increased cardiac or pulmonary organ dysfunction, as measured by troponin, brain natriuretic peptide, and oxygenation were noted. Patients with a history of melanoma had similar 90-day mortality compared with other cancer survivors (OR 1.21, 95% CI 0.62 – 2.35). Conclusions Melanoma therapies did not appear to be associated with increased severity of COVID-19 or worsening organ dysfunction. Patients with history of melanoma had similar 90-day survival following COVID-19 compared with other cancer survivors.

COVID-19 in Patients with Melanoma: A Single-Institution Study

“…Meng et al showed that omicron has a suboptimal fusion capacity in comparison to other variants [ 35 ], and numerous clinical studies have reported that omicron results in less severe disease and fewer hospitalizations [ 36 , 37 , 38 , 39 , 40 , 41 , 42 ], even after adjustment for potential confounders, such as vaccination status [ 38 , 39 , 40 ], age and frailty [ 40 ], suggesting that omicron and its subvariants may exhibit a reduced inherent virulence. This may contribute to the decreased COVID-19 severity and hospitalization rate observed in our study compared to studies that were carried out during earlier stages of the pandemic [ 26 , 43 ].…”

“…The GRAVID study by the Spanish Melanoma Group reported that stage and melanoma treatment did not affect prognosis in a cohort of 150 unvaccinated melanoma patients [ 25 ]. Similarly, Johnson et al reported that melanoma therapy, irrespective of modality, was not associated with severity of COVID-19 [ 26 ]. Treatment continuation, therefore, should be examined, particularly for asymptomatic and mild cases, considering the potential negative influence of treatment delay in melanoma outcome.…”

“…Both molecularly targeted treatments (for BRAF mutated cases) and immunotherapy with immune checkpoint inhibitors (ICIs) are first-line treatment options for advanced disease [ 22 ]. Evidence on the impact of melanoma and its treatment on COVID-19 severity and survival are scarce and derive mostly from early studies that include small numbers of patients [ 19 , 23 ] and melanoma registry-based studies [ 24 , 25 , 26 ]. The present study is an analysis of 121 melanoma patients treated at a large academic tertiary referral center in Greece who were diagnosed with COVID-19.…”

Comparison of adverse effects of anti-tumor therapy for breast cancer shortly after COVID-19 diagnosis vs. the control period

“…In our study, no cardiotoxicity events caused by anthracyclines, trastuzumab, or pertuzumab were observed, which may be related to the routine cardiac function monitoring in our center during the COVID-19 pandemic. Another study assessed organ function in relation to systemic melanoma therapy (e.g., immune-related adverse events, and cardiomyopathy caused by targeted drugs) and concluded that patients with melanoma on targeted or immune therapy did not have enhanced organ damage after COVID-19 ( 8 ). This is similar to our findings.…”

“…Existing research focuses on the impact of chemotherapy, molecular targeted therapy, immunotherapy, etc., on the risk of severe COVID-19 and COVID-19-related death (4)(5)(6). However, there is still controversy regarding the adverse reactions related to tumor treatment after infection in patients with solid tumors, and there are few relevant reports that include data for the Omicron variant (7,8).…”