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Women receiving standard treatment in New York City for ovarian, uterine, and cervical cancers are not at increased risk of being hospitalized for or dying from COVID-19 due to their cancer, a new study shows. The researchers found that neither having cancer nor receiving treatment for it, which can come with its own toxicities, worsened COVID-19 disease outcomes.
Led by researchers at NYU Langone’s Perlmutter Cancer Center and NYU Grossman School of Medicine, the study showed that 121 women, ages 51 to 63, who were receiving standard treatments for such malignancies and who contracted the pandemic coronavirus had similar rates of hospitalization and death as those who only had COVID-19.
Publishing in the journal Cancer online July 31, the study showed that 54 percent of the women (66 of 121) required hospitalization and among these, 25 percent (17 of 66) died, for an overall death rate of 14 percent. This is comparable to the results of another study, which showed a 21 percent death rate among all 5,700 hospitalized patients with COVID-19 in the city, who were mostly male (60 percent) and at greater risk of the disease, researchers say.
Having late-stage gynecologic cancer, cancer surgery, or high-dose chemotherapy also did not increase a woman’s risk of dying from COVID-19.
Importantly, the work also found that 75 percent of gynecologic cancer patients with COVID-19 had a mild form of the disease and recovered from their infection.
“Our study should be reassuring for women with gynecologic cancers who are worried that having cancer increases their risk of becoming seriously ill if they go to the hospital because of COVID-19,” says study lead investigator Olivia Lara, MD, an oncology fellow in the Department of Obstetrics and Gynecology at Perlmutter. These patients already contend with increased inflammation and imbalanced immune systems that, in theory, coronavirus infection could make worse.
“Women with gynecologic cancers have the same risk factors for dying from COVID-19 as women without these cancers,” says study senior investigator Bhavana Pothuri, MD, MS, a professor in the Department of Obstetrics and Gynecology at Perlmutter.
These shared risk factors, she says, which overall double women’s risk of dying from COVID-19, are being African-American or having two or more underlying health conditions, such as hypertension, obesity, and diabetes.
As part of the study, researchers reviewed the medical records of women treated for both COVID-19 and gynecologic cancer at area hospitals between March 1 and April 22, 2020. These included NYU Langone’s Perlmutter Cancer Center, NYC Health + Hospitals Bellevue Hospital, Memorial Sloan-Kettering Cancer Center, Columbia University Medical Center, SUNY Downstate Medical Center, and the Montefiore Medical System.
Another study finding was that a small number (eight of 121) of participants receiving immunotherapy, drugs that harness the immune system to attack cancer cells, were three times more likely to die than women who were receiving standard radiation, surgery, chemotherapy, or a combination of these therapies. However, Pothuri cautions that the number of women receiving immunotherapy was not large enough to lead to any firm recommendations about clinical care. (or to result in any firm conclusions about clinical care)
Pothuri says the team has plans to analyze patient records for further insights into any factors that might lessen the impact of these underlying risk factors for COVID-19 on women with cancer, including how best to communicate with local community groups.
For now, Pothuri says, women should definitely not put off screening, diagnosis, or treatment of new cancers out of any additional fear they have about the risks from COVID-19. “The basic rules of cancer care have not changed during the pandemic,” she says. “Early detection, screening, and care lead to more people surviving what remains a leading cause of death among American women.”
Funding support for the study was provided by participating hospitals. Pothuri has participated in other research projects sponsored by various manufacturers of cancer drugs and has also served on advisory boards to Tesaro, now part of GlaxoSmithKline; AstraZeneca; Merck; Genentech, now part of the Roche Group; Clovis Oncology, and Eisai. All of these arrangements are being managed in accordance with the policies and practices of NYU Langone.
Besides Lara and Pothuri, other NYU Langone researchers involved in the study are Maria Smith, BS; Megan Sutter, Ph.D.; and Julia Fehniger, MD. Additional research support was provided by study co-investigators Roisin O’Cearbhaill, MD; and Justin Jee, MD, Ph.D., at Memorial Sloan-Kettering Cancer Center; Anne Knisely, MD; and Jason Wright, MD, at Columbia University; Jennifer McEachron, MD; and Yi-Chun Lee, MD, at the State University of New York; and Sara Isani, MD; and Lisa Gabor, MD, at Albert Einstein College of Medicine.