Dutch Oncology COVID-19 consortium:Outcome of COVID-19 in patients with cancer in a nationwide cohort study

Aim of the study: Patients with cancer might have an increased risk for severe outcome of coronavirus disease 2019 (COVID-19). To identify risk factors associated with a worse outcome of COVID-19, a nationwide registry was developed for patients with cancer and COVID-19. Methods: This observational cohort study has been designed as a quality of care registry and is executed by the Dutch Oncology COVID-19 Consortium (DOCC), a nationwide collaboration of oncology physicians in the Netherlands. A questionnaire has been developed to collect pseudonymised patient data on patients' characteristics, cancer diagnosis and treatment. All patients with COVID-19 and a cancer diagnosis or treatment in the past 5 years are eligible. Results: Between March 27th and May 4th, 442 patients were registered. For this first analysis, 351 patients were included of whom 114 patients died. In multivariable analyses, age ≥65 years (p < 0.001), male gender (p = 0.035), prior or other malignancy (p = 0.045) and active diagnosis of haematological malignancy (p = 0.046) or lung cancer (p = 0.003) were independent risk factors for a fatal outcome of COVID-19. In a subgroup analysis of patients with active malignancy, the risk for a fatal outcome was mainly determined by tumour type (haematological malignancy or lung cancer) and age (≥65 years). Conclusion: The findings in this registry indicate that patients with a haematological malignancy or lung cancer have an increased risk of a worse outcome of COVID-19. During the ongoing COVID-19 pandemic, these vulnerable patients should avoid exposure to severe acute respiratory syndrome coronavirus 2, whereas treatment adjustments and prioritising vaccination, when available, should also be considered

Resilience in advanced cancer patients who obtain a long-term response to immunotherapy or targeted therapy:An ecological momentary assessment study

Background: Approximately half of advanced cancer patients with a long-term response to immuno- or targeted therapy (IT/TT) (ie, long-term responders (LTRs)) experience heightened distress due to persistent uncertainty. Purpose: We aimed to study to what extent supportive factors (ie, illness acceptance, tolerance of uncertainty, mindfulness, social support, optimism, emotion regulation variability, and positive affect in general and prior to a stressor) predict micro-level resilience in response to unpleasant daily life events. Methods: We conducted an observational cohort study with a baseline assessment of supportive factors, followed by Ecological Momentary Assessment with 8 assessments a day for 14 consecutive days. Resilience was operationalized as maintenance of low negative affect (NA) or a smaller increase in NA to an unpleasant event, as this suggests that partial recovery has already taken place. We used Dynamic Structural Equation Models to study supportive factors of resilience. Results: We included data from 61 patients with advanced melanoma or lung cancer with confirmed response to or long-term stable disease while on IT/TT. More unpleasant daily life events were associated with increases in NA. The multivariate model did not identify any supportive factors. Exploratory analysis using separate models tentatively indicated that LTRs with higher levels of illness acceptance, mindfulness, optimism, and general positive affect showed a smaller increase in NA in response to an unpleasant event (ie, more resilient response). Conclusions: Preliminary findings suggest that illness acceptance, mindfulness, optimism, and general positive affect are supportive factors of resilience in LTRs. Future research should include these factors at momentary level to enhance insight into the resilience process