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1.
Curr Oncol ; 28(1): 278-282, 2021 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-33419159

RESUMO

Patients with cancer are more vulnerable to severe COVID-19. As a result, routine SARS-CoV-2 testing of asymptomatic patients with cancer is recommended prior to treatment. However, there is limited evidence of its clinical usefulness. The objective of this study is to evaluate the value of routine testing of asymptomatic patients with cancer. Asymptomatic patients with cancer attending Odette Cancer Centre (Toronto, ON, Canada) were tested for SARS-CoV-2 prior to and during treatment cycles. Results were compared to positivity rates of SARS-CoV-2 locally and provincially. All 890 asymptomatic patients tested negative. Positivity rates in the province were 1.5%, in hospital were 1.0%, and among OCC's symptomatic cancer patients were 0% over the study period. Given our findings and the low SARS-CoV-2 community positivity rates, we recommend a dynamic testing model of asymptomatic patients that triggers testing during increasing community positivity rates of SARS-CoV-2.


Assuntos
Infecções Assintomáticas , Neoplasias/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Institutos de Câncer , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Ontário
2.
J Clin Invest ; 131(1)2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33216735

RESUMO

Many individuals possess B cells capable of recognizing epitopes on the spike glycoprotein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this issue of the JCI, Paschold and Simnica et al. interrogated the frequency of SARS-CoV-2-specific B cell receptor rearrangements in healthy subjects based on age and cancer status. The authors found that while SARS-CoV-2-specific antibody signatures can be identified in the repertoires of young, healthy individuals, such sequences are less frequent in elderly subjects or patients with cancer. Overall, this study sheds light on B cell repertoire restrictions that might lead to an unfavorable clinical course of coronavirus disease 2019 infection in at-risk populations.


Assuntos
Anticorpos Antivirais/imunologia , Linfócitos B/imunologia , Neoplasias/imunologia , Receptores de Antígenos de Linfócitos B/imunologia , /imunologia , Idoso , Feminino , Humanos , Masculino , Neoplasias/virologia
3.
Recent Results Cancer Res ; 217: 13-45, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33200360

RESUMO

Seven viruses including the Epstein-Barr virus (EBV), hepatitis B virus (HBV), hepatitis C virus (HCV), Kaposi's sarcoma herpes virus (KSHV), human immunodeficiency virus, type-1 (HIV-1), human T cell lymphotrophic virus, type-1 (HTLV-1), and human papillomavirus (HPV) have been classified as Group 1 human carcinogens by the International Agency for Research on Cancer (IARC). The conclusions are based on the findings of epidemiological and mechanistic studies. EBV, HPV, HTLV-1, and KSHV are direct carcinogens; HBV and HCV are indirect carcinogens through chronic inflammation; and HIV-1 is an indirect carcinogen through immune suppression. Some viruses may cause more than one cancer, while some cancers may be caused by more than one virus. However, only a proportion of persons infected by these oncogenic viruses will develop specific cancers. A series of studies have been carried out to assess the viral, host, and environmental cofactors of EBV-associated nasopharyngeal carcinoma, HBV/HCV-associated hepatocellular carcinoma, and HPV-associated cervical carcinoma. Persistent infection, high viral load, and viral genotype are important risk predictors of these virus-caused cancers. Risk calculators incorporating host and viral risk predictors have been developed for the prediction of long-term risk of hepatocellular carcinoma, nasopharyngeal carcinoma and cervical cancer. These risk calculators are useful for the triage and clinical management of infected patients. Both clinical trials and national programs of immunization, antiviral therapy and screening have demonstrated a significant reduction in the incidence of cancers caused by HBV, HCV, and HPV. Future research on gene-gene and gene-environment interactions of oncogenic viruses and the human host using large-scale longitudinal studies with serial measurements of biosignatures are in urgent need.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Neoplasias , Vírus Oncogênicos , Viroses , Carcinoma Hepatocelular/virologia , Herpesvirus Humano 4 , Humanos , Neoplasias Hepáticas/virologia , Neoplasias/virologia , Viroses/epidemiologia
4.
Recent Results Cancer Res ; 217: 325-354, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33200371

RESUMO

Hepatitis B virus (HBV), hepatitis C virus (HCV), human papilloma virus (HPV), Epstein-Barr virus (EBV), human T-cell lymphotropic virus type 1 (HTLV-1), Kaposi's sarcoma-associated herpesvirus (KSHV), and Merkel cell polyomavirus (MCV) contribute to about 10-15% global burden of human cancers. Conventional chemotherapy or molecular target therapies have been used to treat virus-associated cancers. However, a more proactive approach would be the use of antiviral treatment to suppress or eliminate viral infections to prevent the occurrence of cancer in the first place. Antiviral treatments against chronic HBV and HCV infection have achieved this goal, with significant reduction in the incidence of hepatocellular carcinoma in treated patients. Antiviral treatments for EBV, KSHV, and HTLV-1 had limited success in treating refractory EBV-associated lymphoma and post-transplant lymphoproliferative disorder, KSHV-associated Kaposi's sarcoma in AIDS patients, and HTLV-1-associated acute, chronic, and smoldering subtypes of adult T-cell lymphoma, respectively. Therapeutic HPV vaccine and RNA interference-based therapies for treating HPV-associated infection or cervical cancers also showed some encouraging results. Taken together, antiviral therapies have yielded promising results in cancer prevention and treatment. More large-scale studies in a real-world setting are necessary to confirm the efficacy of antiviral therapy. Further investigation for more effective and convenient antiviral regimens warrants more attention.


Assuntos
Antivirais , Carcinoma Hepatocelular , Herpesvirus Humano 8 , Neoplasias Hepáticas , Adulto , Antivirais/farmacologia , Antivirais/uso terapêutico , Carcinoma Hepatocelular/prevenção & controle , Carcinoma Hepatocelular/virologia , Herpesvirus Humano 4 , Humanos , Neoplasias Hepáticas/prevenção & controle , Neoplasias Hepáticas/virologia , Neoplasias/prevenção & controle , Neoplasias/virologia
5.
Oncoimmunology ; 9(1): 1857112, 2020 12 08.
Artigo em Inglês | MEDLINE | ID: mdl-33344044

RESUMO

Formyl peptide receptor 1 (FPR1) is a pattern-recognition receptor that detects bacterial as well as endogenous danger-associated molecular patterns to trigger innate immune responses by myeloid cells. A single nucleotide polymorphism, rs867228 (allelic frequency 19-20%), in the gene coding for FPR1 accelerates the manifestation of multiple carcinomas, likely due to reduced anticancer immunosurveillance secondary to a defect in antigen presentation by dendritic cells. Another polymorphism in FPR1, rs5030880 (allelic frequency 12-13%), has been involved in the resistance to plague, correlating with the fact that FPR1 is the receptor for Yersinia pestis. Driven by the reported preclinical effects of FPR1 on lung inflammation and fibrosis, we investigated whether rs867228 or rs5030880 would affect the severity of coronavirus disease-19 (COVID-19). Data obtained on patients from two different hospitals in Paris refute the hypothesis that rs867228 or rs5030880 would affect the severity of COVID-19.


Assuntos
/genética , Neoplasias/genética , Peste/genética , Receptores de Formil Peptídeo/genética , /isolamento & purificação , /epidemiologia , Feminino , Humanos , Imunidade Inata , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias/patologia , Neoplasias/virologia , Pandemias , Paris/epidemiologia , Peste/microbiologia , Peste/patologia , Polimorfismo de Nucleotídeo Único , /genética
6.
Eur J Cancer ; 141: 92-104, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33130550

RESUMO

BACKGROUND: The COVID-19 pandemic hit all over the world, and cancer patients are more vulnerable for COVID-19. The mortality rate may increase up to 25% in solid malignancies. In parallel to increased mortality rates among cancer patients, safety concerns regarding cancer treatment has increased over time. However, there were contradictory results for the cancer treatment during pandemic. In this study, we assessed the effect of cancer treatment on the severity of COVID-19. METHODS: The MEDLINE database was searched on September 01, 2020. Primary end-points were severe disease and death in the cancer patients treated within the last 30 days before COVID-19 diagnosis. Quality of included studies was assessed by Newcastle-Ottawa scale. The generic inverse-variance method was used to calculate odds ratios (ORs) for each outcome. RESULTS: Sixteen studies were included for this meta-analysis. Chemotherapy within the last thirty days before COVID-19 diagnosis increased the risk of death in cancer patients after adjusting for confounding variables (OR: 1.85; 95% confidence interval: 1.26-2.71). However, severe COVID-19 risk did not increase. Furthermore, targeted therapies, immunotherapy, surgery and radiotherapy did not increase the severe disease and death risk in cancer patients with COVID-19. CONCLUSION: Chemotherapy increased the risk of death from COVID-19 in cancer patients. However, there was no safety concern for immunotherapy, targeted therapies, surgery and radiotherapy.


Assuntos
Antineoplásicos/uso terapêutico , Neoplasias/tratamento farmacológico , Neoplasias/virologia , Antineoplásicos/farmacologia , Feminino , Humanos , Masculino , Neoplasias/mortalidade , Pandemias , Turquia/epidemiologia
7.
Eur J Cancer ; 141: 171-184, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33161241

RESUMO

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.


Assuntos
/epidemiologia , Neoplasias/epidemiologia , Neoplasias/virologia , Idoso , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias/terapia , Países Baixos/epidemiologia , Pandemias , Sistema de Registros , Fatores de Risco , Resultado do Tratamento
8.
JCO Glob Oncol ; 6: 1674-1683, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33151771

RESUMO

PURPOSE: The COVID-19 pandemic has severely affected clinical practice in oncology, leading to organizational, ethical, and medical issues. In particular, it has raised challenges in the context of competing care priorities between COVID-19 and cancer treatment. Residents on the front line face difficulties related to increasing care needs and urgent reorganization of health care systems while managing psychological stress and uncertainty. We aimed to evaluate the impact of the COVID-19 pandemic on oncology residents. METHODS AND MATERIALS: We conducted a national survey (39 questions) in France among oncology and radiation therapy residents to determine the psychological impact and professional difficulties (eg, reassignment, training/research time, supervision, teleworking, management of patients) associated with the first peak of the COVID-19 pandemic. RESULTS: Overall, 222 residents (medical oncologists, 61%; radiation therapists, 39%) participated in our survey, representing approximately one third of all residents and fellows in France. One third of respondents had been reassigned to a COVID-19 ward. Training and research activity decreased for 89% and 41% of respondents, respectively. Two thirds (70%) of respondents declared that they had faced ethical issues, 35% felt worried about their own health, and 23% experienced psychological distress. According to the Hospital Anxiety and Depression Scale, 32% were anxious and 17% depressed. Consumption of tobacco, psychostimulants, and alcohol increased in 31%, 24%, and 29% of respondents, respectively. CONCLUSION: French oncology residents were highly affected by the first peak of the COVID-19 pandemic in terms of professional activity and psychological impact. This national survey can be used as a basis for improved management, medical reorganization, and training of residents during the ongoing COVID-19 pandemic.


Assuntos
/psicologia , Oncologia/tendências , Neoplasias/psicologia , Pandemias , /complicações , /patologia , Assistência à Saúde , França/epidemiologia , Humanos , Neoplasias/complicações , Neoplasias/epidemiologia , Neoplasias/virologia , Oncologistas/psicologia , Estresse Psicológico/epidemiologia
10.
PLoS One ; 15(11): e0241225, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33196642

RESUMO

Oncology is a highly siloed field of research in which sub-disciplinary specialization has limited the amount of information shared between researchers of distinct cancer types. This can be attributed to legitimate differences in the physiology and carcinogenesis of cancers affecting distinct anatomical sites. However, underlying processes that are shared across seemingly disparate cancers probably affect prognosis. The objective of the current study is to investigate whether multitask learning improves 5-year survival cancer patient survival prediction by leveraging information across anatomically distinct HPV related cancers. Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) program database. The study cohort consisted of 29,768 primary cancer cases diagnosed in the United States between 2004 and 2015. Ten different cancer diagnoses were selected, all with a known association with HPV risk. In the analysis, the cancer diagnoses were categorized into three distinct topography groups of varying specificity. The most specific topography grouping consisted of 10 original cancer diagnoses differentiated by the first two digits of the ICD-O-3 topography code. The second topography grouping consisted of cancer diagnoses categorized into six distinct organ groups. Finally, the third topography grouping consisted of just two groups, head-neck cancers and ano-genital cancers. The tasks were to predict 5-year survival for patients within the different topography groups using 14 predictive features which were selected among descriptive variables available in the SEER database. The information from the predictive features was shared between tasks in three different ways, resulting in three distinct predictive models: 1) Information was not shared between patients assigned to different tasks (single task learning); 2) Information was shared between all patients, regardless of task (pooled model); 3) Only relevant information was shared between patients grouped to different tasks (multitask learning). Prediction performance was evaluated with Brier scores. All three models were evaluated against one another on each of the three distinct topography-defined tasks. The results showed that multitask classifiers achieved relative improvement for the majority of the scenarios studied compared to single task learning and pooled baseline methods. In this study, we have demonstrated that sharing information among anatomically distinct cancer types can lead to improved predictive survival models.


Assuntos
Aprendizagem , Comportamento Multitarefa , Neoplasias/mortalidade , Neoplasias/virologia , Infecções por Papillomavirus/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Programa de SEER , Tamanho da Amostra , Análise de Sobrevida , Adulto Jovem
11.
In Vivo ; 34(6): 3731-3734, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33144491

RESUMO

BACKGROUND/AIM: In 2020, because of coronavirus pandemic, medical activities changed. The aim of this report is to compare the volumes of Pisa radiotherapy activities from March 9th to May 31st, 2020, with the same period in 2019. PATIENTS AND METHODS: We analyzed the activity of our Unit to evaluate how logistics changes, related to the COVID-19 epidemic, impacted on volumes of radiotherapy (RT) activity and on the number of cases of COVID-19 infections observed in healthcare professionals and patients. RESULTS: The total number of first-time visits between March-May 2020 was reduced by 18%, probably due to delays in diagnosis and histological tests as well as the temporary closure of the operating rooms. None of the healthcare professionals and only two patients contracted the infection. CONCLUSION: We were able to treat all patients referred to our hospital and we were able to reduce risk of infection for both our patients and healthcare staff, guaranteeing continuum of care for our oncological patients.


Assuntos
Infecções por Coronavirus/radioterapia , Neoplasias/radioterapia , Pandemias , Pneumonia Viral/radioterapia , Betacoronavirus/patogenicidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Feminino , Humanos , Masculino , Neoplasias/complicações , Neoplasias/epidemiologia , Neoplasias/virologia , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia
12.
Cancer Treat Res Commun ; 25: 100214, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33038570

RESUMO

During this COVID-19 pandemic, patients with symptoms such as fever, cough, sore throat, and coryza were advised to have RT-PCR testing for SARS-CoV-2 infection. We described here an elderly female with chronic lymphocytic leukemia, who presented with atypical symptoms that were not directly attributable to COVID-19. This patient was admitted to the non-COVID-19 ward for supportive care. Later, her chest x-ray revealed pneumonia that was confirmed to be COVID-19 by RT-PCR testing several days later. In resource-poor settings where molecular testing results suffered from delays or were altogether unavailable, the use of diagnostic imaging such as a chest x-ray could serve as a quick guide in the assessment and management of these patients especially if the imaging results suggest COVID-19 infection.


Assuntos
/diagnóstico , Leucemia Linfocítica Crônica de Células B/diagnóstico por imagem , Neoplasias/diagnóstico , Faringite/diagnóstico , /complicações , /virologia , Tosse/complicações , Tosse/diagnóstico , Tosse/diagnóstico por imagem , Tosse/virologia , Feminino , Humanos , Leucemia Linfocítica Crônica de Células B/complicações , Leucemia Linfocítica Crônica de Células B/diagnóstico , Leucemia Linfocítica Crônica de Células B/virologia , Neoplasias/complicações , Neoplasias/diagnóstico por imagem , Neoplasias/virologia , Pandemias , Faringite/complicações , Faringite/diagnóstico por imagem , Faringite/virologia , Raios X
13.
Cancer Cell ; 38(5): 598-601, 2020 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-33038939

RESUMO

During the COVID-19 pandemic, research on "cytokine storms" has been reinvigorated in the field of infectious disease, but it also has particular relevance to cancer research. Interleukin-6 (IL-6) has emerged as a key component of the immune response to SARS-CoV-2, such that the repurposing of anti-IL-6 therapeutics for COVID-19 is now a major line of investigation, with several ongoing clinical trials. We lay a framework for understanding the role of IL-6 in the context of cancer research and COVID-19 and suggest how lessons learned from cancer research may impact SARS-CoV-2 research and vice versa.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/complicações , Citocinas/sangue , Inflamação/etiologia , Neoplasias/imunologia , Pneumonia Viral/complicações , Índice de Gravidade de Doença , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Citocinas/imunologia , Humanos , Inflamação/patologia , Neoplasias/sangue , Neoplasias/virologia , Pandemias , Pneumonia Viral/imunologia , Pneumonia Viral/virologia
14.
Cancer Cell ; 38(5): 629-646, 2020 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-33049215

RESUMO

Patients with cancer have been disproportionately affected by the COVID-19 pandemic. This effect has included the adverse outcomes in patients with cancer who develop COVID-19, the impact of the COVID-19 pandemic on the delivery of cancer care, and the severe disruption to cancer research. However, patients with cancer are a heterogeneous population, and recent studies have now documented factors that allow risk stratification of patients with cancer in order to optimize care. In this review, we highlight data at the intersection of COVID-19 and cancer, including the biological interplay between the two diseases and practical recommendations for the treatment of patients with cancer during the pandemic. We additionally discuss the potential long-lasting impact of the pandemic on cancer care due to its deleterious effect on cancer research, as well as biological insights from the cancer research community that could help develop novel therapies for all patients with COVID-19.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Assistência à Saúde/normas , Neoplasias/terapia , Pneumonia Viral/complicações , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Humanos , Neoplasias/epidemiologia , Neoplasias/virologia , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
16.
Cancer Cell ; 38(5): 605-608, 2020 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-33098754

RESUMO

Countries in Latin America and the Caribbean have become hotspots of the novel coronavirus (COVID-19) pandemic, exacerbating socioeconomic inequalities and overwhelming fragmented health systems. Studies from the United States and Europe have highlighted the disproportionate effects of COVID-19 on patients with cancer and the disruption it has caused on cancer care delivery. The HOLA COVID-19 Study aims to understand how cancer care in Latin American countries has been affected by the COVID-19 pandemic.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Assistência à Saúde/estatística & dados numéricos , Assistência à Saúde/tendências , Neoplasias/terapia , Pneumonia Viral/complicações , Guias de Prática Clínica como Assunto/normas , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Humanos , Cooperação Internacional , América Latina/epidemiologia , Neoplasias/epidemiologia , Neoplasias/virologia , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
17.
PLoS Pathog ; 16(10): e1008849, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33002095

RESUMO

Epstein-Barr virus (EBV) causes lymphomas and epithelial cell cancers. Though generally silent in B lymphocytes, this widely prevalent virus can cause endemic Burkitt lymphoma and post-transplant lymphoproliferative disorders/lymphomas in immunocompromised hosts. By learning how EBV breaches barriers to cell proliferation, we hope to undermine those strategies to treat EBV lymphomas and potentially other cancers. We had previously found that EBV, through activation of cellular STAT3 prevents phosphorylation of Chk1, and thereby, suppresses activation of the intra-S phase cell-cycle checkpoint, a potent barrier to oncogene-driven proliferation. This observation prompted us to examine the consequences on DNA repair since homologous recombination repair, the most error-free form, requires phosphoChk1. We now report that the defect in Chk1 phosphorylation also curtails RAD51 nucleation, and thereby, homologous recombination repair of DNA double strand breaks. The resulting reliance on error-prone microhomology-mediated end-joining (MMEJ) repair makes EBV-transformed cells susceptible to PARP inhibition and simultaneous accrual of genome-wide deletions and insertions resulting from synthesis-dependent MMEJ. Analysis of transcriptomic and drug susceptibility data from hundreds of cancer lines reveals a STAT3-dependent gene-set predictive of susceptibility of cancers to synthetic lethal PARP inhibition. These findings i) demonstrate how the tumor virus EBV re-shapes cellular DNA repair, ii) provide the first genome-wide evidence for insertions resulting from MMEJ in human cells, and iii) expand the range of cancers (EBV-related and -unrelated) that are likely to respond to synthetic lethal inhibitors given the high prevalence of cancers with constitutively active STAT3.


Assuntos
Linfócitos B/virologia , Proteína BRCA1/metabolismo , Proteína BRCA2/metabolismo , Quebras de DNA de Cadeia Dupla , Infecções por Vírus Epstein-Barr/virologia , Reparo de DNA por Recombinação , Fator de Transcrição STAT3/metabolismo , Adolescente , Adulto , Linfócitos B/citologia , Linfócitos B/metabolismo , Proteína BRCA1/genética , Proteína BRCA2/genética , Linfoma de Burkitt/genética , Linfoma de Burkitt/patologia , Linfoma de Burkitt/virologia , Proliferação de Células , Reparo do DNA por Junção de Extremidades , Infecções por Vírus Epstein-Barr/genética , Infecções por Vírus Epstein-Barr/metabolismo , Herpesvirus Humano 4/isolamento & purificação , Humanos , Neoplasias/genética , Neoplasias/patologia , Neoplasias/virologia , Fosforilação , Fator de Transcrição STAT3/genética , Adulto Jovem
18.
Eur J Cancer ; 141: 62-81, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33129039

RESUMO

BACKGROUND: Cancer patients are thought to have an increased risk of developing severe Coronavirus Disease 2019 (COVID-19) infection and of dying from the disease. In this work, predictive factors for COVID-19 severity and mortality in cancer patients were investigated. PATIENTS AND METHODS: In this large nationwide retro-prospective cohort study, we collected data on patients with solid tumours and COVID-19 diagnosed between March 1 and 11th June 2020. The primary end-point was all-cause mortality and COVID-19 severity, defined as admission to an intensive care unit (ICU) and/or mechanical ventilation and/or death, was one of the secondary end-points. RESULTS: From April 4 to 11th June 2020, 1289 patients were analysed. The most frequent cancers were digestive and thoracic. Altogether, 424 (33%) patients had a severe form of COVID-19 and 370 (29%) patients died. In multivariate analysis, independent factors associated with death were male sex (odds ratio 1.73, 95%CI: 1.18-2.52), The Eastern Cooperative Oncology Group Performance Scale (ECOG PS) ≥ 2 (OR 3.23, 95%CI: 2.27-4.61), updated Charlson comorbidity index (OR 1.08, 95%CI: 1.01-1.16) and admission to ICU (OR 3.62, 95%CI 2.14-6.11). The same factors, age along with corticosteroids before COVID-19 diagnosis, and thoracic primary tumour site were independently associated with COVID-19 severity. None of the anticancer treatments administered within the previous 3 months had any effect on mortality or COVID-19 severity, except for cytotoxic chemotherapy in the subgroup of patients with detectable severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcriptase polymerase chain reaction (RT-PCR), which was associated with a slight increase of the risk of death (OR 1.53; 95%CI: 1.00-2.34; p = 0.05). A total of 431 (39%) patients had their systemic anticancer treatment (such as chemotherapy, targeted or immune therapy) interrupted or stopped following diagnosis of COVID-19. CONCLUSIONS: Mortality and COVID-19 severity in cancer patients are high and are associated with general characteristics of patients. We found no deleterious effects of recent anticancer treatments, except for cytotoxic chemotherapy in the RT-PCR-confirmed subgroup of patients. In almost 40% of patients, the systemic anticancer therapy was interrupted or stopped after COVID-19 diagnosis.


Assuntos
/mortalidade , Neoplasias/mortalidade , Neoplasias/virologia , Idoso , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Estudos de Coortes , Feminino , França/epidemiologia , Humanos , Masculino , Neoplasias/terapia , Pandemias , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , /isolamento & purificação
19.
Acta Gastroenterol Belg ; 83(3): 426-431, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33094590

RESUMO

PURPOSE: The prevalence of hepatitis B virus (HBV) reacti- vation in HBsAg-negative/anti-HBc-positive patients receiving chemotherapy for solid tumors is not fully known. The aim of this study was to investigate the incidence and outcomes of HBV reactivation in these patients. METHODS: Data among 645 HBsAg-negative/ anti-HBc-positive patients who underwent intravenous chemotherapy were retrospectively analyzed. Patients were categorized into two groups, based on received antiviral prophylaxis (n = 43) or not (n = 602). HBV reactivation was defined as the presence of detectable serum HBV DNA or HBsAg seroconversion from negative to positive, with or without increased liver enzymes. RESULTS: HBV reactivation was detected in 3 patients (0.49%) among non-antiviral prophylaxis group and in none of those with antiviral prophylaxis. Two of the HBV reactivation detected patients were successfully treated with rescue therapy, while the third died due to liver failure. CONCLUSIONS: HBV reactivation is rare in HBsAg-negative and anti-HBc-positive patients receiving chemotherapy for solid tumors. However, considering the fatal outcomes patients must be closely monitored in terms of HBV-DNA positivity and/or HBsAg seroreversion and pre-emptive antiviral therapy must be initiated as soon as HBV reactivation occurs.


Assuntos
Hepatite B , Neoplasias , Ativação Viral , Antineoplásicos/uso terapêutico , Hepatite B/complicações , Hepatite B/tratamento farmacológico , Hepatite B/epidemiologia , Antígenos de Superfície da Hepatite B/imunologia , Humanos , Neoplasias/tratamento farmacológico , Neoplasias/virologia , Estudos Retrospectivos
20.
Eur J Cancer ; 140: 86-104, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33068941

RESUMO

Since its first detection in China in late 2019 the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated infectious disease COVID-19 continue to have a major impact on global healthcare and clinical practice. Cancer patients, in particular those with haematological malignancies, seem to be at an increased risk for a severe course of infection. Deliberations to avoid or defer potentially immunosuppressive therapies in these patients need to be balanced against the overarching goal of providing optimal antineoplastic treatment. This poses a unique challenge to treating physicians. This guideline provides evidence-based recommendations regarding prevention, diagnostics and treatment of SARS-CoV-2 infection and COVID-19 as well as strategies towards safe antineoplastic care during the COVID-19 pandemic. It was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO) by critically reviewing the currently available data on SARS-CoV-2 and COVID-19 in cancer patients applying evidence-based medicine criteria.


Assuntos
Antineoplásicos/uso terapêutico , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Assistência à Saúde/normas , Prática Clínica Baseada em Evidências/normas , Neoplasias/tratamento farmacológico , Pneumonia Viral/complicações , Guias de Prática Clínica como Assunto/normas , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Gerenciamento Clínico , Alemanha/epidemiologia , Humanos , Neoplasias/epidemiologia , Neoplasias/virologia , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Prognóstico , Sociedades Médicas
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