How do patients with thoracic cancers fare when they develop COVID-19? The researchers behind the TERAVOLT registry are trying to find out.

TERAVOLT investigator Alessio Cortellini, MD, of the University of L’Aquila (Italy), joined host David Henry, MD, to discuss the TERAVOLT registry and its findings, which were recently presented at the European Society for Medical Oncology Virtual Congress 2020.

What is TERAVOLT?

• TERAVOLT is an international registry of patients with thoracic cancers and COVID-19 that was launched in March 2020 by Marina Garassino, MD, of the National Cancer Institute of Milan.
• The registry enrolls patients with any solid thoracic cancer – small cell and non–small cell lung cancer, mesothelioma, thymic epithelial tumors, and other pulmonary neuroendocrine neoplasms.
• Patients are deemed to have COVID-19 if they test positive by reverse transcription–polymerase chain reaction or serology or if they have radiologic or clinical characteristics of COVID-19 and known interaction with a COVID-positive person.
• TERAVOLT website: http://teravolt-consortium.org/

TERAVOLT data at ESMO 2020

• Data presented at ESMO 2020 included 1,012 patients from 20 countries, mostly in Europe (74%) and North America (23%).
• The data encompass patient characteristics, oncologic treatment and COVID-directed therapy, and outcomes.
• In all, 32% of patients died of COVID-19.
• A multivariable model revealed several factors associated with an increased risk of mortality, including:
  • Eastern Cooperative Oncology Group (ECOG) performance status of 2 or greater (odds ratio, 3.6; P < .001)
  • Stage IV cancer (OR, 1.9; P < .001)
  • Former or current smoker (OR, 1.8; P < .01)
  • Prior steroid use (OR, 1.7; P < .01)
  • Age 65 years or older (OR, 1.5; P = .01)
  • Receiving chemotherapy or no systemic treatment versus immunotherapy, chemoimmunotherapy, or targeted therapy (OR, 1.4; P = .03)
• Espinar JB et al. ESMO 2020, Abstract LBA75. https://bit.ly/371aGIJ

A tool to predict mortality

• Based on their findings, TERAVOLT researchers developed a nomogram that can help predict mortality in patients with thoracic cancers and COVID-19.
• Patients receive points based on ECOG performance status, cancer stage, smoking habits, age, steroid use, and systemic cancer treatment.
  • For example, a 70-year-old smoker with an ECOG score of 2 who is receiving third-line treatment with docetaxel for stage IV squamous non–small cell lung cancer would have a score of 260 points, which translates to a greater than 60% risk of death.
  • A 50-year-old never-smoker with an ECOG score of 0 who is receiving first-line osimertinib for stage IV non–small cell lung cancer would have a score of 55 points, which translates to a less than 20% risk of death.

Disclosures:

Dr. Cortellini and Dr. Henry have no financial disclosures relevant to this episode.

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