Background: Overall, patients with cancer experience a greater risk of adverse outcomes following SARS-CoV-2 infection; however, little is known for those with BC.

Methods: CCC19 (NCT04354701) is an international cohort study aimed at investigating the impact of COVID-19 in patients with a history of or active cancer using de-identified data on patient demographics, cancer history, clinical course and outcomes of COVID-19. The current analysis includes patients from U.S. and Canada with invasive BC and laboratory-confirmed SARS-CoV-2 entered between March 17, 2020 and July 2, 2020. Co-primary outcomes were hospitalization during COVID-19 illness and 30-day all-cause mortality. Frequencies for categorical variables and medians (range) for continuous variables were estimated. Final presentation will include bivariable and multivariable Cox proportional hazards regression analysis to identify risk factors (including BC subtypes and therapies, for which data collection is ongoing) associated with 30-day all-cause mortality and severe COVID-19 illness (composite of any hospitalization requiring supplemental oxygen, admission to an intensive care unit [ICU], use of mechanical ventilation, or death).

Results: During the study period, a total of 2683 patients with cancer and COVID-19 were accrued in the CCC19 registry including 529 (20%) with invasive BC. Among patients with BC, 352 (67%) were 60 years or older; 518 (98%) were women; 275 (52%) non-Hispanic White, 116 (22%) non-Hispanic Black, 70 (13%) Hispanic, 56 (11%) in other categorizations; 178 (34%) had a smoking history; 75 (14%) ECOG performance status ≥2; 191 (36%) with >2 active comorbidities; 64 (12%) with AJCC stage IV disease at BC diagnosis; and 267 (50%) were on anti-cancer treatment including systemic therapy, radiation, or surgery within 3 months of COVID-19 diagnosis. At least 323 (61%) patients with BC had 30-day follow-up after COVID-19 diagnosis, and 35 (7%) had 90-day follow-up. COVID-19 illness at initial diagnosis required outpatient care in 288 (54%), inpatient care in 193 (36%), and ICU care in 40 (8%). Overall, 247 (47%) were hospitalized and 30-day all-cause mortality was 9%. 30-day all-cause mortality rates by receipt of major BC treatment modalities (within past 3 months) were: 10% for those on cytotoxic systemic therapy vs 5% and 12% for noncytotoxic systemic therapy and local therapy, respectively. The table shows hospitalization and mortality outcomes by major demographic and BC treatment strata. The final presentation will incorporate the latest patient accrual and evaluate independent clinical risk factors associated with serious COVID-19 outcomes in patients with BC.

Conclusions: This represents the largest study to date of COVID-19 outcomes in patients with invasive BC. Nearly half of the patients with BC required hospitalization during their COVID-19 disease course and we observed a 9% 30-day all-cause mortality.

Submitted on behalf of the COVID-19 and Cancer Consortium (ccc19us.org)

Table 1. COVID-19 related hospitalization and 30-day all-cause mortality for all patients with invasive BC

NAny Hospitalization30-day all-cause Mortality
N% [95% CI]N% [95% CI]
Total population 529 247 47 [42-51] 49 9 [7-12] 
Age      
<60 177 44 25 [19-32] 2 1 [0-4] 
60-69 115 51 44 [35-54] 8 7 [3-13] 
70-79 120 66 55 [46-64] 17 14 [8-22] 
80+ 117 86 74 [65-81] 22 19 [12-27] 
ECOG PS      
0-1 322 122 38 [33-43] 16 5 [3-8] 
2+ 75 61 81 [71-89] 16 21 [13-32] 
Active Comorbidities      
0 74 10 14 [7-23] 0 0 [0-5] 
1-2 223 94 42 [36-49] 17 8 [5-12] 
>2 191 129 68 [60-74] 29 15 [10-21] 
Treatment Intent     
Curative 186 64 34 [28-42] 9 5 [2-9] 
Palliative 74 39 53 [41-64] 12 16 [9-27] 
Cancer Status      
Remission/NED 331 154 47 [41-52] 24 7 [5-11] 
Active disease, stable or responding to treatment 119 48 40 [31-50] 7 6 [2-12] 
Active disease, progressing 37 27 73 [56-86] 11 30 [16-47] 
Treatment Modality (within 3 months)     
Cytotoxic chemotherapy 83 35 42 [31-54] 8 10 [4-18] 
Noncytotoxic therapy 185 64 35 [28-42] 10 5 [3-10] 
Local therapy (surgery or radiation) 34 17 50 [32-68] 4 12 [3-27] 
NAny Hospitalization30-day all-cause Mortality
N% [95% CI]N% [95% CI]
Total population 529 247 47 [42-51] 49 9 [7-12] 
Age      
<60 177 44 25 [19-32] 2 1 [0-4] 
60-69 115 51 44 [35-54] 8 7 [3-13] 
70-79 120 66 55 [46-64] 17 14 [8-22] 
80+ 117 86 74 [65-81] 22 19 [12-27] 
ECOG PS      
0-1 322 122 38 [33-43] 16 5 [3-8] 
2+ 75 61 81 [71-89] 16 21 [13-32] 
Active Comorbidities      
0 74 10 14 [7-23] 0 0 [0-5] 
1-2 223 94 42 [36-49] 17 8 [5-12] 
>2 191 129 68 [60-74] 29 15 [10-21] 
Treatment Intent     
Curative 186 64 34 [28-42] 9 5 [2-9] 
Palliative 74 39 53 [41-64] 12 16 [9-27] 
Cancer Status      
Remission/NED 331 154 47 [41-52] 24 7 [5-11] 
Active disease, stable or responding to treatment 119 48 40 [31-50] 7 6 [2-12] 
Active disease, progressing 37 27 73 [56-86] 11 30 [16-47] 
Treatment Modality (within 3 months)     
Cytotoxic chemotherapy 83 35 42 [31-54] 8 10 [4-18] 
Noncytotoxic therapy 185 64 35 [28-42] 10 5 [3-10] 
Local therapy (surgery or radiation) 34 17 50 [32-68] 4 12 [3-27] 
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Citation Format: Ali Raza Khaki, Dimpy P Shah, Maryam B Lustberg, Melissa K Accordino, Daniel G Stover, Gayathri Nagaraj, Donna R Rivera, Edith A Perez, Sara M Tolaney, Jeffrey Peppercorn, Petros Grivas, Jeremy L Warner, Corrie A Painter, Gilberto de Lima Lopes, Jr, Solange Peters, Michael A Thompson, Toni K Choueiri, Brian I Rini, Gary H Lyman, Nicole M Kuderer, Shaveta Vinayak. Characteristics and outcomes of SARS-CoV-2 infection in patients with invasive breast cancer (BC) from the COVID-19 and cancer consortium (CCC19) cohort study [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-01.

©2021 American Association for Cancer Research.
2021
American Association for Cancer Research.