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Background <p>The long-term impact of COVID-19 on cancer patients receiving immune checkpoint inhibitors (ICIs) remained unknown. This study aimed to investigate the association between COVID-19 and long-term outcomes in ICIs-treated lung cancer patients.</p> Methods <p>Three hundred eighty-one patients with advanced lung cancer who were treated with ICIs were enrolled and followed for at least 6 months in 10 medical centers in China during Omicron pandemic. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Cox model with time-dependent covariate and landmark analysis were used.</p> Results <p>The multivariable analysis showed that patients with COVID-19 had significantly worse OS (HR: 2.59 [1.58–4.26], <i>P</i> &lt; 0.001) and PFS (HR: 1.55 [1.02–2.35], <i>P</i> &lt; 0.001). In landmark analyses, COVID-19 that occurred within 3 months after initiation of ICIs was found to be associated with shorter OS (HR: 3.40 [1.70–6.77],<i> P</i> = 0.001) and PFS (HR: 3.40 [1.70–6.77], <i>P</i> = 0.02). In subgroup analysis, both mild and severe COVID-19 were associated with shorter OS (mild, HR: 2.39 [1.33–4.29], <i>P</i> = 0.004; severe, HR 4.46 [2.39–8.33], <i>P</i> &lt; 0.002) and PFS (mild, HR 1.71 [1.05–2.78], <i>P</i> = 0.03; severe, HR 3.32 [1.97–5.60], <i>P</i> &lt; 0.002). Additionally, there were no significant differences in OS or PFS among patients with varying treatment delays.</p> Conclusions <p>COVID-19 had a negative impact on the long-term outcomes of patients with lung cancer who received ICIs, particularly if the infection occurred during the first 3&#xa0;months of ICIs treatment. These findings are crucial for addressing the COVID-19 epidemic and other respiratory infectious diseases.</p>

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Long-term impact of COVID-19 in patients with lung cancer receiving immune checkpoint inhibitors: a multicenter cohort study during Omicron pandemic

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月26日

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  • Yajuan Zhang,
  • Yanlin Li,
  • Yamin Zhang,
  • Tian Zhang,
  • Miao Li,
  • Xin Yu,
  • Tongfei Wang,
  • Xiemin Feng,
  • Rui Xu,
  • Weihu Xia,
  • Hong Xu,
  • Xiaojie Song,
  • Yaning Zhao,
  • Xinli Hou,
  • Hui Wei,
  • Zhiyan Liu,
  • Ying Zan,
  • Bing Zhao,
  • Chunling Liu,
  • Xiaopeng He,
  • Xuan Liang,
  • Min Jiao,
  • Wenjuan Wang,
  • Duolao Wang,
  • Lili Jiang,
  • Baibing Mi,
  • Yixue Bai,
  • Xubo Huang,
  • Xiaohui Jia,
  • Xiaolan Fu,
  • Yuan Shen,
  • Hui Guo,
  • Mengjie Liu

摘要

Background

The long-term impact of COVID-19 on cancer patients receiving immune checkpoint inhibitors (ICIs) remained unknown. This study aimed to investigate the association between COVID-19 and long-term outcomes in ICIs-treated lung cancer patients.

Methods

Three hundred eighty-one patients with advanced lung cancer who were treated with ICIs were enrolled and followed for at least 6 months in 10 medical centers in China during Omicron pandemic. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Cox model with time-dependent covariate and landmark analysis were used.

Results

The multivariable analysis showed that patients with COVID-19 had significantly worse OS (HR: 2.59 [1.58–4.26], P < 0.001) and PFS (HR: 1.55 [1.02–2.35], P < 0.001). In landmark analyses, COVID-19 that occurred within 3 months after initiation of ICIs was found to be associated with shorter OS (HR: 3.40 [1.70–6.77], P = 0.001) and PFS (HR: 3.40 [1.70–6.77], P = 0.02). In subgroup analysis, both mild and severe COVID-19 were associated with shorter OS (mild, HR: 2.39 [1.33–4.29], P = 0.004; severe, HR 4.46 [2.39–8.33], P < 0.002) and PFS (mild, HR 1.71 [1.05–2.78], P = 0.03; severe, HR 3.32 [1.97–5.60], P < 0.002). Additionally, there were no significant differences in OS or PFS among patients with varying treatment delays.

Conclusions

COVID-19 had a negative impact on the long-term outcomes of patients with lung cancer who received ICIs, particularly if the infection occurred during the first 3 months of ICIs treatment. These findings are crucial for addressing the COVID-19 epidemic and other respiratory infectious diseases.