A multicenter, observational study to evaluate the safety of restarting antitumor therapy recovered from COVID-19

Cancer patients face a higher risk of adverse effects from coronavirus disease 2019 (COVID-19) compared to the general population. However, the safety of restarting antitumor therapy following COVID-19 recovery remains unclear.
In this prospective, multicenter study conducted between January 1 and 30 March 2023, 419 eligible cancer patients who had recovered from COVID-19 were screened across four medical centers. The primary endpoint was the incidence of treatment-emergent adverse events (TEAEs) during the first cycle of antitumor therapy resumed within 3 months after COVID-19 recovery. Changes in clinical laboratory parameters were assessed as secondary endpoints.
A total of 270 eligible participants were included in this study. The common grade 3 or worse TEAEs were fatigue (3.3%), anemia (1.1%), leukopenia (0.7%), and elevated alanine transaminase (0.3%). No severe cardiac toxicity and significant abnormalities on the chest computed tomography (CT) were observed. D-dimer and cardiac troponin I (cTNI) were significantly increased after treatment (p < 0.05). Increased inflammatory cytokines of peripheral blood could be observed after administration of oxaliplatin and trastuzumab.
Restarting systemic antitumor therapy in solid tumor patients after COVID-19 recovery is generally safe. Systemic inflammatory and coagulation function of patients should be monitored during treatment.
There have been very few studies so far that closely followed Chinese cancer patients recovering from coronavirus disease 2019 (COVID-19) to see how safe for them to restart cancer treatment. Our research, the multicenter, observational study shows that restarting treatment is generally safe, even for patients with advanced cancer. We did not observe any serious heart or lung side effects. However, we did notice increases in certain blood markers related to inflammation and clotting after treatment. These changes likely reflect the body’s response to having had COVID-19. We recommend monitoring these blood markers during treatment to keep patients safe.