BioChem - DOS

Clinical outcomes of coronavirus disease in patients with breast cancer treated with granulocyte colony-stimulating factor following chemotherapy: Triangulation of evidence using population-based cohort and Mendelian randomization analyses

International journal of cancer: Journal international du cancer

Wang, Yali; Cai, Weifeng; He, Peng; Cai, Qindong; Huang, Jinhua; Liu, Shougui; Chen, Minyan; Chen, Lili; Lin, Yuxiang; Hou, Jialin; Li, Jing; Fu, Chengbin; Han, Zhonghua; Han, Hui; Lin, Shunguo; Xu, Chunsen; Fu, Fangmeng; Wang, Chuan

<P><B>Abstract</B><P>Recombinant human granulocyte colony&#x2010;stimulating factor (G&#x2010;CSF) administration in patients with cancer and coronavirus disease (COVID&#x2010;19) remains controversial. Concerns exist that it may worsen COVID&#x2010;19 outcomes by triggering an inflammatory cytokine storm, despite its common use for managing chemotherapy&#x2010;induced neutropenia (CIN) or febrile neutropenia post&#x2010;chemotherapy. Here, we determined whether prophylactic or therapeutic G&#x2010;CSF administration following chemotherapy exacerbates COVID&#x2010;19 progression to severe/critical conditions in breast cancer patients with COVID&#x2010;19. Between December 2022 and February 2023, all 503 enrolled breast cancer patients had concurrent COVID&#x2010;19 and received G&#x2010;CSF post&#x2010;chemotherapy, with most being vaccinated pre&#x2010;chemotherapy. We prospectively observed COVID&#x2010;19&#x2010;related adverse outcomes, conducted association analyses, and subsequently performed Mendelian randomization (MR) analyses to validate the causal effect of genetically predicted G&#x2010;CSF or its associated granulocyte traits on COVID&#x2010;19 adverse outcomes. Only 0.99% (5/503) of breast cancer patients experienced COVID&#x2010;19&#x2010;related hospitalization following prophylactic or therapeutic G&#x2010;CSF administration after chemotherapy. No mortality or progression to severe/critical COVID&#x2010;19 occurred after G&#x2010;CSF administration. Notably, no significant associations were observed between the application, dosage, or response to G&#x2010;CSF and COVID&#x2010;19&#x2010;related hospitalization (all <I>p</I> >.05). Similarly, the MR analyses showed no evidence of causality of genetically predicted G&#x2010;CSF or related granulocyte traits on COVID&#x2010;19&#x2010;related hospitalization or COVID&#x2010;19 severity (all <I>p</I> >.05). There is insufficient evidence to substantiate the notion that the prophylactic or therapeutic administration of G&#x2010;CSF after chemotherapy for managing CIN in patients with breast cancer and COVID&#x2010;19 would worsen COVID&#x2010;19 outcomes, leading to severe or critical conditions, or even death, especially considering the context of COVID&#x2010;19 vaccination.</P></P>

2024

Wiley (John WileySons)

0020-7136

1097-0215

155

3

pp.545-557

10.1002/ijc.34914

http://click.ndsl.kr/servlet/OpenAPIDetailView?keyValue=05787966&target=NART&cn=NART130435350