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Old 01-19-2022, 02:40 PM   #1
Nguyen
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covid infection and cancer patients ...

Note the content in below links likely to change every few months, sometime more often.

The COVID-19 Treatment Guidelines Panel's Statement on Therapies for High-Risk, Nonhospitalized Patients With Mild to Moderate COVID-19

https://www.covid19treatmentguidelin...very&utm_term=

When To Go to the Hospital for COVID 19

https://www.stlukesonline.org/health...l-for-covid-19
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Old 04-08-2022, 01:59 PM   #2
Nguyen
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Breakthrough SARS-CoV-2 Infections, Hospitalizations, and Mortality in Vaccinated Pat

With the arrival of Delta, Omicron, and their variants, lots of covid treatments have changed with the latest occurs just today. People should be aware (see link in first post) of it and to keep their PCP update just in case.

Nguyen


Breakthrough SARS-CoV-2 Infections, Hospitalizations, and Mortality in Vaccinated Patients With Cancer in the US Between December 2020 and November 2021


https://jamanetwork.com/journals/jam...stract/2791076


Abstract

Importance Limited data have been presented to examine breakthrough SARS-CoV-2 infections, hospitalizations, and mortality in vaccinated patients with cancer in the US.

Objectives To examine the risk of breakthrough SARS-CoV-2 infection, hospitalizations, and mortality in vaccinated patients with cancer between December 2020 and November 2021.

Design, Setting, and Participants Retrospective cohort study of electronic health records (EHRs) of vaccinated patients from a multicenter and nationwide database in the US during the period of December 2020 through November 2021. The study population comprised patients who had documented evidence of vaccination (2 doses of Moderna or Pfizer-BioNTech or single dose of Janssen/Johnson & Johnson vaccines) in their EHRs from December 2020 to November 2021 and had no SARS-CoV-2 infection prior to vaccination.

Exposures The 12 most common cancers combined and separately; recent vs no recent encounter for cancer; and breakthrough SARS-CoV-2 infection.

Main Outcomes and Measures Time trends of incidence proportions of breakthrough SARS-CoV-2 infections from December 2020 to November 2021 in vaccinated patients with all cancer; cumulative risks of breakthrough infections in vaccinated patients for all cancer and 12 common cancer types; hazard ratios (HRs) and 95% CIs of breakthrough infections between propensity score–matched patients with vs without cancer and between propensity score–matched patients with cancer who had a recent medical encounter for cancer vs those who did not; overall risks, HRs, and 95% CIs of hospitalizations and mortality in patients with cancer who had breakthrough infections vs those who did not.

Results Among 45 253 vaccinated patients with cancer (mean [SD] age, 68.7 [12.4] years), 53.5% were female, 3.8% were Asian individuals, 15.4% were Black individuals, 4.9% were Hispanic individuals, and 74.1% were White individuals. Breakthrough SARS-CoV-2 infections in patients with cancer increased from December 2020 to November 2021 and reached 52.1 new cases per 1000 persons in November 2021. The cumulative risk of breakthrough infections in patients with all cancer was 13.6%, with highest risk for pancreatic (24.7%), liver (22.8%), lung (20.4%), and colorectal (17.5%) cancers, and lowest risk for thyroid (10.3%), endometrial (11.9%), and breast (11.9%) cancers, vs 4.9% in the noncancer population (P < .001). Patients with cancer had significantly increased risk for breakthrough infections vs patients without cancer (HR, 1.24; 95% CI, 1.19-1.29), with greatest risk for liver (HR, 1.78; 95% CI, 1.38-2.29), lung (HR, 1.73; 95% CI, 1.50-1.99), pancreatic (HR, 1.64; 95% CI, 1.24-2.18), and colorectal (HR, 1.53; 95% CI, 1.32-1.77) cancers and lowest risk for thyroid (HR, 1.07; 95% CI, 0.88-1.30) and skin (HR, 1.17; 95% CI, 0.99-1.38) cancers. Patients who had medical encounters for cancer within the past year had higher risk for breakthrough infections than those who did not (HR, 1.24; 95% CI, 1.18-1.31). Among patients with cancer, the overall risk for hospitalizations and mortality was 31.6% and 3.9%, respectively, in patients with breakthrough infections, vs 6.7% and 1.3% in those without breakthrough infections (HR for hospitalization: 13.48; 95% CI, 11.42-15.91; HR for mortality: 6.76; 95% CI, 4.97-9.20).

Conclusions and Relevance This cohort study showed significantly increased risks for breakthrough infection in vaccinated patients with cancer, especially those undergoing active cancer care, with marked heterogeneity among specific cancer types. Breakthrough infections in patients with cancer were associated with significant and substantial risks for hospitalizations and mortality.
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Old 04-21-2022, 10:52 AM   #3
Nguyen
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Re: covid infection and cancer patients ...

Happen to run across an article that shows un-expected anti-tumor effect (via bone microenvironment) of CDK4/6 inhibitor particularly abemaciclib. This might explained (in addition to denosumab) why tumors in my wife bone’s met are stabled while those in the lung are not. Looking a little deeper I noticed CDK4/6 drugs are metabolized by enzyme CYP3A4.

When Paxlovid first came out, I read up on its mechanism of action and noticed that ritonavir (paxlovid composes of ritonavir and nirvatravir) “uses” CYP3A4 pathway. So I am almost certain that if you are on CDK4/6 inhibitor (abemaciclib, palpociclib, ribociclib), be sure to discuss this possible drug interaction with your doctor if needing to use Paxlovid.

Nguyen
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Old 04-21-2022, 11:17 PM   #4
donocco
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Re: covid infection and cancer patients ...

Nguyen

I thought this forum was closed down. maybe it was just google. If you will mail the link to donocco5w4@aol.com. I may not be able to find it again

Paul
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Old 04-22-2022, 07:14 PM   #5
Nguyen
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Re: covid infection and cancer patients ...

I found drugs interaction sites, www.drugs.com, medscape.com, and webmd.com. All 3's confirm interaction between Paxlovid and Abemaciclib. But only drugs.com shows interaction between Paxlovid and ribociclib or palpociclib.
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Old 09-23-2022, 09:46 AM   #6
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Long covid—an update for primary care

Useful to know in case one needs it. Keep in mind a number of extremely overwork exhausted physicians could not keep up with the latest.

https://www.bmj.com/content/bmj/378/...72117.full.pdf
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Old 12-29-2022, 09:52 PM   #7
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Association of COVID-19 Vaccination With Breakthrough Infections and Complications in

Association of COVID-19 Vaccination With Breakthrough Infections and Complications in Patients With Cancer



https://jamanetwork.com/journals/jam...rticle/2800127

Key Points

Question What is the outcome of COVID-19 vaccination in patients with hematologic and solid cancer?

Findings In this cohort study of 289 400 vaccinated patients with cancer and 1 157 600 matched noncancer controls, patients with cancer had significantly higher risk of breakthrough SARS-CoV-2 infection and COVID-19 outcomes including hospitalization and death; the risk was substantial for patients with hematologic cancer and patients with solid cancer receiving active chemotherapy. A third vaccine dose was associated with lower risk of infection and severe outcomes.

Meaning Patients receiving cancer treatment and patients with hematologic cancer, regardless of treatment status, should be prioritized for booster vaccination, preexposure prophylaxis, and, in the event of SARS-CoV-2 infection, early antiviral therapy.
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Old 02-02-2023, 02:23 PM   #8
Nguyen
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Tumor marker response to SARS-CoV-2 infection among patients with cancer

Tumor marker response to SARS-CoV-2 infection among patients with cancer

https://onlinelibrary.wiley.com/doi/...1002/cam4.4646


Abstract
Background

Inflammatory responses from benign conditions can cause non-cancer-related elevations in tumor markers. The severe acute respiratory coronavirus 2 (SARS-CoV-2) induces a distinct viral inflammatory response, resulting in coronavirus disease 2019 (COVID-19). Clinical data suggest carcinoembryonic antigen (CEA), carbohydrate antigen 19–9 (CA 19–9), and cancer antigen 125 (CA 125) levels might rise in patients with COVID-19. However, available data excludes cancer patients, so little is known about the effect of COVID-19 on tumor markers among cancer patients.

Methods

We conducted a case series and identified patients with a positive SARS-CoV-2 PCR test, diagnosis of a solid tumor malignancy, and a CEA, CA 19–9, CA 125, or CA 27–29 laboratory test. Cancer patients with documented COVID-19 infection and at least one pre- and two post-infection tumor marker measurements were included. We abstracted the electronic health record for demographics, cancer diagnosis, treatment, evidence of cancer progression, date and severity of COVID-19 infection, and tumor marker values.

Results

Seven patients were identified with a temporary elevation of tumor marker values during the post-COVID-19 period. Elevation in tumor marker occurred within 56 days of COVID-19 infection for all patients. Tumor markers subsequently decreased at the second time point in the post-infectious period among all patients.

Conclusion

We report temporary elevations of cancer tumor markers in the period surrounding COVID-19 infection. To our knowledge this is the first report of this phenomenon in cancer patients and has implications for clinical management and future research.
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Old 02-11-2023, 10:54 AM   #9
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Updated COVID-19 Guidance for People Who Are Immunocompromised

Updated COVID-19 Guidance for People Who Are Immunocompromised

https://jamanetwork.com/journals/jam...m_medium=email

Information for Persons Who Are Immunocompromised Regarding Prevention and Treatment of SARS-CoV-2 Infection in the Context of Currently Circulating Omicron Sublineages — United States, January 2023

https://www.cdc.gov/mmwr/volumes/72/...cid=mm7205e3_w
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