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Old 01-19-2022, 02:40 PM   #1
Nguyen
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Join Date: Nov 2005
Posts: 383
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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Posts: 383
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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Join Date: Nov 2005
Posts: 383
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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