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García-Donas J, de Velasco G, Madurga R, Chamorro J, Rosero D, Etxaniz O, Pérez-Gracia JL, Pinto Á, Cacho D, Barba M, Borrega P, Lázaro M, Rodriguez L, Villalobos L, García L, Cuellar A, Solís-Hernández MP, González A, Pernaut C, Rodríguez-Moreno JF. Case-control study assessing the impact of COVID19 in advanced kidney cancer patients treated with antiangiogenics or immunotherapy: the COVID-REN study. Clin Transl Oncol 2024; 26:732-738. [PMID: 37556096 DOI: 10.1007/s12094-023-03295-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/24/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Cancer is a risk factor for developing severe COVID19. Additionally, SARS-CoV2 has a special tropism for renal cells and complications like thrombosis or cytokine storm could be enhanced by standard treatments in kidney cancer (i.e., antiangiogenics or immunotherapy). Thus, understanding the impact of COVID19 in patients with this tumor is key for their correct management. METHODS We designed a retrospective case-control study comparing the outcome of three groups of advanced kidney cancer patients on systemic treatment: cohort A (developed COVID19 while on antiangiogenics), cohort B (developed COVID19 while on immunotherapy) and cohort C (non-infected). Matching factors were age, gender, and treatment. RESULTS 95 patients were recruited in 16 centers in Spain from September 2020 to May 2021. Finally, 85 were deemed as eligible (23 cohort A, 21 cohort B, 41 cohort C). Patients with COVID required more dose interruptions (25 vs. six) and hospitalizations (10 vs. none) than those without COVID (both p = 0.001). No difference between cohorts A and B was observed regarding hospitalization or length of stay. No ICU admission was registered and one patient in cohort B died due to COVID19. Regarding cancer evolution, three patients in cohort A presented progressive disease after COVID19 compared to two in cohort B. One case in cohort B, initially deemed as stable disease, achieved a partial response after COVID19. CONCLUSIONS Kidney cancer patients who developed COVID19 while on systemic therapy required more treatment interruptions and hospitalizations than those non-infected. However, no significant impact on cancer outcome was observed. Also, no difference was seen between cases on antiangiogenics or immunotherapy.
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Affiliation(s)
| | | | - Rodrigo Madurga
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - Diana Rosero
- Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | | | | | - Diego Cacho
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - María Barba
- HM Hospitales-Centro Integral Oncológico Clara Campal, Madrid, Spain
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Łyszczarz B. Productivity losses from short-term work absence due to neoplasms in Poland. Sci Rep 2024; 14:3289. [PMID: 38332168 PMCID: PMC10853257 DOI: 10.1038/s41598-024-53878-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/06/2024] [Indexed: 02/10/2024] Open
Abstract
Previous evidence on productivity losses from neoplasms focuses mostly on the economic burden from mortality, covers single cancer diagnoses and neglects non-malignant neoplasms. This study aims to broaden this perspective by analysing losses resulting from work absence and all neoplasm diagnoses. The analysis applies the human capital method and social insurance data to estimate productivity losses attributable to neoplasm-related short-term work absence in Poland in the period 2012-2022. The productivity losses due to work absence attributable to all neoplasms in Poland were €583 million in 2012 (0.143% of gross domestic product) and they increased to €969 million in 2022 (0.164%). Around 60% of the losses were associated with cancers while the remaining part of the burden was due to non-malignant neoplasms. The neoplasms that led to the highest losses were benign neoplasms, breast cancer, colorectum cancer and prostate cancer. The cancer sites characterised by the greatest losses per absence episode were brain cancer, lung cancer and oesophageal cancer. For most of the neoplasms, we observed increasing losses in an 11-year period analysed. Investing in effective public health policies that tackle neoplasms has the potential to reduce both the health burden and economic losses resulting from these diseases.
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Affiliation(s)
- Błażej Łyszczarz
- Department of Health Economics, Nicolaus Copernicus University in Toruń, Sandomierska 16, 85-830, Bydgoszcz, Poland.
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3
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Lein A, Liu DT, Haas M, Salkic A, Ibrisevic A, Uscuplic S, Harcinovic A, Brkic T, Thurner T, F Brkic F. Impact of the COVID-19 pandemic on management of surgically treated laryngeal squamous cell carcinoma. BIOMOLECULES & BIOMEDICINE 2024; 24:188-195. [PMID: 37638405 PMCID: PMC10787613 DOI: 10.17305/bb.2023.9481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/24/2023] [Accepted: 08/24/2023] [Indexed: 08/29/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the treatment of cancer patients, particularly in terms of treatment choices. This study aimed to assess the effects of the COVID-19 pandemic on the management of surgically treated laryngeal squamous cell carcinoma (LSCC) patients, focusing specifically on changes in treatment modalities. We retrospectively analyzed the data from 102 patients who underwent surgical treatment for LSCC between January 1, 2019, and December 31, 2021, at our tertiary medical center. Patient demographics, histological characteristics, and treatment modalities were extracted from electronic medical records and compared between two time periods: pre-COVID-19 and during COVID-19, marked by the introduction of the hospital entry triage. Of the total patients, 53 (52%) were in the pre-COVID-19 group, and 49 (48%) were in the COVID-19 group. No significant differences in patient characteristics at the initial work-up were observed between the two groups. However, a significant shift in treatment modalities was noted. Fewer patients received postoperative adjuvant therapy in the COVID-19 group (70.5%) compared to the pre-COVID-19 group (95.5%). Importantly, this change did not significantly impact the one-year overall survival (OS) rates. The reduction in the use of postoperative adjuvant therapy during the COVID-19 pandemic may be attributed to efforts to minimize hospital visits due to the risk of COVID-19 infection. Further research is warranted to validate these findings and to investigate the potential effects of such changes in treatment modalities on the long-term survival.
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Affiliation(s)
- Alexander Lein
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - David T Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Markus Haas
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Almir Salkic
- Department of Otorhinolaryngology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Azra Ibrisevic
- Department of Otorhinolaryngology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Sabrina Uscuplic
- Department of Otorhinolaryngology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Alen Harcinovic
- Department of Otorhinolaryngology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Taria Brkic
- Friedrich-Alexander University, Erlangen-Nuernberg, Germany
| | - Thomas Thurner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Faris F Brkic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
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4
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Morton C, Sullivan R, Sarker D, Posner J, Spicer J. Revitalising cancer trials post-pandemic: time for reform. Br J Cancer 2023; 128:1409-1414. [PMID: 36959378 PMCID: PMC10035974 DOI: 10.1038/s41416-023-02224-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 02/06/2023] [Accepted: 02/28/2023] [Indexed: 03/25/2023] Open
Abstract
The COVID-19 pandemic posed significant risk to the health of cancer patients, compromised standard cancer care and interrupted clinical cancer trials, prompting dramatic streamlining of services. From this health crisis has emerged the opportunity to carry forward an unexpected legacy of positive reforms to clinical cancer research, where conventionally convoluted approvals processes, inefficient trial design, procedures and data gathering could benefit from the lessons in rationalisation learned during the pandemic.
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Affiliation(s)
- Cienne Morton
- Department of Medical Oncology, Guy's & St Thomas NHS Foundation Trust, London, UK.
| | | | - Debashis Sarker
- Department of Medical Oncology, Guy's & St Thomas NHS Foundation Trust, London, UK
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - John Posner
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - James Spicer
- Department of Medical Oncology, Guy's & St Thomas NHS Foundation Trust, London, UK
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
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5
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Ma TM, Parikh NR, Philipson RG, van Dams R, Chang EM, Hegde JV, Kishan AU, Kaprealian TB, Steinberg ML, Raldow AC. Experience of Telemedicine Visits in Radiation Oncology During the COVID-19 Pandemic: A US National Survey and Lessons Learned for Incorporating Telemedicine Post-COVID-19. Adv Radiat Oncol 2023; 8:100924. [PMID: 36532603 PMCID: PMC9744187 DOI: 10.1016/j.adro.2022.100924] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/06/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose We sought to survey the attitudes and perceptions of US radiation oncologists toward the adoption of telemedicine during the COVID-19 pandemic and offer suggestions for its integration in the postpandemic era. Methods and Materials A 25-question, anonymous online survey was distributed nationwide to radiation oncologists. Results One hundred and twenty-one respondents completed the survey, with 92% from academia. Overall, 79% worked at institutions that had implemented a work-from-home policy, with which 74% were satisfied. Despite nearly all visit types being conducted in-person before COVID-19, 25%, 41%, and 5% of the respondents used telemedicine for more than half of their new consultations, follow-up, and on-treatment visits, respectively, during the COVID-19 pandemic. Most (83%) reported being comfortable integrating telemedicine. Although telemedicine was appreciated as being more convenient for patients (97%) and reducing transmission of infectious agents (83%), the most commonly perceived disadvantages were difficulty in performing physical examinations (90%), patients' inability to use technology adequately (74%), and technical malfunctions (72%). Compared with in-person visits, telemedicine was felt to be inferior in establishing a personal connection during consultation (90%) and assessing for toxicity while on-treatment (88%) and during follow-up (70%). For follow-up visits, genitourinary and thoracic were perceived as most appropriate for telemedicine while gynecologic and head and neck were considered the least appropriate. Overall, 70% were in favor of more telemedicine, even after pandemic is over. Conclusions Telemedicine will likely remain part of the radiation oncology workflow in most clinics after the pandemic. It should be used in conjunction with in-person visits, and may be best used for conducting follow-up visits in certain disease sites such as genitourinary and thoracic malignancies.
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Affiliation(s)
- Ting Martin Ma
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California
| | | | - Rebecca G. Philipson
- Department of Radiation Oncology, Torrance Memorial Medical Center, Torrance, California
| | - Ritchell van Dams
- Department of Radiation Oncology, Dana Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts
| | - Eric M. Chang
- Department of Radiation Oncology, Oregon Health and Science University, Portland, Oregon
| | - John V. Hegde
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California
| | - Amar U. Kishan
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California
| | - Tania B. Kaprealian
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California
| | - Michael L. Steinberg
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California
| | - Ann C. Raldow
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California,Corresponding author: Ann C. Raldow, MD, MPH
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Impact of the COVID-19 pandemic on care and psychological impact on cancer patients. Curr Opin Support Palliat Care 2022; 16:138-143. [DOI: 10.1097/spc.0000000000000614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Habbous S, Tai X, Beca JM, Arias J, Raphael MJ, Parmar A, Crespo A, Cheung MC, Eisen A, Eskander A, Singh S, Trudeau M, Gavura S, Dai WF, Irish J, Krzyzanowska M, Lapointe-Shaw L, Naipaul R, Peacock S, Yeung L, Forbes L, Chan KKW. Comparison of Use of Neoadjuvant Systemic Treatment for Breast Cancer and Short-term Outcomes Before vs During the COVID-19 Era in Ontario, Canada. JAMA Netw Open 2022; 5:e2225118. [PMID: 35917122 PMCID: PMC9346546 DOI: 10.1001/jamanetworkopen.2022.25118] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE In response to an increase in COVID-19 infection rates in Ontario, several systemic treatment (ST) regimens delivered in the adjuvant setting for breast cancer were temporarily permitted for neoadjuvant-intent to defer nonurgent breast cancer surgical procedures. OBJECTIVE To examine the use and compare short-term outcomes of neoadjuvant-intent vs adjuvant ST in the COVID-19 era compared with the pre-COVID-19 era. DESIGN, SETTING, AND PARTICIPANTS This was a retrospective population-based cohort study in Ontario, Canada. Patients with cancer starting selected ST regimens in the COVID-19 era (March 11, 2020, to September 30, 2020) were compared to those in the pre-COVID-19 era (March 11, 2019, to March 10, 2020). Patients were diagnosed with breast cancer within 6 months of starting systemic therapy. MAIN OUTCOMES AND MEASURES Estimates were calculated for the use of neoadjuvant vs adjuvant ST, the likelihood of receiving a surgical procedure, the rate of emergency department visits, hospital admissions, COVID-19 infections, and all-cause mortality between treatment groups over time. RESULTS Among a total of 10 920 patients included, 7990 (73.2%) started treatment in the pre-COVID-19 era and 7344 (67.3%) received adjuvant ST; the mean (SD) age was 61.6 (13.1) years. Neoadjuvant-intent ST was more common in the COVID-19 era (1404 of 2930 patients [47.9%]) than the pre-COVID-19 era (2172 of 7990 patients [27.2%]), with an odds ratio of 2.46 (95% CI, 2.26-2.69; P < .001). This trend was consistent across a range of ST regimens, but differed according to patient age and geography. The likelihood of receiving surgery following neoadjuvant-intent chemotherapy was similar in the COVID-19 era compared with the pre-COVID-19 era (log-rank P = .06). However, patients with breast cancer receiving neoadjuvant-intent hormonal therapy were significantly more likely to receive surgery in the COVID-19 era (log-rank P < .001). After adjustment, there were no significant changes in the rate of emergency department visits over time between patients receiving neoadjuvant ST, adjuvant ST, or ST only during the ST treatment period or postoperative period. Hospital admissions decreased in the COVID-19 era for patients who received neoadjuvant ST compared with adjuvant ST or ST alone (P for interaction = .01 for both) in either setting. CONCLUSIONS AND RELEVANCE In this cohort study, patients were more likely to start neoadjuvant ST in the COVID-19 era, which varied across the province and by indication. There was limited evidence to suggest any substantial impact on short-term outcomes.
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Affiliation(s)
- Steven Habbous
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Xiaochen Tai
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Jaclyn M Beca
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
- Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada
| | - Jessica Arias
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Michael J. Raphael
- Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Ambica Parmar
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Andrea Crespo
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Matthew C Cheung
- Hematology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Andrea Eisen
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Antoine Eskander
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Simron Singh
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Maureen Trudeau
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Scott Gavura
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Wei Fang Dai
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Jonathan Irish
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Monika Krzyzanowska
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Department of Medical Oncology & Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Lauren Lapointe-Shaw
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rohini Naipaul
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Stuart Peacock
- Cancer Control Research, BC Cancer, Vancouver, British Columbia, Canada
| | - Lyndee Yeung
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Leta Forbes
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
- Division of Medical Oncology, RS McLaughlin Durham Regional Cancer Centre Lakeridge Health, Oshawa, Ontario, Canada
| | - Kelvin K. W. Chan
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
- Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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Carvalho AS, Brito Fernandes Ó, de Lange M, Lingsma H, Klazinga N, Kringos D. Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a scoping review. BMC Health Serv Res 2022; 22:786. [PMID: 35715795 PMCID: PMC9204363 DOI: 10.1186/s12913-022-08166-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/06/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cancer comprises a high burden on health systems. Performance indicators monitoring cancer outcomes are routinely used in OECD countries. However, the development of process and cancer-pathway based information is essential to guide health care delivery, allowing for better monitoring of changes in the quality of care provided. Assessing the changes in the quality of cancer care during the COVID-19 pandemic requires a structured approach considering the high volume of publications. This study aims to summarize performance indicators used in the literature to evaluate the impact of the COVID-19 pandemic on cancer care (January-June 2020) in OECD countries and to assess changes in the quality of care as reported via selected indicators. METHODS Search conducted in MEDLINE and Embase databases. Performance indicators and their trends were collated according to the cancer care pathway. RESULTS This study included 135 articles, from which 1013 indicators were retrieved. Indicators assessing the diagnostic process showed a decreasing trend: from 33 indicators reporting on screening, 30 (91%) signalled a decrease during the pandemic (n = 30 indicators, 91%). A reduction was also observed in the number of diagnostic procedures (n = 64, 58%) and diagnoses (n = 130, 89%). The proportion of diagnoses in the emergency setting and waiting times showed increasing trends (n = 8, 89% and n = 14, 56%, respectively). A decreasing trend in the proportion of earliest stage cancers was reported by 63% of indicators (n = 9), and 70% (n = 43) of indicators showed an increasing trend in the proportion of advanced-stage cancers. Indicators reflecting the treatment process signalled a reduction in the number of procedures: 79%(n = 82) of indicators concerning surgeries, 72%(n = 41) of indicators assessing radiotherapy, and 93%(n = 40) of indicators related to systemic therapies. Modifications in cancer treatment were frequently reported: 64%(n = 195) of indicators revealed changes in treatment. CONCLUSIONS This study provides a summary of performance indicators used in the literature to assess the cancer care pathway from January 2020 to June 2020 in OECD countries, and the changes in the quality of care signalled by these indicators. The trends reported inform on potential bottlenecks of the cancer care pathway. Monitoring this information closely could contribute to identifying moments for intervention during crises.
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Affiliation(s)
- Ana Sofia Carvalho
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands.
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Óscar Brito Fernandes
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Mats de Lange
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
| | - Hester Lingsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Niek Klazinga
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Dionne Kringos
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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Sharafeldin N, Bates B, Vachhani P. How the COVID-19 Pandemic Reshaped the Management of Leukemia and Affected Patient Outcomes. Curr Treat Options Oncol 2022; 23:688-702. [PMID: 35334062 PMCID: PMC8951659 DOI: 10.1007/s11864-022-00975-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 11/29/2022]
Abstract
The coronavirus disease-19 (COVID-19) pandemic has posed numerous challenges to the global healthcare system. Of particular gravity is adult and pediatric patients with hematologic malignancies who are among the most vulnerable groups of patients at risk of severe COVID-19 outcomes. In the early phases of the pandemic, several treatment modifications were proposed for patients with leukemia. Largely speaking, these were adopting less-intense therapies and more utilization of the outpatient setting. Over time, our understanding and management have become more nuanced. Furthermore, equipped with vaccinations to prevent COVID-19 infection and availability of treatments in the presence of COVID-19 infection, the recommendations on management of patients with leukemia have evolved. Patient’s leukemia characteristics, possibility of targeted therapy, vaccination status, symptomatology, comorbidities, goal of anti-leukemic therapy, the intensity of therapy, the setting of treatment, as well as loco regional factors like dynamic incidence of COVID-19 in the community and hospital/ICU bed status are among many factors that influence the decisions. Furthermore, the oncology community has adopted delaying the anti-leukemia therapy for a limited time frame, if clinically possible, so as to still deliver most appropriate therapy while minimizing risks. Early adoption of growth factor support and conservative blood transfusion practices have helped as well. In this review, we discuss the impact of COVID-19 on outcomes and share considerations for treatments of leukemias. We describe the impact on both clinical care (from diagnosis to treatment) and research, and cover the literature on vaccines and treatments for COVID-19 in relation to leukemia.
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Affiliation(s)
- Noha Sharafeldin
- Division of Hematology and Oncology and O'Neal Comprehensive Cancer Center, Heersink School of Medicine, University of Alabama at Birmingham (UAB), 1600 7th Avenue South, Lowder 500, Birmingham, AL, 35233, USA.
| | - Benjamin Bates
- The Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA
| | - Pankit Vachhani
- Division of Hematology and Oncology and O'Neal Comprehensive Cancer Center, Heersink School of Medicine, University of Alabama at Birmingham (UAB), 1600 7th Avenue South, Lowder 500, Birmingham, AL, 35233, USA
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Bernabe-Ramirez C, Velazquez AI, Olazagasti C, Decat Bergerot C, Bergerot PG, Corona Cruz J, Riano I, Adaniel C, Ramirez F, Anampa J, Cajina C, Mena E, Gracia E, Menendez A, Idrovo H, Bezares R, Castillo Fernandez OO, Duque L, Corrales-Rodríguez L, Ramos G, Kihn-Alarcón AJ, Schlam I, Bruno X, Umanzor G, Castro JL, Losco F, Ubillos L, Richardet E, Soto-Perez-de-Celis E, Duma N. HOLA COVID-19 Study: Evaluating the Impact of Caring for Patients With COVID-19 on Cancer Care Delivery in Latin America. JCO Glob Oncol 2022; 8:e2100251. [PMID: 35245084 PMCID: PMC8920462 DOI: 10.1200/go.21.00251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 12/04/2021] [Accepted: 02/01/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The HOLA COVID-19 study sought to evaluate the impact of COVID-19 on oncology practices across Latin America (LATAM), challenges faced by physicians, and how practices and physicians adapted while delivering care to patients with cancer. METHODS This international cross-sectional study of oncology physicians in LATAM included a 43-item anonymous online survey to evaluate changes and adaptations to clinical practice. Multivariable logistic regression analyses were used to evaluate the association of caring for patients with COVID-19 and changes to clinical practice. RESULTS A total of 704 oncology physicians from 19 countries completed the survey. Among respondents, the most common specialty was general oncology (34%) and 56% of physicians had cared for patients with COVID-19. The majority of physicians (70%) noted a decrease in the number of new patients evaluated during the COVID-19 pandemic when compared with prepandemic, and 73% reported adopting the use of telemedicine in their practice. More than half (58%) of physicians reported making changes to the treatments that they offered to patients with cancer. In adjusted models, physicians who had cared for patients with COVID-19 had higher odds of changing the type of chemotherapy or treatments that they offered (adjusted odds ratio 1.81; 95% CI, 1.30 to 2.53) and of delaying chemotherapy start (adjusted odds ratio 2.05; 95% CI, 1.49 to 2.81). Physicians identified significant delays in access to radiation and surgical services, diagnostic tests, and supportive care. CONCLUSION The COVID-19 pandemic has significantly disrupted global cancer care. Although changes to health care delivery are a necessary response to this global crisis, our study highlights the significant disruption and changes to the treatment plans of patients with cancer in LATAM resulting from the COVID-19 health care crisis.
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Affiliation(s)
| | - Ana I. Velazquez
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA
- National Clinician Scholars Program, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
| | - Coral Olazagasti
- Sylvester Comprehensive Cancer Center at the University of Miami, Miami, ML
| | | | | | | | - Ivy Riano
- Hematology and Oncology Section, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | | | | | - Jesus Anampa
- Montefiore Medical Center/Albert Einstein College of Medicine/Albert Einstein Cancer Center, Bronx, NY
| | - Carmen Cajina
- Universidad Nacional Autonoma de Nicaragua, Managua, Nicaragua
| | - Evelin Mena
- Instituto Nacional Del Cancer Rosa Emilia Sanchez Perez de Tavares (INCART), Santo Domingo, Dominican Republic
| | - Elias Gracia
- National Institute of Oncology and Radiobiology, Havana City, Cuba
| | | | | | | | | | - Liseth Duque
- Hospital Universitario Dr Jose Maria Vargas, Caracas, Venezuela
| | | | - Glenda Ramos
- SOLCA, Instituto Oncologico Nacional, Guayaquil, Ecuador
| | - Alba J. Kihn-Alarcón
- Research Department, Liga Nacional Contra el Cáncer & Instituto de Cancerología, Guatemala City, Guatemala
| | | | - Ximena Bruno
- Hematology Oncology Division, Department of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Jenny Lissette Castro
- Department of Medical Oncology, Oncology Hospital, Salvadoran Institute of Social Security, Rosales National Hospital, San Salvador, El Salvador
| | - Federico Losco
- Instituto Alexander Fleming, Ciudad Autónoma de Buenos Aires, Argentina
| | | | | | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Narjust Duma
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
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11
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Jeba J, Thankachan AM, Jacob A, Kandasamy R, Susithra DN. COVID-19 - Initial Lockdown: Implications on Cancer Treatment among Palliative Care Outpatients. Indian J Palliat Care 2022; 28:3-6. [PMID: 35673370 PMCID: PMC9165453 DOI: 10.25259/ijpc_314_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 02/09/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives The pandemic and the lockdown has challenged palliative care patients especially those on palliative oncological treatments. This study aims to understand the effect of COVID-19 and initial lockdown on palliative oncological treatments among palliative care patients. Materials and Methods A retrospective chart review of patients who attended the palliative care outpatient clinic, between 21 April and 12 May 2020, was done. Sociodemographic and palliative oncological treatment details were reviewed. Results Of the 107 patients included, 53.7% were between 40 and 60 years of age, and 58.3% were women. A large proportion (63%) was unemployed and 40.2% had to rent vehicles for hospital travel. During this period, palliative oncological treatment was interrupted or deferred in 20% and 3.5%, respectively. During this period, homecare services were also affected in about 12.2% of our patients. Conclusion The COVID-19 pandemic and the lockdown have affected the palliative oncological treatment of palliative care outpatients with cancer. The implications of interrupted and deferred treatment on patient outcomes would be seen in the months and years to follow. Palliative care teams should enhance patient and caregiver support and promote non-abandonment and continuum of care during such unprecedented times.
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Affiliation(s)
- Jenifer Jeba
- Department of Radiotherapy, Palliative Care Unit, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Ansu Mary Thankachan
- Department of Radiotherapy, Palliative Care Unit, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Annie Jacob
- Department of Radiotherapy, Palliative Care Unit, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Ramu Kandasamy
- Department of Radiotherapy, Palliative Care Unit, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - D. N. Susithra
- Department of Radiotherapy, Palliative Care Unit, Christian Medical College Hospital, Vellore, Tamil Nadu, India
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12
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Bernacki K, Keister A, Sapiro N, Joo JS, Mattle L. Impact of COVID-19 on patient and healthcare professional attitudes, beliefs, and behaviors toward the healthcare system and on the dynamics of the healthcare pathway. BMC Health Serv Res 2021; 21:1309. [PMID: 34872537 PMCID: PMC8646017 DOI: 10.1186/s12913-021-07237-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND COVID-19 has dramatically changed how healthcare is delivered and experienced. METHODS One-on-one interviews and a virtual ethnographic roundtable were conducted among 45 patients, caregivers, and healthcare professionals (HCPs) in 4 therapeutic areas from the United States and Japan: overactive bladder, vasomotor symptoms, prostate cancer, and metastatic urothelial carcinoma. The goal was to identify the impact of COVID-19 on patient/caregiver and HCP attitudes, interactions, beliefs, and behaviors toward the healthcare system and care pathway. RESULTS Four foundational themes were identified: 1) COVID-19 risk is relative; 2) isolation is collateral damage; 3) telehealth is a parallel universe; and 4) COVID-19 is destabilizing the foundations of healthcare. Numerous insights, influenced by diverse cultural, social, and psychological factors, were identified within each theme. CONCLUSIONS The impacts of COVID-19 were noticeable at multiple points of care during the "universal" care pathway, including at initial screening, referral to specialists, diagnosis, treatment initiation/surgery, and during ongoing care. Greater appreciation of the short- and long-term impacts of COVID-19 and resulting gaps in care may act as a catalyst for positive change in future patient care.
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Affiliation(s)
- Katarzyna Bernacki
- Astellas Pharma Inc. Patient Centricity, 1 Astellas Way, Northbrook, IL, 60062, USA.
| | - Angie Keister
- Astellas Pharma Inc. Patient Centricity, 1 Astellas Way, Northbrook, IL, 60062, USA
| | | | - Jin Su Joo
- Throughline Strategy, Toronto, ON, Canada
| | - Lisa Mattle
- Astellas Pharma Inc. Patient Centricity, 1 Astellas Way, Northbrook, IL, 60062, USA.
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13
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van Not OJ, van Breeschoten J, van den Eertwegh AJM, Hilarius DL, De Meza MM, Haanen JB, Blank CU, Aarts MJB, van den Berkmortel FWPJ, de Groot JWB, Hospers GAP, Ismail RK, Kapiteijn E, Piersma D, van Rijn RS, Stevense-den Boer MAM, van der Veldt AAM, Vreugdenhil G, Boers-Sonderen MJ, Blokx WAM, Suijkerbuijk KPM, Wouters MWJM. The unfavorable effects of COVID-19 on Dutch advanced melanoma care. Int J Cancer 2021; 150:816-824. [PMID: 34605003 PMCID: PMC8652896 DOI: 10.1002/ijc.33833] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/23/2021] [Accepted: 08/09/2021] [Indexed: 12/21/2022]
Abstract
The COVID‐19 pandemic had a severe impact on medical care. Our study aims to investigate the impact of COVID‐19 on advanced melanoma care in the Netherlands. We selected patients diagnosed with irresectable stage IIIc and IV melanoma during the first and second COVID‐19 wave and compared them with patients diagnosed within the same time frame in 2018 and 2019. Patients were divided into three geographical regions. We investigated baseline characteristics, time from diagnosis until start of systemic therapy and postponement of anti‐PD‐1 courses. During both waves, fewer patients were diagnosed compared to the control groups. During the first wave, time between diagnosis and start of treatment was significantly longer in the southern region compared to other regions (33 vs 9 and 15 days, P‐value <.05). Anti‐PD‐1 courses were postponed in 20.0% vs 3.0% of patients in the first wave compared to the control period. Significantly more patients had courses postponed in the south during the first wave compared to other regions (34.8% vs 11.5% vs 22.3%, P‐value <.001). Significantly more patients diagnosed during the second wave had brain metastases and worse performance status compared to the control period. In conclusion, advanced melanoma care in the Netherlands was severely affected by the COVID‐19 pandemic. In the south, the start of systemic treatment for advanced melanoma was more often delayed, and treatment courses were more frequently postponed. During the second wave, patients were diagnosed with poorer patient and tumor characteristics. Longer follow‐up is needed to establish the impact on patient outcomes.
What's new?
Little is known about the effects of COVID‐19 on advanced melanoma care. In this study, the authors examined several quality indicators of care. They observed a worsening in baseline characteristics, longer time between diagnosis and start of treatment and more postponed anti‐PD‐1 antibody courses with differences between the northern, middle and southern regions. Future studies are necessary to assess the long‐term consequences of our observed changes in advanced melanoma care.
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Affiliation(s)
- Olivier J van Not
- Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands.,Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jesper van Breeschoten
- Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands.,Department of Medical Oncology, Amsterdam UMC, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Alfonsus J M van den Eertwegh
- Department of Medical Oncology, Amsterdam UMC, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Doranne L Hilarius
- Department of Pharmacy, Rode Kruis Ziekenhuis, Beverwijk, The Netherlands
| | - Melissa M De Meza
- Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands.,Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.,Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - John B Haanen
- Department of Medical Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Christian U Blank
- Department of Medical Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Division of Molecular Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Maureen J B Aarts
- Department of Medical Oncology, GROW School of Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | | | - Geke A P Hospers
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rawa K Ismail
- Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht, The Netherlands
| | - Ellen Kapiteijn
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Djura Piersma
- Department of Internal Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Rozemarijn S van Rijn
- Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | | | - Astrid A M van der Veldt
- Department of Medical Oncology and Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Gerard Vreugdenhil
- Department of Internal Medicine, Maxima Medical Center, Eindhoven, The Netherlands
| | - Marye J Boers-Sonderen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Willeke A M Blokx
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Michel W J M Wouters
- Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands.,Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.,Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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14
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Costa GJ, de Azevedo CRAS, Júnior JIC, Bergmann A, Thuler LCS. Higher severity and risk of in-hospital mortality for COVID-19 patients with cancer during the year 2020 in Brazil: A countrywide analysis of secondary data. Cancer 2021; 127:4240-4248. [PMID: 34343344 PMCID: PMC8426714 DOI: 10.1002/cncr.33832] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/07/2021] [Accepted: 07/12/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) and cancer are serious public health problems worldwide. However, little is known about the risk factors of in-hospital mortality among COVID-19 patients with and without cancer in Brazil. The objective of this study was to evaluate the risk factors of in-hospital mortality among COVID-19 patients with and without cancer and to compare mortality according to gender and topography during the year 2020 in Brazil. METHODS This was a secondary data study of hospitalized adult patients with a diagnosis of COVID-19 by real-time polymerase chain reaction testing in Brazil. The data were collected from the Influenza Epidemiological Surveillance Information System. RESULTS This study analyzed data from 322,817 patients. The prevalence of cancer in patients with COVID-19 was 2.3%. COVID-19 patients with neurological diseases and cancer had the most lethal comorbidities in both sexes. COVID-19 patients with cancer were more likely to be older (median age, 67 vs 62 years; P < .001), to have a longer hospital stay (13.1 vs 11.5 days; P < .001), to be admitted to the intensive care unit (45.3% vs 39.6%; P < .001), to receive more invasive mechanical ventilation (27.1% vs 21.9%), and to have a higher risk of death (adjusted odds ratio [aOR], 1.94; 95% confidence interval [CI], 1.83-2.06; P < .001) than those without cancer. Patients with hematological neoplasia (aOR, 2.85; 95% CI, 2.41-3.38; P < .001) had a higher risk of mortality than those with solid tumors (aOR, 1.83; 95% CI, 1.72-1.95; P < .001) in both sexes. CONCLUSIONS Brazilian COVID-19 patients with cancer have higher disease severity and a higher risk of mortality than those without cancer.
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Affiliation(s)
- Guilherme Jorge Costa
- Department of Teaching and Research, Pernambuco Cancer Hospital, Recife, Brazil.,Department of Pneumology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil
| | | | - José Iran Costa Júnior
- Department of Oncology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil.,Oncologia D'Or, Recife, Brazil
| | - Anke Bergmann
- Clinical Epidemiology Program, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
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15
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Tarricone R, Listorti E, Tozzi V, Torbica A, Banks H, Ghislandi S, Altini M, Annicchiarico M, Ardizzoni A, Bordon P, Bossi P, Cascinu S, Numico G, Puglisi F, Fasola G. Transformation of Cancer Care during and after the COVID Pandemic, a point of no return. The Experience of Italy. J Cancer Policy 2021; 29:100297. [PMID: 34316437 PMCID: PMC8297965 DOI: 10.1016/j.jcpo.2021.100297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/27/2021] [Accepted: 07/11/2021] [Indexed: 10/25/2022]
Abstract
Policymakers everywhere struggle to introduce therapeutic innovation while controlling costs, a particular challenge for the universal Italian National Healthcare System (SSN), which spends only 8.8% of GDP to care for one of the world's oldest populations. Oncology provides a telling example, where innovation has dramatically improved care and survival, transforming cancer into a chronic condition. However, innovation has also increased therapy duration, adverse event management, and service demand. The SSN risks collapse unless centralized cancer planning changes gear, particularly with Covid-19 causing treatment delays, worsening patient prognosis and straining capacity. In view of the 750 billion Euro "Next Generation EU", released by the European Union to relieve Member States hit by the pandemic, the SSN tapped a multidisciplinary research team to identify key strategies for equitable uptake of innovations in treatment and delivery, with emphasis on data-driven technological and managerial advancements - and lessons from Covid-19.
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Affiliation(s)
- R Tarricone
- Department of Social and Political Science, Bocconi University, Via Roentgen 1, 20135, Milan, Italy.,Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Via Sarfatti 10, 20136, Milan, Italy
| | - E Listorti
- Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Via Sarfatti 10, 20136, Milan, Italy
| | - V Tozzi
- Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Via Sarfatti 10, 20136, Milan, Italy
| | - A Torbica
- Department of Social and Political Science, Bocconi University, Via Roentgen 1, 20135, Milan, Italy.,Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Via Sarfatti 10, 20136, Milan, Italy
| | - H Banks
- Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Via Sarfatti 10, 20136, Milan, Italy
| | - S Ghislandi
- Department of Social and Political Science, Bocconi University, Via Roentgen 1, 20135, Milan, Italy
| | - M Altini
- Istituto Romagnolo per lo studio dei Tumori "Dino Amadori", 47014, Meldola, Italy
| | | | | | | | - P Bossi
- University of Brescia, Brescia, Italy
| | - S Cascinu
- Vita-San Raffaele University, Milan, Italy
| | - G Numico
- Azienda Ospedaliera Santa Croce di Cuneo, Italy
| | - F Puglisi
- Centro di Riferimento Oncologico, Aviano, Italy
| | - G Fasola
- Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
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16
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Lazarus G, Budiman RA, Rinaldi I. Does immune checkpoint inhibitor increase the risks of poor outcomes in COVID-19-infected cancer patients? A systematic review and meta-analysis. Cancer Immunol Immunother 2021; 71:373-386. [PMID: 34173850 PMCID: PMC8233621 DOI: 10.1007/s00262-021-02990-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 06/16/2021] [Indexed: 12/17/2022]
Abstract
Background The association between immune checkpoint inhibitor (ICI) and outcomes of cancer patients with coronavirus disease 2019 (COVID-19) infection has yet to be systematically evaluated. This meta-analysis aims to investigate the effects of ICI treatment on COVID-19 prognosis, including mortality, severity, and any other prognosis-related outcomes. Methods Eligible studies published up to 27 February 2021 were included and assessed for risk of bias using the Quality in Prognosis Studies tool. A random-effects meta-analysis was conducted to estimate the pooled effect size along with its 95% confidence intervals. The quality of body evidence was evaluated using the modified Grading of Recommendations Assessment, Development, and Evaluation framework. Results Eleven studies involving a total of 2826 COVID-19-infected cancer patients were included in the systematic review. We discovered a moderate-to-high quality of evidence that ICI was not associated with a higher mortality risk, while the other outcomes yielded a very low-to-low-evidence quality. Although our findings indicated that ICI did not result in a higher risk of severity and hospitalization, further evidence is required to confirm our findings. In addition, we discovered that prior exposure to chemoimmunotherapy may be linked with a higher risk of COVID-19 severity (OR 8.19 [95% CI: 2.67–25.08]; I2 = 0%), albeit with small sample size. Conclusion Our findings indicated that ICI treatment should not be adjourned nor terminated during the current pandemic. Rather, COVID-19 vigilance should be increased in such patients. Further studies with larger cohorts and higher quality of evidence are required to substantiate our findings. Trial registration number This project has been prospectively registered at PROSPERO (registration ID: CRD42020202142) on 4 August 2020. Supplementary Information The online version contains supplementary material available at 10.1007/s00262-021-02990-9.
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Affiliation(s)
- Gilbert Lazarus
- Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No. 6, RW 5, Kenari, Kec. Senen, Kota Jakarta Pusat, Jakarta, 10430, Indonesia.
| | - Refael Alfa Budiman
- Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No. 6, RW 5, Kenari, Kec. Senen, Kota Jakarta Pusat, Jakarta, 10430, Indonesia
| | - Ikhwan Rinaldi
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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17
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Affiliation(s)
- Aakash Desai
- Division of Medical Oncology, Department of Medicine, Mayo Clinic, Rochester, MN.,Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Narjust Duma
- Division of Hematology, Medical Oncology and Palliative Care, Department of Medicine, University of Wisconsin, Madison, WI
| | - Gilberto Lopes
- Division of Medical Oncology, Department of Medicine, Sylvester Comprehensive Cancer Center at the University of Miami, Miami, FL
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18
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Zhou J, Liu Y, Xu M, Mei L, Ruan S, Zhang N, Yi P, Chen Q, Tan J. Management of Breast Cancer Patients During the Coronavirus Disease 2019 Pandemic: The Experience From the Epicenter of China, Wuhan. Clin Breast Cancer 2021; 22:e1-e7. [PMID: 34078565 PMCID: PMC8099546 DOI: 10.1016/j.clbc.2021.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/27/2021] [Accepted: 04/28/2021] [Indexed: 11/21/2022]
Abstract
Background The coronavirus disease 2019 pandemic is a global public health event. Wuhan used to be the epicenter of China and finally controlled the outbreak through city lockdown and many other policies. However, the pandemic and the prevention strategies had a huge impact on the medical care procedures for patients with breast cancer, leading to the delay or interruption of anticancer therapies. Patients and Methods To better serve patients with breast cancer under the premise of epidemic control, many strategies have been proposed and optimized in our center. One of the most important parts of these strategies is the promotion of telemedicine, including online consultation, online prescription, and drug mailing services. Results In keeping with the city and hospital policies, we have also introduced stricter ward management policies and more precise care. Conclusion Here, we collected the diagnosis and treatment process of patients with breast cancer in our center during the coronavirus disease 2019 pandemic, which was found to be correlated to a reduction in chemotherapy-related myelosuppression and hepatic dysfunction, hoping to provide a reference for other cancer centers that may suffer from the similar situation.
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Affiliation(s)
- Jun Zhou
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuyin Liu
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Xu
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Mei
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shengnan Ruan
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ning Zhang
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pengfei Yi
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qianzhi Chen
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Tan
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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19
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Labaki C, Peters S, Choueiri TK. Treatment Decisions for Patients with Cancer during the COVID-19 Pandemic. Cancer Discov 2021; 11:1330-1335. [PMID: 33811043 DOI: 10.1158/2159-8290.cd-21-0210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients with cancer have been disproportionally affected by the COVID-19 pandemic, with high rates of severe outcomes and death. Similarly, treatment decisions in this vulnerable population have been altered to a major degree during the past year, with significant disruption of care reported. Although complex, therapeutic choices in patients with cancer in times of COVID-19 are critical, as they may save thousands of lives. A mounting body of evidence, in addition to clear recommendations by multiple international societies, can help oncologists decide appropriately the necessity to administer antineoplastic regimens, helping to avoid a surge in cancer-related deaths in the upcoming months.
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Affiliation(s)
- Chris Labaki
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Toni K Choueiri
- Dana-Farber Cancer Institute, Boston, Massachusetts. .,Harvard Medical School, Boston, Massachusetts
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20
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Martei YM, Rick TJ, Fadelu T, Ezzi MS, Hammad N, Quadri NS, Rodrigues B, Simonds H, Grover S, Incrocci L, Vanderpuye V. Impact of COVID-19 on Cancer Care Delivery in Africa: A Cross-Sectional Survey of Oncology Providers in Africa. JCO Glob Oncol 2021; 7:368-377. [PMID: 33689484 PMCID: PMC8081536 DOI: 10.1200/go.20.00569] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/21/2020] [Accepted: 02/09/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE The COVID-19 pandemic has disrupted cancer care globally. There are limited data of its impact in Africa. This study aims to characterize COVID-19 response strategies and impact of COVID-19 on cancer care and explore misconceptions in Africa. METHODS We conducted a web-based cross-sectional survey of oncology providers in Africa between June and August 2020. Descriptive statistics and comparative analysis by income groups were performed. RESULTS One hundred twenty-two participants initiated the survey, of which 79 respondents from 18 African countries contributed data. Ninety-four percent (66 of 70) reported country mitigation and suppression strategies, similar across income groups. Unique strategies included courier service and drones for delivery of cancer medications (9 of 70 and 6 of 70, respectively). Most cancer centers remained open, but > 75% providers reported a decrease in patient volume. Not previously reported is the fear of infectivity leading to staff shortages and decrease in patient volumes. Approximately one third reported modifications of all cancer treatment modalities, resulting in treatment delays. A majority of participants reported ≤ 25 confirmed cases (44 of 68, 64%) and ≤ 5 deaths because of COVID-19 (26 of 45, 58%) among patients with cancer. Common misconceptions were that Africans were less susceptible to the virus (53 of 70, 75.7%) and decreased transmission of the virus in the African heat (44 of 70, 62.9%). CONCLUSION Few COVID-19 cases and deaths were reported among patients with cancer. However, disruptions and delays in cancer care because of the pandemic were noted. The pandemic has inspired tailored innovative solutions in clinical care delivery for patients with cancer, which may serve as a blueprint for expanding care and preparing for future pandemics. Ongoing public education should address COVID-19 misconceptions. The results may not be generalizable to the entire African continent because of the small sample size.
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Affiliation(s)
- Yehoda M. Martei
- Department of Medicine (Hematology-Oncology), University of Pennsylvania, Philadelphia, PA
| | - Tara J. Rick
- Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | | | - Nazik Hammad
- Queen's University Cancer Center of Southeastern Ontario, Kingston Health Science Center, Kingston, ON, Canada
| | | | - Belmira Rodrigues
- African Organization for Research and Training in Cancer, Cape Town, South Africa
| | - Hannah Simonds
- Division of Radiation Oncology, Medical Imaging and Clinical Oncology, Tygerberg Academic Hospital, Cape Town, South Africa
| | - Surbhi Grover
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Luca Incrocci
- Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Verna Vanderpuye
- National Center for Radiotherapy and Nuclear Medicine, Korle-Bu Teaching Hospital, Accra, Ghana
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21
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Naipaul RD, Mercer RE, Chan KKW, Yeung L, Forbes L, Gavura S. Clinician Perspectives of COVID-19-Related Cancer Drug Funding Measures in Ontario. ACTA ACUST UNITED AC 2021; 28:1056-1066. [PMID: 33652898 PMCID: PMC8025744 DOI: 10.3390/curroncol28020103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/12/2021] [Accepted: 02/23/2021] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic has a significant impact on cancer patients and the delivery of cancer care. To allow clinicians to adapt treatment plans for patients, Ontario Health (Cancer Care Ontario) issued a series of interim funding measures for the province’s New Drug Funding Program (NDFP), which covers the cost of most hospital-delivered cancer drugs. To assess the utility of the measures and the need for their continuation, we conducted an online survey of Ontario oncology clinicians. The survey was open 3–25 September 2020 and generated 105 responses. Between April and June 2020, 46% of respondents changed treatment plans for more than 25% of their cancer patients due to the pandemic. Clinicians report broad use of interim funding measures. The most frequently reported strategies used were treatment breaks for stable patients (62%), extending dosing intervals (59%), and deferring routine imaging (56%). Most clinicians anticipate continuing to use these interim funding measures in the coming months. The survey showed that adapting cancer drug funding policies has supported clinical care in Ontario during the pandemic.
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Affiliation(s)
- Rohini D. Naipaul
- Provincial Drug Reimbursement Programs, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada; (R.D.N.); (R.E.M.); (K.K.W.C.); (L.Y.); (L.F.)
| | - Rebecca E. Mercer
- Provincial Drug Reimbursement Programs, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada; (R.D.N.); (R.E.M.); (K.K.W.C.); (L.Y.); (L.F.)
- Canadian Centre for Applied Research in Cancer Control, Toronto, ON M5G 2L3, Canada
| | - Kelvin K. W. Chan
- Provincial Drug Reimbursement Programs, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada; (R.D.N.); (R.E.M.); (K.K.W.C.); (L.Y.); (L.F.)
- Canadian Centre for Applied Research in Cancer Control, Toronto, ON M5G 2L3, Canada
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
| | - Lyndee Yeung
- Provincial Drug Reimbursement Programs, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada; (R.D.N.); (R.E.M.); (K.K.W.C.); (L.Y.); (L.F.)
| | - Leta Forbes
- Provincial Drug Reimbursement Programs, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada; (R.D.N.); (R.E.M.); (K.K.W.C.); (L.Y.); (L.F.)
| | - Scott Gavura
- Provincial Drug Reimbursement Programs, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada; (R.D.N.); (R.E.M.); (K.K.W.C.); (L.Y.); (L.F.)
- Correspondence: ; Tel.: +1-416-217-1299
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22
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Onesti CE, Tagliamento M, Curigliano G, Harbeck N, Bartsch R, Wildiers H, Tjan-Heijnen V, Martin M, Rottey S, Generali D, Campone M, Cristofanilli M, Pusztai L, Peeters M, Berchem G, Cortes J, Ruhstaller T, Ciruelos E, Rugo HS, Jerusalem G. Expected Medium- and Long-Term Impact of the COVID-19 Outbreak in Oncology. JCO Glob Oncol 2021; 7:162-172. [PMID: 33529077 PMCID: PMC8081548 DOI: 10.1200/go.20.00589] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE The COVID-19 pandemic has affected healthcare systems globally, leading to reorganization of medical activities. We performed an international survey aimed to investigate the medium- and long-term impact on oncology units. MATERIALS AND METHODS An 82-item survey was distributed from June 17 to July 14, 2020 among medical oncologists worldwide. RESULTS One hundred nine medical oncologists from 18 countries in Europe (n = 93), United States (n = 5), and Latin America (n = 11) answered the survey. A systematic tracing of COVID-19–positive patients was continued in the postacute phase by 77.1% of the centers; 64.2% of the respondents participated in a local registry and 56% in international or national registries of infected patients. Treatment adaptations were introduced, and surgery was the most affected modality being delayed or canceled in more than 10% of patients in 34% of the centers, whereas early cessation of palliative treatment was reported in 32.1% of the centers; 64.2% of respondents reported paying attention to avoid undertreatments. The use of telemedicine has been largely increased. Similarly, virtual tools are increasingly used particularly for medical education and international or national or multidisciplinary meetings. 60.6% of the participants reduced clinical activity, and 28.4% compensated by increasing their research activity. Significant reduction of clinical trial activities is expected in 37% of centers this year. The well-being of healthcare staff would not recover by the end of the year according to 18% of the participants. CONCLUSION The COVID-19 outbreak has had a major impact on oncologic activity, which will persist in the future, irrespective of geographical areas.
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Affiliation(s)
- Concetta Elisa Onesti
- Medical Oncology Department, CHU Sart Tilman Liege and Laboratory of Human Genetics, GIGA Research Institute, University of Liège, Liège, Belgium
| | - Marco Tagliamento
- Oncology Department, University of Genova and IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Giuseppe Curigliano
- Oncology and Hemato-Oncology, European Institute of Oncology, IRCCS and University of Milan, Milan, Italy
| | - Nadia Harbeck
- Breast Center, Department OB&GYN and CCCLMU, LMU University Hospital, Munich, Germany
| | - Rupert Bartsch
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University of Vienna, Wien, Austria
| | - Hans Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Vivianne Tjan-Heijnen
- Medical Oncology, Maastricht University Medical Center (MUMC), Maastricht, Netherlands
| | - Miguel Martin
- Departamento de Medicina, Instituto de Investigación Sanitaria Gregorio Marañón Universidad Complutense, Madrid, Spain
| | - Sylvie Rottey
- Department of Medical Oncology, UZ Gent, Gent, Belgium
| | - Daniele Generali
- UO Patologia Mammaria e Ricerca Traslazionale-Breast Unit, Azienda Socio-Sanitaria, Territoriale di Cremona and University of Trieste, Cremona, Italy
| | - Mario Campone
- Medical Oncology, Institut de Cancérologie de l'Ouest-Pays de la Loire, Saint-Herblain, France
| | - Massimo Cristofanilli
- Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Lajos Pusztai
- Yale Cancer Center, Yale School of Medicine, New Haven, CT
| | - Marc Peeters
- Oncology Department, University Hospital Antwerp (UZA), Edegem, Belgium
| | - Guy Berchem
- Hemato-Oncology Department, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Javier Cortes
- Oncology Department, IOB Institute of Oncology, Quiron Group, Madrid, Barcelona, Spain.,Vall d'Hebron Institute of Oncology (VHIO), Centro Cellex, Carrer de Natzaret, Barcelona, Spain
| | - Thomas Ruhstaller
- Medical Oncology, Breast Center Eastern Switzerland, St Gallen, Switzerland.,University of Basel, St Gallen, Switzerland
| | - Eva Ciruelos
- Medical Oncology, University Hospital 12 de Octubre, Madrid, Spain
| | - Hope S Rugo
- Breast Care Center, University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | - Guy Jerusalem
- Medical Oncology, CHU Sart Tilman Liège and University of Liège, Liège, Belgium
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23
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El-Shakankery KH, Kefas J, Miller R. COVID-19, the Future Vaccine and What It Means for Cancer Patients on Immunotherapy. Front Oncol 2021; 10:631611. [PMID: 33598436 PMCID: PMC7882718 DOI: 10.3389/fonc.2020.631611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/29/2020] [Indexed: 01/04/2023] Open
Affiliation(s)
| | - Joanna Kefas
- Department of Medicine, St Bartholomew’s Hospital, London, United Kingdom
| | - Rowan Miller
- Department of Medical Oncology, St Bartholomew’s Hospital, London, United Kingdom
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24
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Karacin C, Acar R, Bal O, Eren T, Sendur MAN, Acikgoz Y, Karadurmus N, Imamoglu GI, Oksuzoglu OB, Dogan M. "Swords and Shields" against COVID-19 for patients with cancer at "clean" and "pandemic" hospitals: are we ready for the second wave? Support Care Cancer 2021; 29:4587-4593. [PMID: 33479795 PMCID: PMC7819771 DOI: 10.1007/s00520-021-06001-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/12/2021] [Indexed: 12/13/2022]
Abstract
Purpose COVID-19 will continue to disrupt the diagnosis-treatment process of cancer patients. Dr. Abdurrahman Yurtaslan Ankara Oncology Hospital has been considered as a ‘non-pandemic’ center (‘clean’) in Ankara, the capital city of Turkey. The other state hospitals that also take care of cancer patients in Ankara were defined as ‘pandemic’ centers. This study aimed to evaluate hospital admission changes and the precautionary measures in clean and pandemic centers during the pandemic. The effect of these measures and changes on COVID-19 spreading among cancer patients was also evaluated. Methods The patients admitted to the medical oncology follow-up, new diagnosis, or chemotherapy (CT) outpatient clinics during the first quarter of pandemic period (March 15–June 1, 2020) of each center were determined and compared with the admissions of the same frame of previous year (March 15–June 1, 2019). COVID-19 PCR test results in clean and pandemic centers were compared with each other. Telemedicine was preffered in the clean hospital to keep on follow-up of the cancer patients as ‘noninfected’. Results In the clean hospital, COVID-19-infected patients that needed to be hospitalized were referred to pandemic hospitals. COVID-19 test positivity rate was eight-fold higher for outpatient clinic admissions in pandemic hospitals (p < 0.001). The number of patients admitted new diagnosis outpatient clinics in both clean and pandemic hospitals decreased significantly during the pandemic compared with the previous year. Conclusion We consider that local strategic modifications and defining ‘clean’ hospital model during infectious pandemic may contribute to protect and treat cancer patients during pandemic.
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Affiliation(s)
- Cengiz Karacin
- Department of Medical Oncology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, 06200, Ankara, Yenimahalle, Turkey.
| | - Ramazan Acar
- Department of Medical Oncology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Oznur Bal
- Department of Medical Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Tulay Eren
- Department of Medical Oncology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Mehmet Ali Nahit Sendur
- Department of Medical Oncology, Ankara City Hospital, Yildirim Beyazit University, Ankara, Turkey
| | - Yusuf Acikgoz
- Department of Medical Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Nuri Karadurmus
- Department of Medical Oncology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Goksen Inanc Imamoglu
- Department of Medical Oncology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Omur Berna Oksuzoglu
- Department of Medical Oncology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, 06200, Ankara, Yenimahalle, Turkey
| | - Mutlu Dogan
- Department of Medical Oncology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, 06200, Ankara, Yenimahalle, Turkey
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25
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Yekedüz E, Utkan G, Ürün Y. Commentary: Should all cancer patients be tested for COVID-19 before each chemotherapy cycle? J Oncol Pharm Pract 2021; 27:450-452. [PMID: 33470163 DOI: 10.1177/1078155220988753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cancer patients under active chemotherapy are more vulnerable to coronavirus disease 19 (COVID-19). There are still some controversies regarding routine polymerase chain reaction testing of asymptomatic cancer patients before chemotherapy cycles. Despite a lack of data, Al-Shamsi et al. showed higher COVID-19 positivity rate among asymptomatic cancer patients. Furthermore, mortality rate was higher in this group of patients. There is no high evidence-based recommendation from the cancer societies for testing asymptomatic patients before each chemotherapy cycle. In this commentary, we assessed the current publications and guidelines regarding this issue.
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Affiliation(s)
- Emre Yekedüz
- Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.,Ankara University Cancer Research Institute, Ankara, Turkey
| | - Güngör Utkan
- Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.,Ankara University Cancer Research Institute, Ankara, Turkey
| | - Yüksel Ürün
- Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.,Ankara University Cancer Research Institute, Ankara, Turkey
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26
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Wu JTY, Kwon DH, Glover MJ, Henry S, Wood D, Rubin DL, Koshkin VS, Schapira L, Shah SA. Changes in Cancer Management due to COVID-19 Illness in Patients with Cancer in Northern California. JCO Oncol Pract 2020; 17:e377-e385. [PMID: 33332170 PMCID: PMC8462649 DOI: 10.1200/op.20.00790] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE The response to the COVID-19 pandemic has affected the management of patients with cancer. In this pooled retrospective analysis, we describe changes in management patterns for patients with cancer diagnosed with COVID-19 in two academic institutions in the San Francisco Bay Area. MATERIALS AND METHODS Adult and pediatric patients diagnosed with COVID-19 with a current or historical diagnosis of malignancy were identified from the electronic medical record at the University of California, San Francisco, and Stanford University. The proportion of patients undergoing active cancer management whose care was affected was quantified and analyzed for significant differences with regard to management type, treatment intent, and the time of COVID-19 diagnosis. The duration and characteristics of such changes were compared across subgroups. RESULTS A total of 131 patients were included, of whom 55 were undergoing active cancer management. Of these, 35 of 55 (64%) had significant changes in management that consisted primarily of delays. An additional three patients not undergoing active cancer management experienced a delay in management after being diagnosed with COVID-19. The decision to change management was correlated with the time of COVID-19 diagnosis, with more delays identified in patients treated with palliative intent earlier in the course of the pandemic (March/April 2020) compared with later (May/June 2020) (OR, 4.2; 95% CI, 1.03 to 17.3; P = .0497). This difference was not seen among patients treated with curative intent during the same timeframe. CONCLUSION We found significant changes in the management of cancer patients with COVID-19 treated with curative and palliative intent that evolved over time. Future studies are needed to determine the impact of changes in management and treatment on cancer outcomes for patients with cancer and COVID-19.
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Affiliation(s)
- Julie Tsu-Yu Wu
- Department of Medical Oncology, Stanford University, Stanford, CA
| | - Daniel H Kwon
- Department of Medical Oncology, University of California, San Francisco, San Francisco, CA
| | - Michael J Glover
- Department of Internal Medicine, Stanford University, Stanford, CA
| | - Solomon Henry
- Department of Biomedical Data Science, Stanford University, Stanford, CA
| | - Douglas Wood
- Department of Biomedical Data Science, Stanford University, Stanford, CA
| | - Daniel L Rubin
- Department of Biomedical Data Science, Stanford University, Stanford, CA
| | - Vadim S Koshkin
- Department of Medical Oncology, University of California, San Francisco, San Francisco, CA
| | - Lidia Schapira
- Department of Medical Oncology, Stanford University, Stanford, CA
| | - Sumit A Shah
- Department of Medical Oncology, Stanford University, Stanford, CA
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27
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Schmidt AL, Bakouny Z, Bhalla S, Steinharter JA, Tremblay DA, Awad MM, Kessler AJ, Haddad RI, Evans M, Busser F, Wotman M, Curran CR, Zimmerman BS, Bouchard G, Jun T, Nuzzo PV, Qin Q, Hirsch L, Feld J, Kelleher KM, Seidman D, Huang HH, Anderson-Keightly HM, Abou Alaiwi S, Rosenbloom TD, Stewart PS, Galsky MD, Choueiri TK, Doroshow DB. Cancer Care Disparities during the COVID-19 Pandemic: COVID-19 and Cancer Outcomes Study. Cancer Cell 2020; 38:769-770. [PMID: 33176161 PMCID: PMC7609043 DOI: 10.1016/j.ccell.2020.10.023] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Andrew L Schmidt
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Ziad Bakouny
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Sheena Bhalla
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA
| | - John A Steinharter
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Douglas A Tremblay
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA
| | - Mark M Awad
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Alaina J Kessler
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA
| | - Robert I Haddad
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Michelle Evans
- Department of Medicine, Icahn School of Medicine at Mount Sinai Hospital, New York, NY 10029, USA
| | - Fiona Busser
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Michael Wotman
- Department of Medicine, Icahn School of Medicine at Mount Sinai Hospital, New York, NY 10029, USA
| | - Catherine R Curran
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Brittney S Zimmerman
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA
| | - Gabrielle Bouchard
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Tomi Jun
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA
| | - Pier V Nuzzo
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Qian Qin
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA
| | - Laure Hirsch
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Jonathan Feld
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA
| | - Kaitlin M Kelleher
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Danielle Seidman
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA
| | - Hsin-Hui Huang
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA
| | | | - Sarah Abou Alaiwi
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Talia D Rosenbloom
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA
| | - Penina S Stewart
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA
| | - Matthew D Galsky
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA
| | - Toni K Choueiri
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Deborah B Doroshow
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA.
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28
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Kumar P, Aggarwal M, Dhawan R, Dass J, Kumar G, Sharma V, Mirza S, Senapati J, Ganju N, Vaid T, Vijayran M, Panda T, Pragna GS, Krishna SS, Khandelwal A, Verghese R, Tyagi S, Seth T, Mahapatra M. Tele-Medicine Services in Hematological Practice During Covid Pandemic: Its Feasibility and Difficulties. Indian J Hematol Blood Transfus 2020; 37:528-533. [PMID: 33250594 PMCID: PMC7678769 DOI: 10.1007/s12288-020-01385-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 11/12/2020] [Indexed: 12/11/2022] Open
Abstract
In COVID 19 pandemic, delivery and access of health care services have become challenging. Telemedicine services can be considered for management of patients with hematological diseases. This study included all patients who enrolled for telemedicine facility for hematology from May 15 to July 15, 2020. Patient’s demographic and disease related parameters were recorded during the teleconsultation call. Overall satisfaction of attending doctor and patients were also recorded. A total of 1187 teleconsultation appointments were taken, of which 944 (79.6%) were successfully attended. Median age of patients was 38 years (range- 0.5–78 years), with 38% females. 55% of successful calls were from patients suffering a malignant hematological disorder. 24% had an active complaint pertaining to their disease or treatment. Of these, 162 (17%) were asked for a physical consultation. A significant association was found between the requirement of physical consultation and diagnosis (p < 0.001), absence of active complaint (< 0.0001) and education level of responder (p = 0.008). Patients understand that teleconsultation is helpful in preventing COVID-19 infection (71.4%) and avoids outpatient department rush (14.5%) associated with physical appointments; and around 80% patients were satisfied with the teleconsult. With the emergence of COVID 19, many localities under partial lockdown with constant fear of contacting virus amongst patients and health care providers, we can clearly see the advantages as well as feasibility of telemedicine services for our patients. The acute surge in telemedicine could be harnessed in the future to provide comprehensive and integrated care to patients of hematological disorders.
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Affiliation(s)
- Pradeep Kumar
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Mukul Aggarwal
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Rishi Dhawan
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Jasmita Dass
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Ganesh Kumar
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishnu Sharma
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Saleem Mirza
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Jayastu Senapati
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Neha Ganju
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Tejasvini Vaid
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Mona Vijayran
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Tribikram Panda
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - G Stitha Pragna
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Sahitya Sri Krishna
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Akash Khandelwal
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Renjith Verghese
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Tyagi
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Tulika Seth
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Manoranjan Mahapatra
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
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29
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Nichetti F, Bini M, Ambrosini M, Ottini A, Rametta A, Leporati R, Polastri D, Pircher C, Dotti K, Ferrari L, de Braud F. COVID-19 risk for patients undergoing anticancer treatment at the outpatient clinic of the National Cancer Institute of Milan: the COVINT study. ESMO Open 2020; 5:esmoopen-2020-000883. [PMID: 33158968 PMCID: PMC7650074 DOI: 10.1136/esmoopen-2020-000883] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 10/05/2020] [Accepted: 10/05/2020] [Indexed: 12/18/2022] Open
Abstract
Background In the midst of the COVID-19 pandemic, patients with cancer are regarded as a highly vulnerable population. Overall, those requiring hospital admission for treatment administration are potentially exposed to a higher risk of infection and worse outcome given the multiple in-hospital exposures and the treatment immunosuppressive effects. Methods COVINT is an observational study assessing COVID-19 incidence among patients receiving anticancer treatment in the outpatient clinic of the Istituto Nazionale dei Tumori di Milano. All consecutive patients with non-haematological malignancies treated with intravenous or subcutaneous/intramuscular anticancer therapy in the outpatient clinic were enrolled. The primary endpoint is the rate of occurrence of COVID-19. Secondary endpoints included the rate of COVID-19-related deaths and treatment interruptions. The association between clinical and biological characteristics and COVID-19 occurrence is also evaluated. COVID-19 diagnosis is defined as (1) certain if confirmed by reverse transcriptase PCR assay of nasopharyngeal swabs (NPS); (2) suspected in case of new symptoms or CT scan evidence of interstitial pneumonia with negative/not performed NPS; (3) negative in case of neither symptoms nor radiological evidence. Results In the first 2 months (16 February–10 April 2020) of observation, 1081 patients were included. Of these, 11 (1%) were confirmed and 73 (6.7%) suspected for COVID-19. No significant differences in terms of cancer and treatment type emerged between the three subgroups. Prophylactic use of myeloid growth factors was adopted in 5.3%, 2.7% and 0% of COVID-19-free, COVID-19-suspected and COVID-19-confirmed patients (p=0.003). Overall, 96 (8.9%) patients delayed treatment as a precaution for the pandemic. Among the 11 confirmed cases, 6 (55%) died of COVID-19 complications, and anticancer treatment was restarted in only one. Conclusions During the pandemic peak, accurate protective measures successfully resulted in low rates of COVID-19 diagnosis, although with high lethality. Prospective patients’ surveillance will continue with NPS and serology testing to provide a more comprehensive epidemiological picture, a biological insight on the impact of cytotoxic treatments on the immune response, and to protect patients and healthcare workers.
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Affiliation(s)
- Federico Nichetti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Marta Bini
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Margherita Ambrosini
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Arianna Ottini
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Alessandro Rametta
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Rita Leporati
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Daniela Polastri
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Chiara Pircher
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Katia Dotti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Laura Ferrari
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Filippo de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
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30
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Bakouny Z, Hawley JE, Choueiri TK, Peters S, Rini BI, Warner JL, Painter CA. COVID-19 and Cancer: Current Challenges and Perspectives. Cancer Cell 2020; 38:629-646. [PMID: 33049215 PMCID: PMC7528740 DOI: 10.1016/j.ccell.2020.09.018] [Citation(s) in RCA: 155] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023]
Abstract
Patients with cancer have been disproportionately affected by the COVID-19 pandemic. This effect has included the adverse outcomes in patients with cancer who develop COVID-19, the impact of the COVID-19 pandemic on the delivery of cancer care, and the severe disruption to cancer research. However, patients with cancer are a heterogeneous population, and recent studies have now documented factors that allow risk stratification of patients with cancer in order to optimize care. In this review, we highlight data at the intersection of COVID-19 and cancer, including the biological interplay between the two diseases and practical recommendations for the treatment of patients with cancer during the pandemic. We additionally discuss the potential long-lasting impact of the pandemic on cancer care due to its deleterious effect on cancer research, as well as biological insights from the cancer research community that could help develop novel therapies for all patients with COVID-19.
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Affiliation(s)
- Ziad Bakouny
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jessica E Hawley
- Division of Hematology and Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA
| | - Toni K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Brian I Rini
- Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jeremy L Warner
- Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Corrie A Painter
- Cancer Program, Broad Institute of MIT and Harvard, 415 Main Street, Cambridge, MA 02142, USA.
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31
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Sigorski D, Sobczuk P, Osmola M, Kuć K, Walerzak A, Wilk M, Ciszewski T, Kopeć S, Hryń K, Rutkowski P, Stec R, Szczylik C, Bodnar L. Impact of COVID-19 on anxiety levels among patients with cancer actively treated with systemic therapy. ESMO Open 2020; 5:e000970. [PMID: 33097653 PMCID: PMC7590347 DOI: 10.1136/esmoopen-2020-000970] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/14/2020] [Accepted: 09/30/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Life-threatening diseases have a negative impact on emotional well-being and psychosocial functioning. This study aimed to assess the relationship between the level of anxiety caused by a neoplasm and the threat of coronavirus infection among patients with cancer actively treated with systemic therapy during the COVID-19 pandemic. Additionally, we searched for clinical factors associated with a higher level of anxiety. METHODS In this multicentre, prospective, non-interventional study conducted in Poland, we enrolled 306 actively treated patients with cancer and collected their clinical data, including age, gender, cancer type and treatment intention. The fear/anxiety of SARS-CoV-2 were rated in Fear of COVID-19 Scale (SRA-FCV-19S) and Numerical Anxiety Scale (SRA-NAS). The fear and anxiety associated with cancer (CRA) were rated with the NAS (CRA-NAS). RESULTS The mean level of SRA-FCV-19S was 18.5±7.44, which was correlated with the SRA-NAS (r=0.741, p<0.001). SRA-FCV-19S was significantly higher in women versus men (20.18±7.56 vs 16.54±6.83; p<0.001) and was tumour type-dependent (p=0.037), with the highest anxiety observed in patients with breast cancer (17.63±8.75). In the multivariate analysis, only the female gender was significantly associated with higher SRA. CRA-NAS was higher in women versus men (7.07±2.99 vs 5.47±3.01; p<0.001), in patients treated with curative versus palliative intention (7.14±3.06 vs 5.99±3.06; p=0.01) and in individuals aged ≤65 years versus >65 years (6.73±2.96 vs 5.66±3.24; p=0.007). CONCLUSIONS For an actively treated patient with cancer, cancer remains the main life-threatening disease during the COVID-19 pandemic. The need for more attentive psychological care should be provided especially to female patients, patients with breast cancer, those under 65 years of age and treated with curative intention, as these factors are associated with a higher level of anxiety.
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Affiliation(s)
- Dawid Sigorski
- Department of Oncology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.
| | - Paweł Sobczuk
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Małgorzata Osmola
- Department of Hematology, Transplantation and Internal Medicine, University Clinical Centre, Medical University of Warsaw, Warsaw, Poland
| | - Kamil Kuć
- Department of Oncology, St. Pio's Provincial Hospital, Przemyśl, Poland
| | - Anna Walerzak
- Clinical Department of Oncological Surgery, Warmian-Masurian Cancer Center of The Ministry of The Interior and Administration's Hospital, Olsztyn, Poland
| | - Michal Wilk
- Department of Oncology, Centre of Postgraduate Medical Education, European Health Centre, Otwock, Poland
| | - Tomasz Ciszewski
- Department of Oncology, St. Pio's Provincial Hospital, Przemyśl, Poland
| | - Sylwia Kopeć
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Karolina Hryń
- Department of Oncology, St. Pio's Provincial Hospital, Przemyśl, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Rafał Stec
- Department of Oncology, Medical University of Warsaw, Warsaw, Poland
| | - Cezary Szczylik
- Department of Oncology, Centre of Postgraduate Medical Education, European Health Centre, Otwock, Poland
| | - Lubomir Bodnar
- Clinical Department of Oncology and Immuno-Oncology, Warmian-Masurian Cancer Center of The Ministry of The Interior and Administration's Hospital, Olsztyn, Poland
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32
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Yekedüz E, Utkan G, Ürün Y. A systematic review and meta-analysis: the effect of active cancer treatment on severity of COVID-19. Eur J Cancer 2020; 141:92-104. [PMID: 33130550 PMCID: PMC7538140 DOI: 10.1016/j.ejca.2020.09.028] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 09/26/2020] [Indexed: 12/19/2022]
Abstract
Background The COVID-19 pandemic hit all over the world, and cancer patients are more vulnerable for COVID-19. The mortality rate may increase up to 25% in solid malignancies. In parallel to increased mortality rates among cancer patients, safety concerns regarding cancer treatment has increased over time. However, there were contradictory results for the cancer treatment during pandemic. In this study, we assessed the effect of cancer treatment on the severity of COVID-19. Methods The MEDLINE database was searched on September 01, 2020. Primary end-points were severe disease and death in the cancer patients treated within the last 30 days before COVID-19 diagnosis. Quality of included studies was assessed by Newcastle–Ottawa scale. The generic inverse-variance method was used to calculate odds ratios (ORs) for each outcome. Results Sixteen studies were included for this meta-analysis. Chemotherapy within the last thirty days before COVID-19 diagnosis increased the risk of death in cancer patients after adjusting for confounding variables (OR: 1.85; 95% confidence interval: 1.26–2.71). However, severe COVID-19 risk did not increase. Furthermore, targeted therapies, immunotherapy, surgery and radiotherapy did not increase the severe disease and death risk in cancer patients with COVID-19. Conclusion Chemotherapy increased the risk of death from COVID-19 in cancer patients. However, there was no safety concern for immunotherapy, targeted therapies, surgery and radiotherapy.
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Affiliation(s)
- Emre Yekedüz
- Department of Medical Oncology, Ankara University, Ankara, Turkey; Ankara University Cancer Research Institute, Ankara, Turkey.
| | - Güngör Utkan
- Department of Medical Oncology, Ankara University, Ankara, Turkey; Ankara University Cancer Research Institute, Ankara, Turkey
| | - Yüksel Ürün
- Department of Medical Oncology, Ankara University, Ankara, Turkey; Ankara University Cancer Research Institute, Ankara, Turkey
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