A Look at One Institution’s Approach To Cancer Care During the COVID-19 Pandemic

The following article features coverage from the American Association for Cancer Research (AACR) 2020 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

At one institution in Italy, cancer care has been adapted to minimize the risk of COVID-19 infection, while prioritizing cancer care for patients who need imminent care, according to a presentation at the American Association for Cancer Research (AACR) Virtual Annual Meeting I 2020.¹

Paolo A. Ascierto, MD, of the Istituto Nazionale Tumori in Italy, highlighted the multifaceted approach that his institution has adopted to maintain the safety of patients and health care workers. For the safety of patients, this includes prioritizing patients and COVID-19 testing.

“The highest priority for these cancer patients is for those who should get any curative resection for stage III or metastatic disease,” Dr Ascierto said. At his institution, patients who required curative surgery for stage III melanoma, resection of oligometastatic disease, or surgical management of complications from surgical procedures were considered high priority. For patients with less aggressive disease, surgery was delayed.

For adjuvant therapy, some treatments were delayed by up to 12 weeks. For other patients receiving systemic therapy, oral therapies or agents with longer infusion schedules were preferentially selected if possible. However, Dr Ascierto said that the institution did not delay or stop or treatment with targeted or immunotherapies for unresectable stage III or IV melanoma.

Patient follow-up has continued, with most appointments shifted to telemedicine and clinical visits postponed, where possible.

Clinical trial enrollment has been placed on hold, and telemedicine visits are used for most appointments.

COVID-19 testing is important, and Dr Ascierto said that he orders testing for patients with cancer with certain symptoms. “If we have a CT scan with signs of pneumonitis, together with fever, we should be sure that it is not comorbid with COVID-19,” he said. In addition, patients taking BRAF/MEK inhibitors who develop a fever that does not resolve with treatment interruption are tested for COVID-19.

There are limited data regarding the effect of immunotherapy on COVID-19 infection. Dr Ascierto said that his institution currently has 2 patients diagnosed with COVID-19 out of 400 receiving immunotherapy. Both patients were asymptomatic and recovered with a negative test within 10 days.

Trials are ongoing to evaluate the outcomes of patients treated with immunotherapy, as well as anti–IL-6 inhibitors like tocilizumab.

Read more of Cancer Therapy Advisor‘s coverage of AACR 2020 meeting by visiting the conference page.

Reference

Ascierto PA. Experience in using oncology drugs in patients with COVID-19. Presented at: American Association for Cancer Research (AACR) Virtual Annual Meeting I; April 27-28, 2020. Plenary session.