|The following article features coverage from the European Society for Medical Oncology 2020 virtual meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.|
Lockdown measures during the COVID-19 pandemic resulted in anticancer treatment modifications for patients undergoing active treatment of their cancer, which resulted in posttraumatic stress among patients and health care providers, according to results of a prospective study reported at the European Society of Medical Oncology (ESMO) Virtual Congress 2020.
“We assessed the pandemic-induced therapeutic modifications of patients’ cancer treatment and the psychological impact on patients and caregivers [health care providers],” said study presenter Florence Joly, MD, PhD, of the Comprehensive Cancer Centre François Baclesse in France.
The prospective COVIPACT study included 621 patients (575 completed questionnaires) with hematologic or solid cancers and 73 health care providers, including nurses and oncologists, from outpatient departments of 2 cancer centers in France. The primary endpoint was treatment modifications. Secondary endpoints included scores for posttraumatic stress, perceived stress, quality of life, and cognitive complaints, which were collected at baseline during the lockdown and at 3 and 6 months.
At baseline, the median age was 64 years among patients and 40 years among health care providers, of whom, 69% and 81%, respectively, were women. Solid tumors were present in 98% of patients, which included 59% who had metastatic disease. Anticancer treatment included chemotherapy alone (55%), chemotherapy with another agent (16%), immunotherapy alone (11%), and targeted therapy with or without another agent (16%). New treatment was initiated during the lockdown among 37% of patients.
Treatment modifications were necessary among 27% of patients, which was most common among patients with cancers of the breast, thoracic region, and digestive tract. Modifications included treatment interruptions for 15%, postponement for 32%, and changes to administration schedule in 19%.
Dr Joly said that 2 patients contracted SARS-CoV-2 infection, with chemotherapy postponed in 1 patient and no modification of immunotherapy in the other patient.
Treatment modifications were associated with higher rates of posttraumatic stress among patients who rated their stress as high, which was present in 27% of patients who received treatment modifications compared with 19% of patients who did not require treatment modification (P =.049). Overall, high levels of perceived stress was present in 6% of patients, posttraumatic stress in 21%, and insomnia in 24%.
Treatment modifications did not affect quality of life or cognition.
Health care providers demonstrated a higher perceived stress score compared with patients, but most health care providers still reported feelings of professional satisfaction and self-efficacy.
Dr Joly concluded that these data demonstrate “negative impact of treatment modifications on stress related to event[s] among patients.” Therefore, she said “we encourage rapid implementation of psychosocial support for ongoing treated cancer patients to promote emotional resilience in order to avoid posttraumatic stress.”x
Read more of Cancer Therapy Advisor‘s coverage of the ESMO Virtual Congress 2020 by visiting the conference page.
Joly F, Leconte A, Grellard J, et al. Impact of the COVID-19 pandemic on management of medical cancer treatments and psychological consequence for the patients. Presented at: European Society of Medical Oncology (ESMO) Virtual Congress 2020; September 19-21, 2020. Abstract LBA69.