Anti-cancer therapy and clinical trial considerations for gynecologic oncology patients during the COVID-19 pandemic crisis.

The COVID-19 pandemic has consumed considerable resources and has impacted the delivery of cancer care. Patients with cancer may have factors which place them at high risk for COVID 19 morbidity or mortality. Highly immunosuppressive chemotherapy regimens and possible exposure to COVID-19 during treatment may put patients at additional risk. The Society of Gynecologic Oncology convened an expert panel to address recommendations for best practices during this crisis to minimize risk to patients from deviations in cancer care and from COVID-19 morbidity. An expert panel convened to develop initial consensus guidelines regarding anti-neoplastic therapy during the COVID-19 pandemic with respect to gynecologic cancer care and clinical trials. COVID-19 poses special risks to patients who are older, have medical co-morbidities, and cancer. In addition, this pandemic will likely strain resources, making delivery of cancer care or conduct of clinical trials unpredictable. Recommendations are to limit visits and contact with health care facilities by using telemedicine when appropriate, and choosing regimens which require less frequent visits and which are less immunosuppressive. Deviations will occur in clinical trials as a result of limited resources, and it is important to understand regulatory obligations to trial sponsors as well as to the IRB to ensure that clinical trial and patient safety oversight are maintained. The ongoing crisis will strain resources needed to deliver cancer care. When alterations to the delivery of care are mandated, efforts should be taken to minimize risks and maximize safety while approximating standard practice.

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Déclaration de conflit d'intérêts

Declaration of competing interest Dr. Huh has nothing to disclose. Dr. Armstrong reports grants from Astra Zeneca, Clovis, Pfizer, Tesary, Syndax, Esai/Morphotek, from null, outside the submitted work. Dr. Naumann reports personal fees from Astra-Zeneca, grants and personal fees from BioSutro, grants from Bristol-Myers-Squib, personal fees from Clovis, grants and personal fees from Merck, personal fees from Eisai, grants and personal fees from Tesaro/GSK, grants and personal fees from GOG Foundation, grants from OncoMed, outside the submitted work. Dr. Kesterson reports personal fees from GSK/Tesaro, personal fees from Clovis Oncology, outside the submitted work. Dr. Fader reports personal fees and other from Mersana, personal fees from Merck, outside the submitted work. Dr. Liu reports advisory board participation for AstraZeneca, Clovis Oncology, Tesaro/GSK, Genentech, Merck, and Mersana Therapeutics, outside the submitted work; and Institutional PI on industry-sponsored trials from Acetylon Pharmaceuticals, Aravive Biologics, Arch Oncology, AstraZeneca, Atara Biotherapeutics, Boston Biomedical, Bristol-Myers Squibb, Agenus, Clovis Oncology, CytomX Therapeutics, Genentech/Roche, Regeneron Pharmaceuticals, Surface Oncology, Tesaro/GSK, and Vigeo Therapeutics. Dr. Westin reports grants and personal fees from AstraZeneca, grants and personal fees from Clovis Oncology, grants and personal fees from GSK/Tesaro, grants and personal fees from Roche/Genentech, grants and personal fees from Novartis, personal fees from Merck, personal fees from Pfizer, personal fees from Eisai, grants from Cotinga Pharmaceuticals, grants from Bayer, grants from ArQule, personal fees from CIrculogene, outside the submitted work. Dr. Pothuri reports grants, personal fees and non-financial support outside the submitted work; Institutional PI for industry sponsored trials from Tesaro/GSK, AstraZeneca, Merck, Genetech/Roche, and Clovis Oncology. Compensated advisory boards include Tesaro/GSK, AstraZeneca, and Eisai. Dr. Moore reports personal fees and other from Astra Zeneca, grants, personal fees and other from Genentech/Roche, grants, personal fees and other from Immunogen, grants, personal fees and other from Clovis, grants, personal fees and other from Tesaro, personal fees and other from Pfizer, personal fees from Janssen, personal fees from Aravive, personal fees from VBL Therapeutics, personal fees and other from Onco Med, personal fees from Samumed, grants and other from Lilly, personal fees from Eisai, personal fees from Vavotar, personal fees from Abbvie, personal fees from Tarveda, outside the submitted work. Dr. Alvarez Secord reports grants from AbbVie, Amgen, Astra Zeneca, Clovis, Astellas Pharma Inc., Boehringer Ingelheim, Bristol Myers Squibb, Eisai, Endocyte, Exelixis, Incyte, Merck, PharmaMar, Immutep Ltd., Roche/Genentech, Seattle Genetics, Inc., Tesaro/GSK, VBL Therapeutics, National Cancer Trial Network; honoraria from Aravive, Astra Zeneca, Clovis, Cordgenics, Eisai, Janssen/Johnson & Johnson, Merck, Mersana, OncoQuest, Roche/Genentech, Tesaro/GSK Advisory Boards; participation on Clinical Trial Steering Committees (uncompensated) for Roche/Genentech, and VBL Therapeutics; and member of GOG-Foundation Board of Directors, outside the submitted work. Dr. Chan reports personal fees from Acerta, personal fees from Aravive, personal fees from Biodesix, personal fees from Clovis, personal fees from Janssen/J and J, personal fees from Oxigene/Mateon, grants and personal fees from Roche/Genentech, grants and personal fees from Glaxosmithkline/Tesaro, grants and personal fees from Astra Zeneca, personal fees from Eisai, outside the submitted work.