Impact of COVID-19 outbreak on cancer immunotherapy in Italy: a survey of young oncologists.
Adult
Antineoplastic Agents, Immunological
/ administration & dosage
B7-H1 Antigen
/ antagonists & inhibitors
Betacoronavirus
/ immunology
COVID-19
CTLA-4 Antigen
/ antagonists & inhibitors
Coronavirus Infections
/ epidemiology
Drug Prescriptions
/ statistics & numerical data
Female
Geography
Humans
Infection Control
/ standards
Italy
/ epidemiology
Male
Medical Oncology
/ standards
Neoplasms
/ drug therapy
Oncologists
/ statistics & numerical data
Pandemics
/ prevention & control
Pneumonia, Viral
/ epidemiology
Practice Patterns, Physicians'
/ standards
Prevalence
Programmed Cell Death 1 Receptor
/ antagonists & inhibitors
SARS-CoV-2
Surveys and Questionnaires
/ statistics & numerical data
Time-to-Treatment
antineoplastic protocols
healthcare economics and organizations
immunotherapy
lung neoplasms
melanoma
Journal
Journal for immunotherapy of cancer
ISSN: 2051-1426
Titre abrégé: J Immunother Cancer
Pays: England
ID NLM: 101620585
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
accepted:
08
08
2020
entrez:
16
10
2020
pubmed:
17
10
2020
medline:
28
10
2020
Statut:
ppublish
Résumé
The coronavirus disease 2019 (COVID-19) pandemic has overwhelmed the health systems worldwide. Data regarding the impact of COVID-19 on cancer patients (CPs) undergoing or candidate for immune checkpoint inhibitors (ICIs) are lacking. We depicted the practice and adaptations in the management of patients with solid tumors eligible or receiving ICIs during the COVID-19 pandemic, with a special focus on Campania region. This survey (25 questions), promoted by the young section of SCITO (Società Campana di ImmunoTerapia Oncologica) Group, was circulated among Italian young oncologists practicing in regions variously affected by the pandemic: high (group 1), medium (group 2) and low (group 3) prevalence of SARS-CoV-2-positive patients. For Campania region, the physician responders were split into those working in cancer centers (CC), university hospitals (UH) and general hospitals (GH). Percentages of agreement, among High (H) versus Medium (M) and versus Low (L) group for Italy and among CC, UH and GH for Campania region, were compared by using Fisher's exact tests for dichotomous answers and χ This is the first Italian study to investigate the COVID-19 impact on cancer immunotherapy, unique in its type and very clear in the results. The COVID-19 pandemic seemed not to affect the standard practice in the prescription and delivery of ICIs in Italy. Telemedicine was widely used. There was high consensus to interrupt immunotherapy in SARS-CoV-2-positive patients and to adopt ICIs with longer schedule interval. The majority of the responders tended not to delay the start of ICIs; there were no changes in supportive treatments, but some of the physicians opted for delaying surgeries (if part of patients' planned treatment approach). The results from responders in Campania did not differ significantly from the national ones. Our study highlights the efforts of Italian oncologists to maintain high standards of care for CPs treated with ICIs, regardless the regional prevalence of COVID-19, suggesting the adoption of similar solutions. Research on patients treated with ICIs and experiencing COVID-19 will clarify the safety profile to continue the treatments, thus informing on the most appropriate clinical conducts.
Sections du résumé
BACKGROUND
The coronavirus disease 2019 (COVID-19) pandemic has overwhelmed the health systems worldwide. Data regarding the impact of COVID-19 on cancer patients (CPs) undergoing or candidate for immune checkpoint inhibitors (ICIs) are lacking. We depicted the practice and adaptations in the management of patients with solid tumors eligible or receiving ICIs during the COVID-19 pandemic, with a special focus on Campania region.
METHODS
This survey (25 questions), promoted by the young section of SCITO (Società Campana di ImmunoTerapia Oncologica) Group, was circulated among Italian young oncologists practicing in regions variously affected by the pandemic: high (group 1), medium (group 2) and low (group 3) prevalence of SARS-CoV-2-positive patients. For Campania region, the physician responders were split into those working in cancer centers (CC), university hospitals (UH) and general hospitals (GH). Percentages of agreement, among High (H) versus Medium (M) and versus Low (L) group for Italy and among CC, UH and GH for Campania region, were compared by using Fisher's exact tests for dichotomous answers and χ
RESULTS
This is the first Italian study to investigate the COVID-19 impact on cancer immunotherapy, unique in its type and very clear in the results. The COVID-19 pandemic seemed not to affect the standard practice in the prescription and delivery of ICIs in Italy. Telemedicine was widely used. There was high consensus to interrupt immunotherapy in SARS-CoV-2-positive patients and to adopt ICIs with longer schedule interval. The majority of the responders tended not to delay the start of ICIs; there were no changes in supportive treatments, but some of the physicians opted for delaying surgeries (if part of patients' planned treatment approach). The results from responders in Campania did not differ significantly from the national ones.
CONCLUSION
Our study highlights the efforts of Italian oncologists to maintain high standards of care for CPs treated with ICIs, regardless the regional prevalence of COVID-19, suggesting the adoption of similar solutions. Research on patients treated with ICIs and experiencing COVID-19 will clarify the safety profile to continue the treatments, thus informing on the most appropriate clinical conducts.
Identifiants
pubmed: 33060148
pii: jitc-2020-001154
doi: 10.1136/jitc-2020-001154
pmc: PMC7565202
pii:
doi:
Substances chimiques
Antineoplastic Agents, Immunological
0
B7-H1 Antigen
0
CD274 protein, human
0
CTLA-4 Antigen
0
CTLA4 protein, human
0
PDCD1 protein, human
0
Programmed Cell Death 1 Receptor
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
JAMA Oncol. 2016 Oct 1;2(10):1346-1353
pubmed: 27367787
J Exp Clin Cancer Res. 2020 Apr 29;39(1):74
pubmed: 32349775
Expert Rev Anti Infect Ther. 2005 Apr;3(2):251-62
pubmed: 15918782
Nat Cancer. 2020 Apr 21;:1-4
pubmed: 32346676
Eur J Cancer. 2020 Jun;132:199-206
pubmed: 32380430
N Engl J Med. 2020 Jun 11;382(24):2285-2287
pubmed: 32267650
Lancet Oncol. 2020 Mar;21(3):335-337
pubmed: 32066541
Lancet. 2020 Feb 15;395(10223):473-475
pubmed: 32043983
Lancet Glob Health. 2020 May;8(5):e641-e642
pubmed: 32199072
JAMA Oncol. 2020 May 20;:
pubmed: 32433719
Transl Med UniSa. 2020 Feb 20;21:59-60
pubmed: 32123684
J Transl Med. 2014 Oct 21;12:291
pubmed: 25331657
Virchows Arch. 2019 Apr;474(4):421-432
pubmed: 30747264
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
J Antimicrob Chemother. 2008 Sep;62(3):437-41
pubmed: 18565970
Tumori. 2013 May-Jun;99(3):374-81
pubmed: 24158067
Immunotherapy. 2020 Apr;12(5):269-273
pubmed: 32212881
JCO Glob Oncol. 2020 Apr;6:557-559
pubmed: 32250659