Trending Clinical Topic: Cancer and COVID-19

What your doctor is reading on Medscape.com:

MAY 01, 2020 –News about the prevalence of cancer among patients with COVID-19 and concerns related to providing cancer care during a pandemic resulted in this week’s top trending clinical topic. A meta-analysis published in JCO Global Oncology confirmed earlier reports which suggested that patients with cancer, and survivors, are an important at-risk population for COVID-19. The new findings were limited by the retrospective nature of the studies included. The study’s authors hope that additional data from China and Italy will further clarify the types of cancer associated with higher risk, as well as treatment regimens that increase complications of COVID-19 infection.

Multiple cancer and COVID-19 patient registries have launched recently. Their intent is to determine the characteristics of patients with cancer who have the most severe COVID-19 infections, as well as estimates of disease severity, treatment modifications and delays, and clinical outcomes. The American Society of Clinical Oncology (ASCO) is asking practices across the country to share information about their patients for educational purposes. Information collected through the web-based registry will not be made available for commercial purposes. This is in opposition to the data collection being done by CancerLinQ, a wholly owned subsidiary of ASCO. CancerLinQ has been criticized for allowing partner companies to sell access to its data without asking for patients’ permission.

Patients with cancer who are not infected with COVID-19 are still being affected by the pandemic. A survey conducted by the American Cancer Society Cancer Action Network found that nearly a quarter (24%) of respondents experienced a delay in care or treatment. More distressing, 12% reported that not only was their care delayed, but they also had not been told when treatment would be rescheduled. Oncologists are reporting the difficulties they have faced in trying to continue to provide the care their patients need. Many have turned to solutions like telemedicine and other virtual healthcare. Those strategies are among the suggestions provided by authors of a special feature article in the Journal of the National Comprehensive Cancer Network . Their list of 10 recommendations includes prescreening, telemedicine, and limiting procedures. The article also provides guidance for how best to ensure healthcare worker safety while providing cancer care during the crisis.

The management of lung cancer during the COVID-19 crisis is a specific concern. Experts in Europe issued recommendations intended to minimize the risk of patients becoming infected with SARS-CoV-2 while in the hospital receiving treatment. The authors suggest that personalization of care should be emphasized. This includes evaluating the likelihood of treatment benefit and possibly delaying surgery. A novel global registry (TERAVOLT) has been launched to collect data that will be used to develop a tailored risk-assessment strategy for patients with lung cancer. The authors stress that an international consensus on COVID-19 testing in lung cancer is crucial to achieve that goal.

The crossover between COVID-19 and cancer is complex and unfolding. As more recommendations and data become available, the subject is likely to remain among the top trending clinical topics.