Lung Cancer and COVID-19: Global Experts Offer Treatment Guidance
Posted: Tuesday, August 25, 2020
A host of leading international oncologists have published treatment guidance for patients with lung cancer during the global coronavirus pandemic in the Journal of Thoracic Oncology. “Treatment decisions balancing the risk of exposure with effective care require close multidisciplinary discussions and thorough deliberation between caregivers and patients,” stated Chandra P. Belani, MD, of Penn State Cancer Institute, and colleagues.
With no current validated cure for COVID-19 infection, it is important to minimize the risk of exposure to the virus for patients with lung cancer during the pandemic. The authors recommended treatment delay and reduction in face-to-face appointments to reduce transmission of infection. However, treatment delays and avoiding in-person appointments are not always possible, so the authors recommended extensive testing for coronavirus during in-person visits.
When surgery is required, the experts suggest a delay of no more than 6 to 8 weeks. Prioritization of surgery should be based on a phased approach, but generally, surgery should be prioritized in cases where survivorship is at risk if not performed within 3 months. Adjuvant therapy often requires patients to attend the clinic once a day, so it is suggested to implement hypofractionation to reduce the number of visits, thereby minimizing risk of exposure to the coronavirus.
The authors commented that immunotherapy does not appear to pose an increased risk to patients; however, PD-1 inhibitors are often used in patients with lung cancer, and PD-1 may be involved in the immune response against viral infections. Minimizing the risk of exposure to the coronavirus is the best safeguard for patients undergoing immunotherapy.
Ultimately, the authors recommended extensive deliberation between providers and patients to develop an optimal treatment plan, as treatment delays produce their own inherent risks.
See the link below for full details of the guidance overview.
Disclosure: For full disclosures of study authors, visit jto.org.