Risk of SARS-CoV2-Related Mortality in Non-Small Cell Lung Cancer Patients Treated with First-Line Immunotherapy Alone or in Combination with Chemotherapy.

BACKGROUND: The impact of systemic anticancer treatments on SARS-CoV-2-related mortality is still debatable. METHODS: By a retrospective analysis of patients with non-small-cell lung cancer (NSCLC) treated with first-line Pembrolizumab or in combination with chemotherapy (ChT) during the first surge of the pandemic. RESULTS: The adjusted risk of death was higher in patients treated with ChT + Pembrolizumab (HR 4.6, 1.2-17.4, p = 0.02). The SARS-CoV-2-related mortality rate was higher in patients treated with ChT + Pembrolizumab (p = 0.03), ≥70 years (p = 0.03) and current smokers (p = 0.17). CONCLUSIONS: The addition of ChT to immunotherapy could be associated with increased risk of mortality and higher SARS-CoV-2-related mortality rate.

Home-deliverable antitumoral treatments in the age of COVID-19: the Portsmouth experience and a narrative review.

Background and Objective: During the coronavirus disease 2019 (COVID-19) pandemic, risks and priorities of oncologic care have required a thorough reassessment. The chance that fragile patients have exposure to infection during frequent hospital visits is an additional consideration for all therapeutic decisions. Patients with cancer, particularly those with lung cancer, have a greater chance of developing a severe form of COVID-19. Their increased risk is due to the immunosuppression associated with the chemotherapy itself, the underlying pulmonary compromise, which often accompanies lung malignancy or their general poor health. Oncology societies have given precise recommendations on the treatment modalities to be favoured, such as giving up specific palliative or adjuvant treatments, preferring shorter and less cytopenic therapies. In this review, we discussed how some of these curative treatments could be given by administering them at home. In this narrative review, we aim to see if it is safe and feasible to deliver home-administered oncologic intravenous treatments. Methods: By narrative review, we looked for all the articles written in English describing home delivery chemotherapy or immunotherapy programs since 2019 that emerged or evolved during the COVID-19 pandemic. We added real-life data regarding the initiation of home immunotherapy in Portsmouth. Key Content and Findings: There is a growing body of evidence supporting the safety and feasibility of home-administered chemotherapy and immunotherapy treatments. Conclusions: Home-administered chemotherapy and immunotherapy treatments are safe and feasible despite financial challenges, particularly about reimbursement by insurance companies and the loss of earnings for hospitals. Home treatments also require the careful selection of eligible patients and the training and organisation of specialised teams capable of managing the expected complications. It would be interesting to assess the risk-reduction in terms of infections and potential survival gains obtained by these programmes during the COVID pandemic.