ABSTRACT
Background: No specific safety data concerning systemic oncological treatments were available at time of COVID-19 outbreak in Belgium. In our hospital we decided to maintain adjuvant and early line treatments for metastatic disease in patients under 65 and without specific comorbidities and to apply a shared decision approach in other patients while following closely the safety of these treatments. Method(s): Real time safety monitoring was proposed to all patients treated for solid tumours in our day-care unit starting March 1st, 2020. After signing informed consent patients were asked questions concerning protective measures at home, signs of SARS-CoV-2 infection and hospitalisation. Patients' charts were reviewed for outcome, including death, after suspected or proven SARS-CoV-2 infection. Minimum follow-up was 5 weeks after day care unit attendance. Result(s): 387 patients were included in our registry between March 1st and March 31st, 2020. Median age was 64 years-old (range 27-90). Most patients suffered from lung (n=96), breast (n=93), gastrointestinal (n=87), gynaecological (n=38) or urological (n=33) cancers. 131 patients received (neo)adjuvant treatments, 256 patients were treated for metastatic disease. Patients received chemotherapy (n=170), immunotherapy (n=103), targeted therapy (n=68) or other combinations (n=46). Although Belgium had one of the highest infection rates in the world, safety data concerning risk of SARS-CoV-2 infection and outcomes were rather reassuring. A total of 11 patients had either suspected (n=5, 1.3%) or proven (n=6, 1.6%) SARS-CoV-2 infection. Only one 74 years old patient died of COVID-19, another 51 years old patient died of progressive disease but presented also suspicion of SARS-CoV-2 infection at the time of death. Conclusion(s): Analysis of our data for patients treated in March 2020 in the day-care unit are reassuring and suggest higher risk related to under-treatment compared to risk related to continuation of systemic therapy at time of COVID-19 outbreak. Patients' follow-up will be updated and additional analyses and data in particular for April 2020, when the infection rate was still extremely high in Belgium, will be presented. Legal entity responsible for the study: The authors. Funding(s): Fondation Leon Fredericq. Disclosure: A. Rorive: Travel/Accommodation/Expenses: BMS;MSD. B. Sautois: Advisory/Consultancy, Travel/Accommodation/Expenses: Janssen;Advisory/Consultancy: Clovis;Sanofi;Astellas. J. Collignon: Advisory/Consultancy, Travel/Accommodation/Expenses: Roche;Amgen;Pfizer;Advisory/Consultancy: Servier;Bayer;Merck;Lilly;Sanofi;Sirtex;Celgene;Ipsen;Novartis. P. Freres: Advisory/Consultancy: Ipsen;Merck;BMS. C. Gennigens: Advisory/Consultancy, Research grant/Funding (institution): Astra-Zeneca;Advisory/Consultancy: BMS;GSK;Lilly;MSD;Advisory/Consultancy, Travel/Accommodation/Expenses: Ipsen;Pfizer;Pharmamar;Roche. G. Jerusalem: Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Novartis;Roche;Pfizer;Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Lilly;Advisory/Consultancy, Research grant/Funding (institution): Amgen;Advisory/Consultancy, Travel/Accommodation/Expenses: BMS;AstraZeneca;Daiichi Sankyo;Advisory/Consultancy: Abbvie;Travel/Accommodation/Expenses: Medimmune;MerckKGaA. All other authors have declared no conflicts of interest.Copyright © 2020
ABSTRACT
Background: No data concerning systemic oncological treatments' safety during COVID-19 outbreak were available in Belgium. The aim of this study is to analyse patients’ perception of both the risk of infection and the need for change in clinical practice in oncology. Methods: A 12-items questionnaire using the Likert scale for 11 of these questions concerning the patients’ perception of COVID-19 was distributed to patients admitted for systemic therapy of solid tumours in our day-care unit between April 14th and 30th, 2020 (4-6 weeks after lockdown in Belgium). Results: 237 patients were included in our research project after signing an informed consent. Median age was 63 years-old (range 26-90). Most patients suffered from lung (n=59), breast (n=54), gastrointestinal (n=47), gynaecological (n=34) or urological (n=16) cancers or melanoma (n=15). 87 patients received (neo)adjuvant treatments, 150 patients were treated for metastatic disease. Patients received chemotherapy (n=106), immunotherapy (n=60), targeted therapy (n=36) or combinations (n=35). The patients who estimated their risk of dying because of COVID-19 infections as <0.1%, 1%, 10%, 20%, 50% or 100% were respectively 9.7%, 15.2%, 13.5%, 6.3%, 32.4%, 11.4% (no opinion: 10.8%). Most patients agreed (21.5%) or strongly agreed (64.6%) that it is important for them to receive the best cancer treatment available even if this may increase the infection risk. Very few patients agreed (1.3%) or strongly agreed (2.5%) that they were considering stopping the ongoing therapy because of the COVID-19 outbreak. Most patients agreed (33.8%) or strongly agreed (49.4%) that the institution was doing everything possible for risk reduction of contamination while receiving the therapy in the day-care unit. Conclusions: Although patients evaluated the risk of dying due to COVID-19 infection as extremely high, they are still asking for the best oncological care available. The majority recognize the effort of the institution in minimizing infectious risk. Additional analyses will be reported at time of presentation. Questionnaires will be repeated 3 months after the peak of the COVID-19 outbreak. Legal entity responsible for the study: The authors. Funding: Fondation Leon Fredericq. Disclosure: A. Rorive: Travel/Accommodation/Expenses: MSD;Travel/Accommodation/Expenses: BMS. B. Sautois: Advisory/Consultancy, Travel/Accommodation/Expenses: Janssen;Advisory/Consultancy: Clovis;Advisory/Consultancy: Sanofi;Advisory/Consultancy: Astellas. A. Sibille: Advisory/Consultancy, Travel/Accommodation/Expenses: BMS;MSD;Boehringer Ingelheim;Roche;Advisory/Consultancy: AstraZeneca;Takada. J. Collignon: Advisory/Consultancy, Travel/Accommodation/Expenses: Roche;Amgen;Pfizer;Advisory/Consultancy: Servier;Bayer;Merck;Lilly;Sanofi;Sirtex;Celgene;Ipsen;Novartis. C. Gennigens: Advisory/Consultancy, Research grant/Funding (institution): Astra-Zeneca;Advisory/Consultancy: BMS;GSK;Lilly;MSD;Advisory/Consultancy, Travel/Accommodation/Expenses: Ipsen;Pfizer;Pharmamar;Roche. P. Freres: Advisory/Consultancy: Ipsen;Merck;BMS. G. Jerusalem: Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Novartis;Roche;Pfizer;Advisory/Consultancy, Travel/Accommodation/Expenses: Lilly;Amgen;BMS;AstraZeneca;Daiichi Sankyo;Advisory/Consultancy: Abbvie;Travel/Accommodation/Expenses: Medimmune;MerckKGaA. All other authors have declared no conflicts of interest.