Has COVID-19 had a greater impact on female than male oncologists? Results of the ESMO Women for Oncology (W4O) Survey.

BACKGROUND: European Society for Medical Oncology Women for Oncology (ESMO W4O) research has previously shown under-representation of female oncologists in leadership roles. As early reports suggested disproportionate effects of the COVID-19 pandemic on women, the ESMO W4O Committee initiated a study on the impact of the pandemic on the lives of female and male oncologists. METHODS: A questionnaire was sent to ESMO members and put on the ESMO website between 8 June 2020 and 2 July 2020. Questions focused on the working (hospital tasks, laboratory tasks, science) and home (household management, childcare, parent care, personal care) lives of oncologists during and after COVID-19-related lockdowns. RESULTS: Of 649 respondents, 541 completed the questionnaire. Of these, 58% reported that COVID-19 had affected their professional career, 83% of whom said this was in a negative way (85% of women versus 76% of men). Approximately 86% reported that COVID-19 had changed their personal life and 82% their family life. Women were again significantly more affected than men: personal life (89% versus 78%; P = 0.001); family life (84% versus 77%; P = 0.037). During lockdowns, women reported increased time spent on hospital and laboratory tasks compared with men (53% versus 46% and 33% versus 26%, respectively) and a significantly higher proportion of women than men spent less time on science (39% versus 25%) and personal care (58% versus 39%). After confinement, this trend remained for science (42% versus 23%) and personal care (55% versus 36%). CONCLUSIONS: The COVID-19 pandemic has adversely affected the professional and home lives of oncologists, especially women. Reduced research time for female oncologists may have long-lasting career consequences, especially for those at key stages in their career. The gender gap for promotion to leadership positions may widen further as a result of the pandemic.

P09.18 COVID-19 Outcomes in Patients With Thoracic Malignancies According to Gender and Ethnicity (TERAVOLT)

Introduction: Previously reported data on patients with thoracic malignancies who develop COVID-19 have suggested a higher mortality rate compared to the general population and to other cancer types, particularly in patients over 65 years of age or suffering from active or progressive disease. Preliminary data from other studies have suggested that gender and ethnicity may also impact patient outcomes. Methods: TERAVOLT is a multi-center, international observational study composed of a cross-sectional component and a longitudinal cohort component. Eligibility criteria include the presence of any thoracic cancer and a COVID-19 diagnosis confirmed in the laboratory with RT-PCR/serology, highly suspicious radiological and clinical findings, or suspected with symptoms and known contact with a positive person. The overarching goals of this consortium are to provide data for guidance to oncology professionals on managing patients with thoracic malignancies while understanding the risk factors for morbidity and mortality from this novel virus. Clinical outcomes including hospitalization, ICU admission, oxygen requirement and mortality were collected. The association between demographic/clinical characteristics and outcomes were measured with odds ratio with 95% confidence intervals using a logistic regression model. Results: As of August 20, 2020, a total of 1,053 patients with COVID-19 and thoracic cancers from 19 countries and 130 centers have been identified, including 42% females and 84% White, 9.3% African American, 25% Hispanic. The median age of male patients was 69 compared to 66 years of age for females. While ECOG PS was similar between treatment groups, 77% of males were admitted to hospital with a mortality rate of 37% compared to 66% of females with a mortality rate of 28%. The median age of African American patients was 66 years of age compared to 68 and 69 years of age for white and Hispanic patients, respectively;26% of African American and 25% White patients had an ECOG PS ≥2 compared to 19% of Hispanics. A similar percentage of patients were admitted to the hospital and ICU, while the mortality rate for Hispanics was 36% compared to 34% for whites and 26% for African Americans. Conclusion: Similar to the general population, the mortality rate of males with thoracic cancer is higher than females. Regarding ethnicity, there is a difference in the median age of African American patients compared to Whites and Hispanics. Although the severity of COVID-19 disease, as defined by hospital admission, is similar between ethnic groups, the mortality rate in Hispanics is higher. We will present a multivariate analysis of these data according to gender and ethnicity, including the impact of cancer stage, prior cancer therapy, and COVID-19 therapy on outcomes. Keywords: TERAVOLT, international COVID-19 registry, thoracic malignancies

Social distress among medical oncologists and other healthcare professionals during the first wave of COVID-19 pandemic in Italy.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has rapidly spread to every country around the world taking on pandemic proportions. Since 8 March 2020, the Italian government ordered a nationwide lockdown with unavoidable social isolation. Healthcare professionals (HCPs) represent the most physically and emotionally involved category. The aim of this study is to assess the social distress among HCPs in Italy. PATIENTS AND METHODS: In this online, totally anonymous survey, 24 multiple choice questions were posed to medical staff employed in the Italian Healthcare System during the COVID-19 pandemic. Data collection was performed from 30 March to 24 April 2020. RESULTS: A total of 600 HCPs completed the questionnaire. The majority of respondents expressed the fear of being at higher risk of contagion than the general population (83.3%) and the weighty concern of infecting their families (72.5%). An insufficient supply of personal protective equipment (PPE; P = 0.0003) and inadequate training about procedures to follow (P = 0.0092) were seen to significantly coincide with these worries. More than two-thirds declared a change in family organisation, which showed a significant correlation with the concern of infecting their relatives (P < 0.0001). CONCLUSIONS: This is the first Italian survey on social distress among HCPs during the COVID-19 pandemic. The unavailability of PPE, screening procedures and adequate training strongly affected HCPs' emotional status. Although there was a predominance of oncologists (especially from the North of Italy), which impairs the generalisation of our findings, this survey underlined the social impact that this health emergency has had on HCPs.

Thoracic cancers international COVID-19 collaboration (TERAVOLT): Small-cell lung cancer andother rare thoracic malignancies

Background: At the last update of the TERAVOLT registry, patients with thoracic malignancies and COVID-19showed a high mortality rate (35.5% overall and 31% due to COVID-19) compared to the general population and toother solid tumors. Major determinants of mortality were age, Eastern Cooperative Oncology Group PerformanceStatus (ECOG-PS), and previous administration of chemotherapy. No cancer-specific data are available with respectto small-cell lung cancer (SCLC) and other rare thoracic malignancies. Methods: TERAVOLT is an international, multicenter observational registry launched to collect data on patients withthoracic malignancies diagnosed with COVID-19 infection. Risk factors for hospitalization and mortality wereidentified by Wilcoxon rank sum tests (continuous variables) or χ2 tests (categorical variables). Here we present thesubgroup analyses of SCLC and other rare thoracic malignancies, including malignant pleural mesothelioma (MPM), thymic carcinoma/thymoma, and carcinoid/neuroendocrine lung tumors. Results: As of June 4th, 2020, a total of 581 patients with COVID-19 and thoracic cancers have been entered;among them, 66 (11%) were SCLC, 22 (4%) were MPM, 18 (3%) were thymic carcinoma/thymoma, 12 (2%) werecarcinoid/neuroendocrine lung tumors, and 442 (76%) NSCLC;21 were an unknown type. Among SCLC patients,54% were > 65 years old, 56% were males, 98% were current/former smokers, 31% had an ECOG-PS ≥ 2, 67%had stage IV disease, 82% were on current oncologic treatment at the COVID-19 diagnosis, and 58% werereceiving chemotherapy alone or in combination with immune checkpoint inhibitors. Among other non-NSCLCpatients, 56% were > 65 years old, 56% were males, 69% were current/former smokers, 24% had an ECOG-PS ≥ 2,50% had stage IV disease, 52% were on current oncologic treatment at the COVID-19 diagnosis, and 37% werereceiving chemotherapy alone or in combination with immune checkpoint inhibitors. Overall, 79.7% of the patientsrequired hospitalization, 15.4% were admitted to an ICU, and 39.8% died (36.2% due to COVID-19). Among SCLCpatients, 74.2% required hospitalization, 14.3% were admitted to an ICU, and 42.2% died (37.5% due to COVID-19).Among SCLC patients, age > 65 years old (p=0.81), gender (p=0.71), smoking status (p=1.0), ECOG-PS ≥2(p=0.17), disease stage of IV (p=0.37), and having received chemotherapy alone or with checkpoint inhibitors(p=0.84) were not associated with mortality. Conclusions: This analysis confirmed that patients with thoracic malignancies have a high mortality and risk forhospitalization due to COVID-19 overall. SCLC patients showed the highest mortality rate among thoracic cancerpatients.

Thoracic Cancers International COVID-19 Collaboration (TERAVOLT): Impact of type of cancer therapy and COVID therapy on survival

Background: Early reports on cancer patients infected with COVID-19 have suggested a high mortality rate compared to the general population. Patients with thoracic malignancies are considered high risk given their age, preexisting comorbidities, smoking, and pre-existing lung damage in addition to therapies administered to treat their illness. Method: We launched a global consortium to collect data on patients with thoracic malignancies diagnosed with COVID-19 infection to understand the impact on this patient population. Goals of this consortium are to provide data for guidance to oncology professionals on treating patients with thoracic malignancies while understanding the risk factors for morbidity and mortality from this novel virus. Results: As of April 23, 2020, a total of 295 patients across 59 centers and 9 countries have been entered;median age 68, 31% female, 79% current/former smokers, HTN and COPD most common comorbidities;73% NSCLC, 14% SCLC, 4% meso and thymic, 49% patients with stage IV disease, majority on chemo or chemo-IO and 24% receiving RT. The use of IO or chemo-IO does not appear to impact risk of hospitalization, while treatment with TKI appears to be associated with a decreased risk of hospitalization. 73% patients required hospitalization, most common therapy given to treat COVID was antibiotics 67%, antivirals 33%, and steroids 30%. Conclusion: With an ongoing global pandemic of COVID-19 our data suggest that patients with thoracic malignancies are at high risk for hospitalization. Updated results to be presented will include impact on specific chemo-IO regimens and number of lines of therapy, which may impact hospitalization and risk of death as well as which therapies administered may impact survival in patients treated for COVID-19.

Defining COVID-19 outcomes in thoracic cancer patients: TERAVOLT (Thoracic cancERs international coVid 19 cOLlaboraTion)

Background: Patients with thoracic malignancies may have increased risk for COVID-19 mortality. This risk may be attributable to age, comorbidities, smoking history, pulmonary disease burden and cancer-directed therapies. Methods: TERAVOLT is a global consortium examining outcomes and assessing risk factors associated with mortality of patients with thoracic malignancies and COVID-19 infection. Results: As of July 15, 2020, 1012 patients from 20 countries have been entered;median age was 68 with 58 % male, 80% current/former smokers, most common comorbidities of HTN (49%) & COPD (26%);82% NSCLC, 68 % patients with stage IV disease at COVID diagnosis, 65% on treatment (38% chemotherapy, 26% immune checkpoint inhibitor (ICI), 16 % targeted tyrosine kinase inhibitor (TKI). Of these, 72% were hospitalized;56% of patients developed complications, most frequently pneumonia (40%) and 47% who did not have prior oxygen therapy required it. 32% of patients died during their COVID-19 infection. Only 33 % of patients continued their oncology treatment after infection. Patients presenting with pneumonia (OR 2.7 2-3.5), consolidation (OR 2 CI 1,5-2,8), bilateral lung abnormalities (OR 2,8 CI 2-3,9) and pleural effusion (OR 2,7 CI 1,8-4) were at increased risk of mortality. In multivariate analysis age ≥ 65 (OR 1,53 CI 1,11-2,1), active smoking (OR 2 CI 1,3-3), higher stage of cancer (OR 1,9 CI 1,3-2,7), ECOG PS ≥2 (OR 3,7 CI 2,7-5), steroids prior to COVID diagnosis (OR 1,8 CI 1,2-2,7), were associated with increased risk of death, while chemotherapy and TKI therapy use were not and interestingly patients on immunotherapy appeared to be at decreased risk for mortality (OR 0,6 CI 0,5-0,97). Conclusions: Facing this ongoing global pandemic, TERAVOLT is the largest thoracic malignancy database confirming the high risk for COVID-19 mortality in this specific patient group. Physicians need to evaluate the risk of mortality from COVID-19 based on age, smoking status, stage of cancer, performance status, need for steroids and specific therapy in order to determine the appropriateness for cancer therapy and tailor patient care taking into account patients’ wishes and status of pandemic in the country. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: J. Baena Espinar: Advisory/Consultancy: AstraZeneca;Honoraria (self), Travel/Accommodation/Expenses: Angelini. F.R. Hirsch: Advisory/Consultancy: AstraZeneca;Advisory/Consultancy: BMS;Advisory/Consultancy: Merck;Advisory/Consultancy: Daiichi;Advisory/Consultancy: Genentech/Roche;Advisory/Consultancy: Lilly/Loxo;Advisory/Consultancy: Boehringer-Ingelheim. M. Tiseo: Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): AstraZeneca;Advisory/Consultancy, Research grant/Funding (institution): Boehringer Ingelheim;Advisory/Consultancy: Novartis;Advisory/Consultancy: MSD;Advisory/Consultancy: BMS;Advisory/Consultancy: Takeda. E. Felip: Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: AbbVie;Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: AstraZeneca;Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Blue Print Medicines;Advisory/Consultancy, Advisory role or speaker's bureau: Boehringer Ingelheim;Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Bristol-Myers Squibb;Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: GSK;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Eli Lilly;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Guardant Health;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Janssen;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Medscape;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Merck KGaA;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Spea er's bureau: Merck Sharp and Dohme;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Novartis;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Pfizer;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: prIME Oncology;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Roche;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Samsung;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Springer;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Takeda;Advisory/Consultancy, Advisory role or Speaker's bureau: Touchime;Research grant/Funding (self), Research Funding: Fundacion Merck Salud;Research grant/Funding (institution), Research Funding: Grant for Oncology Innovation;Full/Part-time employment, Board (Independent Member: Grifols Boards. H.A. Wakelee: Research grant/Funding (institution), Clinical Research grant: Gilead;Honoraria (self), Advisory/ Consultancy, advisor or consultant honoraria: AstraZeneca;Advisory/Consultancy, Research grant/Funding (institution), advisor or consultant, research: Xcovery;Advisory/Consultancy, advisor or consultant: Jassen;Advisory/Consultancy, advisor or consultant: Daiichi Sankyo, INC;Advisory/Consultancy, advisor or consultant: Helsinn;Advisory/Consultancy, advisor or consultant: Mirati;Advisory/Consultancy, advisor or consultant (not: Takeda;Advisory/Consultancy, advisor or consultant (not: Cellworks;Advisory/Consultancy, Research grant/Funding (institution), advisor or consultant (not: Genentech/Roche;Advisory/Consultancy, Research grant/Funding (institution), advisor or consultant (not: Merck;Travel/Accommodation/Expenses, CME presentation (travel funding): Clinical care options oncology, LLC;Travel/Accommodation/Expenses, CME presentation (travel funding): Fishawack facilitate LTD;Travel/Accommodation/Expenses, CME presentation (travel funding): Medscape;Travel/Accommodation/Expenses, CME presentation (travel funding): Onclive/intellisphere LLC;Travel/Accommodation/Expenses, CME presentation (travel funding): Philips Gillmore Oncology 2018;Travel/Accommodation/Expenses, CME presentation (travel funding): Physician education resource, LLC/MJH;Travel/Accommodation/Expenses, CME presentation (travel funding): Potomac center for medical education;Travel/Accommodation/Expenses, CME presentation (travel funding): Prime Oncology LLC (2018);Travel/Accommodation/Expenses, CME presentation (travel funding): Primo (2018);Travel/Accommodation/Expenses, CME presentation (travel funding): Research to practice;Travel/Accommodation/Expenses, CME presentation (travel funding): UpToDate;Travel/Accommodation/Expenses, CME presentation (travel funding): WebMdHealth;Honoraria (self), Research grant/Funding (institution), honoraria, research funding to: Novartis;Travel/Accommodation/Expenses, International professional society: RGCON- Rajiv gand conference;Travel/Accommodation/Expenses, International professional society: JLCS - japanese lung cancer society;Travel/Accommodation/Expenses, International professional society: KSMO - korean society of medical oncology;Full/Part-time employment, professor of medicine: Stanford university;Travel/Accommodation/Expenses, Scientific advisory committe - travel: ITMIG;Research grant/Funding (institution), research funding to institution: ACEA biosciences. M.C. Garassino: Honoraria (self): Boehringer Ingelheim;Honoraria (self), Local PI, Enrollment in clinical Trials in: Otsuka Pharma;Honoraria (self), Research grant/Funding (institution), PI, Enrollment and Steering: AstraZeneca;Honoraria (self), Research grant/Funding (institution), PI, Enrollment in clinical Trials in: Novartis;Honoraria (self), Research grant/Funding (institution), PI, Enrollment in clinical Trials in: BMS;Honoraria (self), Research grant/Funding (institution), PI, Enrollment in clinic l Trials in: Roche;Honoraria (self), Research grant/Funding (institution), PI, MISP in Thimic malignancies: Pfizer;Honoraria (self), Research grant/Funding (institution), PI, Enrollment in clinical Trials in: Celgene;Research grant/Funding (institution): Incyte;Research grant/Funding (institution): Inivata;Research grant/Funding (self): Takeda;Honoraria (self), PI, Enrollment in clinical Trials Thimic: Tiziana Sciences;Honoraria (self), PI, Enrollment in clinical Trials in: Clovis;Honoraria (self), PI, Enrollment in clinical Trials in: Merck Serono;Honoraria (self), Research grant/Funding (self), PI, Enrollment in clinical Trials in: Bayer;Honoraria (self), Research grant/Funding (institution), PI, Enrollment in clinical Trials in: MSD;Honoraria (self), Local PI, Enrollment and Steering: GlaxoSmithKline S.p.A.;Research grant/Funding (institution): Sanofi-Aventis;Honoraria (self), PI, Enrollment in clinical Trials: Spectrum Pharmaceutcials;Honoraria (self), PI, Enrollment in clinical Trials: Blueprint Medicine;Research grant/Funding (institution): Seattle Genetics;Research grant/Funding (institution): Daiichi Sankyo;Honoraria (self), PI, MISP in Thimic malignancies: Eli Lilly. S. Peters: Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: AbbVie;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: Amgen;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: AstraZeneca;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: Bayer;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: Biocartis;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: Boehringer-Ingelheim;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: Bistrol-Myers Squibb;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium:Clovis;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Daiichi Sankyo;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Debiopharm;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Eli Lilly;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: F. Hoffmann-La Roche;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Foundation Medicine;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Illumina;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Janssen;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Merck Sharp and Dohme;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Merck Serono;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Merrimack;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Novartis;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Pharma Mar;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Pfizer;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Regeneron;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Sanofi;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Seattle Genetics and Takeda;Honoraria (self), Speaker Bureau/Expert testimony, Talk + honorarium: AstraZeneca;Honoraria (self), Speaker Bureau/Expert testimony, Talk + honorarium: Boehringer-Ingelheim;Honoraria (self), Speaker Bureau/Expert testimony, Talk + honorarium: Bristol-Myers Squibb;Honoraria (self), Speaker Bureau/Expert testimony, Talk + honorarium: Eli Lilly;Honoraria (self), Speaker Bureau/Expert testimony, Talk + honorarium: F. Hoffmann-La Roche;Honoraria (self), Speaker Bureau/Expert testimony, Talk + honorarium: Merck Sharp and Dohme. L. Horn: Advisory/Consultancy, Consulting: AstraZeneca;Advisory/Consultancy, Consulting: Genentech-Roche;Advisory/Consultancy, Consulting: Incyte;Advisory/Consultancy, Consulting: Merck;Advisory/Consultancy, Consulting: Pfizer;Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses, Consulting and travel to meeting: Xcovery;dvisory/Consultancy, Consulting: EMD Serono;Advisory/Consultancy, Consulting: Tesaro;Advisory/Consultancy, Consulting: AbbVie;Research grant/Funding (self): Boehringer Ingelheim;Research grant/Funding (self), Travel/Accommodation/Expenses, Honorarium: BMS;Honoraria (self), Honorarium: Medscape;Honoraria (self), Honorarium: PER;Honoraria (self), Honorarium: Research to Practice;Honoraria (self), Honorarium: OncLive;Advisory/Consultancy, Consulting: Amgen;Advisory/Consultancy, Consulting: Bayer. All other authors have declared no conflicts of interest.

Managing cancer patients during the COVID-19 pandemic: an ESMO multidisciplinary expert consensus.

We established an international consortium to review and discuss relevant clinical evidence in order to develop expert consensus statements related to cancer management during the severe acute respiratory syndrome coronavirus 2-related disease (COVID-19) pandemic. The steering committee prepared 10 working packages addressing significant clinical questions from diagnosis to surgery. During a virtual consensus meeting of 62 global experts and one patient advocate, led by the European Society for Medical Oncology, statements were discussed, amended and voted upon. When consensus could not be reached, the panel revised statements until a consensus was reached. Overall, the expert panel agreed on 28 consensus statements that can be used to overcome many of the clinical and technical areas of uncertainty ranging from diagnosis to therapeutic planning and treatment during the COVID-19 pandemic.

Immunometabolic Status of COVID-19 Cancer Patients.

Cancer patients appear to be more likely to be diagnosed with coronavirus disease 2019 (COVID-19). This is supported by the understanding of immunometabolic pathways that intersect patients with infection and cancer. However, data derived by case series and retrospective studies do not offer a coherent interpretation, since data from China suggest an increased risk of COVID-19, while data from the United States and Italy show a prevalence of COVID-19 in cancer patients comparable with the general population. Noteworthy, cancer and COVID-19 exploit distinct patterns of macrophage activation that promote disease progression in the most severe forms. In particular, the alternative activation of M2-polarized macrophages plays a crucial role in cancer progression. In contrast, the macrophage-activation syndrome appears as the source of M1-related cytokine storm in severe COVID-19 disease, thus indicating macrophages as a source of distinct inflammatory states in the two diseases, nonetheless as a common therapeutic target. New evidence indicates that NAMPT/NAD metabolism can direct both innate immune cell effector functions and the homeostatic robustness, in both cancer and infection. Moreover, a bidirectional relationship exists between the metabolism of NAD and the protective role that angiotensin converting enzyme 2, the COVID-19 receptor, can play against hyperinflammation. Within this immunometabolic framework, the review considers possible interference mechanisms that viral infections and tumors elicit on therapies and provides an overview for the management of patients with cancer affected by COVID-19, particularly for the balance of risk and benefit when planning normally routine cancer treatments and follow-up appointments.