ABSTRACT
Background: COVID-19 pandemic has led physicians to change their practice in the treatment of non-small cell lung cancer (NSCLC) to reduce hospital stays of patients. Objective(s): We aimed to assess toxicity and efficacy of extended-interval (EI) dosing of immune checkpoint inhibitors (ICI) compared to standard dose (SD). Method(s): In a retrospective bicentric study, patients with stage III/IV NSCLC treated with ICI +/- pemetrexed in maintenance setting during the month before March 2020 were included. Immune-related adverse events (IRAE) and efficacy were collected until June 2021. Toxicity and survival were assessed using multivariate logistic regression and Cox models. Result(s): Among the 134 identified patients (8 stage III and 126 stage IV, 66 in 1st line and 60 in 2nd or further lines), 70.9% had an EI dosing. In the EI dosing group, 12.6% patients developed grade 3 or more IRAE and 15.4% in the SD group (p=0.8). Treatment was definitively discontinued for toxicity for 9 patients in the EI dosing group and 5 patients in the SD group (p=0.5). Overall survival was not associated with dosage or occurrence of toxicity as timedependent variable (Table). Conclusion(s): Our study suggests that EI dosing of ICI did not affect toxicity, efficacy and survival in NSCLC patients.
ABSTRACT
When a lung cancer patient develops an organ failure, the intensity of the care should be decided taking into account patient's wishes and his plan of carekeeping, in mind that the objective of an intensive care unit (ICU) admission is to allow the patient to be discharged from ICU and hospital with an acceptable quality of life. But the physician in charge of the patient at the time of acute disease often does not have these information. It is therefore essential that the referring oncologist had an early discussion with the patient to inform him and collect his opinion. These information have to be noted in the patient's medical chart. The prognostic criteria of lung cancer patients admitted in ICU are related to the patient's characteristics, the cancer's characteristics and the severity of acute disease. In order that a decision of ICU admission is in accordance with the patient's therapeutic project, a close discussion between the oncologist and the intensivist is essential, especially in this period of SARS-CoV2 pandemy.© 2021 SPLF. Published by Elsevier Masson SAS. All rights reserved.
ABSTRACT
The objective of this document is to formalize a degraded mode management for patients with thoracic cancers in the context of the COVID-19 pandemic. The proposals are based on those of the French High Council for Public Health, on published data outside the context of COVID-19, and on a concerted analysis of the risk-benefit ratio for our patients by a panel of experts specialized on thoracic oncology under the aegis of the French-Language Society of Pulmonology (SPLF)/French-language oncology group. These proposals are evolving (10 April 2020) according to the situations encountered, which will enrich it, and are to be adapted to our institutional organisations and to the evolution of resources during the COVID-19 epidemic. Patients with symptoms and/or COVID-19+ are not discussed in this document and are managed within the framework of specific channels.