ABSTRACT
Background: HER2+ mBC remains incurable, with a need for new HER2-directed therapies and regimens, including chemotherapy-free options. Zanidatamab (zani) is a novel HER2-targeted bispecific antibody that binds HER2 in a unique trans configuration, driving multiple mechanisms of antitumor activity, including complement-dependent cytotoxicity. A CDK4/6 inhibitor combined with endocrine therapy is an approved treatment for HER2-negative/HR+ mBC and this combination has also demonstrated encouraging antitumor activity when paired with HER2-targeted therapy(ies) in HER2+/HR+ mBC. Here, we report results from ZWI-ZW25-202 (NCT04224272), an ongoing singlearm phase 2 study of zani combined with palbociclib (palbo) and fulvestrant (fulv) in pts with HER2+/HR+ mBC. Method(s): Eligibility requirements include: HER2+/HR+ unresectable, locally advanced BC or mBC;ECOG PS of 0 or 1;prior treatment with trastuzumab, pertuzumab and T DM1 (additional prior HER2-targeting agents are permitted);and no prior treatment with CDK4/6 inhibitors. Part 1 of the study evaluated the safety and tolerability of the zani/palbo/fulv combination and determined the recommended doses for use in Part 2, where the antitumor activity of the combination is being evaluated. Endpoints include safety outcomes, progression-free survival at 6 months (PFS6), confirmed objective response rate (cORR) per RECIST v1.1;disease control rate (DCR=complete response [CR] plus partial response [PR] plus stable disease [SD]);duration of response (DOR);PFS;and overall survival. Result(s): As of 24 Feb 2022, 34 pts (33 HER2+/HR+ per central analysis) with a median age of 52 (range 36-77) have been treated. In the metastatic setting, pts had received a median (range) of 4 (1-10) prior systemic regimens, including 3 (1-8) different prior HER2 targeted therapies, and 1 (0-4) endocrine therapy. Seven pts (20%) had prior T DXd treatment and 7 pts had prior fulv treatment. All pts received zani (20 mg/kg Q2W) and standard doses of palbo and fulv. Eighteen pts (53%) remained on treatment;median duration of zani treatment was 6.9 mo (range 0.5- 16.3). A dose-limiting toxicity (DLT) of neutropenia occurred in 1 of 7 DLT-evaluable pts in Part 1. Among all pts (n=34), the most common (>20%) treatment (zani, palbo and/or fulv)-related adverse events (TRAEs) were diarrhea (74%), neutrophil count decreased/neutropenia (62%), stomatitis (41%), asthenia (26%), nausea (24%), and anemia (21%). Grade (Gr) >=3 TRAEs in 2 or more pts included neutrophil count decreased/neutropenia (50%), anemia (6%), diarrhea (6%), and thrombocytopenia (6%). AEs of special interest were all Gr <=2 and included 4 pts with cardiac events (LVEF decrease of >=10% from baseline) and 1 pt with infusion-related reaction. There were no treatment-related serious AEs. Palbo was discontinued for 1 pt due to an AE (AST increase);no pt discontinued zani treatment as a result of AEs. Two deaths occurred: 1 due to disease progression and 1 due to an unrelated AE of pneumonia caused by COVID-19. In 29 pts with measurable disease, the cORR was 34.5% (95% CI: 17.9, 54.3), all responses were cPRs, of which 1 is pending CR confirmation. DOR ranged from 2.3 to 14.9+ mo, with 8 confirmed responses ongoing, and the DCR was 93.1% (95% CI: 77.2, 99.2). Interim median PFS was 11.3 mo (range 0.03-16.7;95% CI: 5.6, not estimable). PFS6 analysis is planned following the completion of enrollment. Conclusion(s): Zani in combination with palbo and fulv shows encouraging antitumor activity with durable responses in heavily pretreated pts and a manageable safety profile. This regimen has the potential to be a chemotherapy-free treatment option in pts with HER2+/HR+ mBC. Enrollment in the study is continuing.
ABSTRACT
We do not know the precise figure for solid organ tumors diagnosed each year in Spain and it is therefore difficult to calculate whether there has been a decrease in cancer diagnoses as a consequence of the pandemic. Some indirect data suggest that the pandemic has worsened the stage at which some non-hematological neoplasms are diagnosed. Despite the lack of robust evidence, oncology patients seem more likely to have a poor outcome when they contract COVID-19. The antibody response to infection in cancer patients will be fundamentally conditioned by the type of neoplasia present, the treatment received and the time of its administration. In patients with hematological malignancies, the incidence of infection is probably similar or lower than in the general population, due to the better protective measures adopted by the patients and their environment. The severity and mortality of COVID-19 in patients with hematologic malignancies is clearly higher than the general population. Since the immune response to vaccination in hematologic patients is generally worse than in comparable populations, alternative methods of prevention must be established in these patients, as well as actions for earlier diagnosis and treatment. Campaigns for the early diagnosis of malignant neoplasms must be urgently resumed, post-COVID manifestations should be monitored, collaboration with patient associations is indisputable and it is urgent to draw the right conclusions to improve our preparedness to fight against possible future catastrophes.
ABSTRACT
Background: DT combination has shown efficacy in the adjuvant setting for BRAF-mutated melanoma (BMM) patients (pts) in clinical trials. Previous reports from DESCRIBE-AD resulted in promising overall survival (OS) rates at 12 months. Methods: An observational retrospective study was carried out in 25 GEM sites in Spain. Histologically confirmed and resected BMM pts previously treated with DT according to standard clinical practice in the adjuvant setting were included. Only surgical resection was allowed as a prior treatment to DT. DT discontinuation rate and time to treatment discontinuation were the primary objective. Secondary objectives included safety and efficacy of the combination. Here, we report 3-year results for OS. Results: From 10/2020 to 03/2021, 65 pts were included. Median age was 58 years, 55% were male and 60%, 25%, and 14% had an ECOG PS 0/1/Uk respectively, one patient presented ECOG 3. Allocation of stage IIIA, IIIB and IIIC according to TNM AJCC 7th edition was 29%, 26% and 32%, respectively. There were 3 pts diagnosed at stage I/II but considered of risk, and 2 pts with stage IV but completely resected, all considered for adjuvant DT. Ulceration was present in 40%, Breslow ≥2 mm in 71%, and nodes were microscopically and macroscopically affected in 39% and 22% of pts, respectively. Only 9.2% of pts discontinued DT prematurely due to toxicity and 21.2% had dose reductions to manage toxicity. After a median follow-up of 36.2 m (range: 13-51.1), the overall OS rate at 3-years was 83.5% (95% CI: 74.5-93.5). According to AJCC 7 stage at diagnosis, the 3-years OS rate was 95.2% (95% CI: 86.6-100), 75% (56-100), and 76.8% (60.7-97.2) for stage I-II-IIIA, IIIB, and IIIC-IV respectively. Throughout the study period 11 (16.9%) pts died, of which 10 died due to disease progression and one due to COVID-19 infection. Conclusions: Adjuvant treatment with DT for melanoma achieved good treatment compliance and has proven efficacy in the real world. Adjuvant DT has a clinical impact in survival in line with previous clinical trial COMBI-AD. Editorial acknowledgement: We acknowledge Mfar Clinical Research staff for their assistance in the development of this . Legal entity responsible for the study: Grupo Español Multidisciplinar en Melanoma (GEM). Funding: Grupo Español Multidisciplinar en Melanoma (GEM) as Sponsor with Industry partner NOVARTIS. Disclosure: P. Cerezuela-Fuentes: Financial Interests, Personal, Other, Consultancy, conference,congress attendance/infrastructure: BMS, MSD, Pierre Fabre, Roche, Sanofi, SunPharma. J. Martín-Liberal: Financial Interests, Personal, Other, Lecture fees: Astellas, MSD;Financial Interests, Personal, Other, Lecture fees, advisory fees: Bristol Myers Squibb, Novartis, Pierre Fabre, Pfizer, Roche, Sanofi;Non-Financial Interests, Personal, Member, membership or affiliation: ASCO, ESMO, SEOM, GEM, EORTC, SOGUG, GEIS. L.A. Fernández-Morales: Financial Interests, Personal, Invited Speaker, Speak at sponsored meetings: BMS, MSD, Pierre-Fabre, Roche;Financial Interests, Personal, Other, Speak at sponsored meetings and advisory role: Novartis. J. Medina Martinez: Financial Interests, Personal, Other, Speaker, consultancy or advisory role or similar activity: Novartis, Roche, Pierre Fabre, BMS, MSD, Sanofi. M. Quindós: Financial Interests, Personal, Other, speaker, consultancy and advisory: AstraZeneca, GSK, Merck Sharp & Dohme, Novartis, PharmaMar, Roche, Bristol Myers Squibb, Pierre Fabre;Financial Interests, Institutional, Other, Clinical trials: Merck Sharp & Dohme, Roche, Bristol Myers Squibb. A. García Castaño: Non-Financial Interests, Advisory Role: Bristol, MSD, Novartis. T. Puértolas: Financial Interests, Personal, Invited Speaker, Speaker and advisory role: BMS, Novartis;Financial Interests, Personal, Invited Speaker: Roche, MSD, Sun-Pharma;Financial Interests, Personal, Other, Speaker and advisory role: Pierre-Fabre;Financial Interests, Personal, Advisory Role: Sanofi;Financial Interests, Institutional, Other, Clinical trial: Roche, BMS, Apexi en Inc, Aduro Biotech, Alkermes Inc;Non-Financial Interests, Institutional, Other, congresses inscriptions: Lilly, Sun-Pharma, Novartis, Roche, MSD;Non-Financial Interests, Institutional, Leadership Role, Vocal: GEM (Grupo Español Multidisciplinar de Melanoma);Non-Financial Interests, Institutional, Affiliate: SEOM (Sociedad Española de Oncología Médica), GEM (Grupo Español Multidisciplinar de Melanoma). P. Ayala de Miguel: Financial Interests, Personal, Invited Speaker, Public speaking: Novartis, Merck Sharp & Dohme, Sanofi, Pierre-Fabré. B. Campos: Financial Interests, Personal, Other, Speaker or advisory role: Roche, BMS, Sanofi, Novartis, Pierre-Fabre, Sun Pharma;Financial Interests, Personal, Other, Speaker role: AstraZeneca, Merck, ROVI, Leo Pharma. E. Espinosa: Financial Interests, Personal, Advisory Role, Advisory: BMS, MSD;Financial Interests, Personal, Other, Advisory, educational activities: Novartis;Financial Interests, Personal, Invited Speaker, Advisory, educational activities: Pierre Fabre;Financial Interests, Personal, Funding, Funding for translational investigation: Roche;Non-Financial Interests, Personal, Member, Vicepresident: Grupo Español Multidisciplinario de Melanoma. A. Rodríguez-Lescure: Financial Interests, Personal, Advisory Role: Pfizer, Novartis, ROCHE, AstraZeneca, Daiichi Sankyo, Seagen;Financial Interests, Personal, Invited Speaker, Public speaking: Pierre-Fabre;Financial Interests, Institutional, Research Grant, Grant for Clinical Trials: BMS, Lilly, Roche, Novartis, Amgen, Pzifer, Zimeworks, AstraZeneca, G1 Therapeutics, Bayer. L. Espasa Font: Financial Interests, Personal, Full or part-time Employment: Novartis. G. Belaustegui Ferrández: Financial Interests, Personal, Full or part-time Employment: Novartis. All other authors have declared no conflicts of interest.
ABSTRACT
Background: Knowledge of the career paths and employment situation of young medical oncologists is lacking. The aim of our study was to evaluate the current professional standing of young medical oncologists during COVID-19 pandemic in Spain. Methods: The SEOM +MIR section conducted a national online survey in May 2021 of young medical oncology consultants (<6 years of expertise) and last year medical oncology residents. Using the electronic mailing available in the SEOM database, professionals from Spain were invited. Results: A total of 136 responses were eligible in the preliminary analysis. 86 (63%) were women. 106 (78%) were consultants and 30 (22%) were residents. 92 (68%) performed standard clinical care and 10 (7%) research activity. 97 (71%) were subspecialized in a main area of interest and almost half of them, 60 (48%), chose it because it was the only option available after residency. 75 (55%) had considered different employment opportunities other than standard clinical care and 33 (25%) showed an interest in increasing their research activity. 68 (50%) had considered working in foreign countries: 40 (29%) in the European Union. The main reasons were: 35 (26%) thought it might increase their professional development and 29 (22%) argued for better salary conditions abroad. Furthermore, 109 (80%) believed the professional standing in Spain was worse than other countries. After finishing their residency, only 20 (14%) were offered a job at their training hospital. Solely, 17 (12%) participants had an indefinite employment contract. 25 (18%) had previously signed a COVID-19 temporary contract. 55 (40%) were worried about their employment stability. Conclusions: The availability of subspecializing in medical oncology may depend on the job opportunity after residency rather than personal interest. The abundance of temporary contracts could have influenced the employment stability concerns observed. Our work contributes and is consistent with the ESMO values focused on the wellbeing of medical oncology professionals. Future mentoring strategies should engage in building a long-term career path for young medical oncologists. Legal entity responsible for the study: SEOM +MIR Section. Funding: Has not received any funding. Disclosure: V. Pacheco-Barcia: Financial Interests, Personal, Invited Speaker, Speaker Fee: Eisai;Financial Interests, Personal, Invited Speaker, Speaker Fee: Merck;Financial Interests, Personal, Invited Speaker, Speaker Fee: Bristol Myers Squibb;Financial Interests, Personal, Invited Speaker, Speaker Fee: LEO Pharma;Financial Interests, Personal, Invited Speaker, Speaker Fee: Kyowa Kirin;Financial Interests, Personal, Invited Speaker, Speaker Fee: Grunenthal;Financial Interests, Personal, Invited Speaker, Speaker FEE: Prostakan;Financial Interests, Personal, Invited Speaker, Speaker Fee: Lilly;Other, Other: Merck. D.A. Sanchez: Financial Interests, Personal, Invited Speaker: Janssen;Non-Financial Interests, Personal and Institutional, Leadership Role, National Representative of Young Doctors of Promotion of Employment in Organización Médica Colegial: Spanish Medical Association;Non-Financial Interests, Personal and Institutional, Leadership Role: President of the Murcian Health Service Company Committee;Non-Financial Interests, Personal and Institutional, Leadership Role: Vice-representative from the European Junior Doctors (EJD) in Oncology Section in UEMS (Uropean Union of Medical Specialties);Non-Financial Interests, Personal, Other: Member of +MIR Section of the Spanish Society of Medical Oncology;Non-Financial Interests, Personal, Other: ESMO member;Non-Financial Interests, Personal, Other: SEOM member. B. Obispo: Financial Interests, Personal, Invited Speaker: Lilly;Financial Interests, Personal, Invited Speaker: Novartis;Financial Interests, Personal, Invited Speaker: Sanofi;Financial Interests, Personal, Invited Speaker: Fresenius;Financial Interests, Personal, Invited Speaker: Angelini Pharma;Financial Interests, Personal, Invited Speaker: Rovi;Financial Interes s, Personal, Invited Speaker: Leo Pharma. A. Quilez: Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Advisory Role: Clovis;Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb;Financial Interests, Personal, Speaker’s Bureau: GSK;Financial Interests, Personal, Advisory Role: GSK. A. Sesma: Financial Interests, Personal, Invited Speaker: MSD. D. Paez: Financial Interests, Personal, Advisory Role: Amgen;Financial Interests, Personal, Speaker’s Bureau: Amgen;Financial Interests, Personal, Speaker’s Bureau: F. Hoffman-La Roche Ltd;Financial Interests, Personal, Advisory Role: Sanofi;Financial Interests, Personal, Advisory Role: Ipsen;Financial Interests, Personal, Speaker’s Bureau: Advanced Accelerator Applications;Financial Interests, Personal, Research Grant, Research funding: Merck Serono. T. Quintanar Verduguez: Financial Interests, Personal, Invited Speaker: Novartis;Financial Interests, Personal, Advisory Role: Novartis;Financial Interests, Personal, Invited Speaker: Abbott;Financial Interests, Personal, Invited Speaker: Nestle;Financial Interests, Personal, Advisory Role: Lilly;Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Other, Consultancy: Astra Zeneca. M. Sánchez Cánovas: Financial Interests, Personal, Invited Speaker: Leo Pharma;Financial Interests, Personal, Invited Speaker: Angelini Pharma;Financial Interests, Personal, Invited Speaker: KyowaKirin;Financial Interests, Institutional, Other: Leo Pharma;Other, Personal, Other, Attending Symposia: Sanofi;Other, Personal, Other, Attending Symposia: MSD;Other, Personal, Other, Attending Symposia: Esteve;Other, Personal, Other, Attending Symposia: Amgen;Other, Personal, Other, Attending Symposia: Servier;Other, Personal, Other, Attending Symposia: Angelini;Other, Personal, Other, Attending Symposia: Leo Pharma;Other, Personal, Other, Educational Programs: Angelini;Other, Personal, Other, Educational Programs: Sanofi;Other, Personal, Other, Educational Programs: Rovi;Other, Personal, Other, Educational Programs: Leo Pharma;Other, Personal, Other, Educational Programs: Servier;Other, Personal, Other, Educational Programs: Merck;Other, Personal, Other, Remunerations for authorship: KyowaKirin;Other, Personal, Other, Remunerations for authorship: Mylan. N. Tarazona: Financial Interests, Personal, Invited Speaker: Amgen;Financial Interests, Personal, Invited Speaker: Servier;Financial Interests, Personal, Invited Speaker: Pfizer;Financial Interests, Personal, Invited Speaker: Merck;Financial Interests, Institutional, Principal Investigator, Principal Investigator: Mutua Madrileña;Financial Interests, Institutional, Principal Investigator: SEOM;Financial Interests, Institutional, Principal Investigator: TTD Group;Non-Financial Interests, Personal, Leadership Role, Member of CIBERONC Liquid Biopsy Working Module since 2018: CIBERONC;Non-Financial Interests, Personal, Leadership Role, Member of ESMO Translational Research and Precision Medicine Working Group for the period 2019-2020.: ESMO;Non-Financial Interests, Personal, Leadership Role, Member of ESMO-MCBS Extended Working Group since 2019: ESMO;Non-Financial Interests, Personal, Leadership Role, Member of ESMO faculty member for the Gastro-Intestinal Tumours faculty group for the period 2019-2023.: ESMO Faculty;Non-Financial Interests, Personal, Leadership Role, Member of Executive Committee SEOM +MIR 2020-2022.: SEOM +MIR. A. Fernandez Montes: Financial Interests, Personal, Advisory Role: Bristol Myers Squibb;Financial Interests, Personal, Advisory Role: MSD;Financial Interests, Personal, Invited Speaker: MSD;Financial Interests, Personal, Invited Speaker: Servier;Financial Interests, Personal, Advisory Role: Lilly;Financial Interests, Personal, Invited Speaker: Lilly;Financial Interests, Personal, Advisory Role: Astra Zeneca;Financial Interests, Personal, Invited Speaker: Pierre Fabre;Financial Interests, Personal, Invited Speaker: Merck. E. Felip: Financial Interest , Personal, Advisory Board: Amgen;Financial Interests, Personal, Advisory Board: AstraZeneca;Financial Interests, Personal, Advisory Board: Bayer;Financial Interests, Personal, Advisory Board: Beigene;Financial Interests, Personal, Advisory Board: Boehringer-Ingelheim;Financial Interests, Personal, Advisory Board: Bristol Myers Squibb;Financial Interests, Personal, Advisory Board: Eli Lilly;Financial Interests, Personal, Advisory Board: F Hoffman-La Roche;Financial Interests, Personal, Advisory Board: Glaxo Smith Kline;Financial Interests, Personal, Advisory Board: Janssen;Financial Interests, Personal, Advisory Board: Medical Trends;Financial Interests, Personal, Advisory Board: Merck Sharp & Dohme;Financial Interests, Personal, Advisory Board: Merck Serono;Financial Interests, Personal, Advisory Board: Peptomyc;Financial Interests, Personal, Advisory Board: Pfizer;Financial Interests, Personal, Advisory Board: Puma;Financial Interests, Personal, Advisory Board: Regeneron;Financial Interests, Personal, Advisory Board: Sanofi;Financial Interests, Personal, Advisory Board: Syneos Health;Financial Interests, Personal, Advisory Board: Takeda;Financial Interests, Personal, Speaker’s Bureau: Amgen;Financial Interests, Personal, Speaker’s Bureau: AstraZeneca;Financial Interests, Personal, Speaker’s Bureau: Bristol Myers Squibb;Financial Interests, Personal, Speaker’s Bureau: Eli Lilly;Financial Interests, Personal, Speaker’s Bureau: F Hoffman-La Roche;Financial Interests, Personal, Speaker’s Bureau: Janssen;Financial Interests, Personal, Speaker’s Bureau: Medscape;Financial Interests, Personal, Speaker’s Bureau: Merck Sharp & Dohme;Financial Interests, Personal, Speaker’s Bureau: Merck Serono;Financial Interests, Personal, Speaker’s Bureau: Peervoice;Financial Interests, Personal, Speaker’s Bureau:Pfizer;Financial Interests, Personal, Speaker’s Bureau: Springer;Financial Interests, Personal, Speaker’s Bureau: Touch MEdical;Other, Personal, Other, Independent member of the board: GRIFOLS. A. Rodríguez-Lescure: Financial Interests, Personal, Advisory Role: Roche;Financial Interests, Personal, Advisory Role: Pfizer;Financial Interests, Personal, Advisory Role: Novartis;Financial Interests, Personal, Advisory Role: Lilly;Financial Interests, Personal, Advisory Role: MSD;Financial Interests, Personal, Advisory Role: Astra Zeneca;Financial Interests, Institutional, Funding: Roche;Financial Interests, Institutional, Funding: Novartis;Financial Interests, Institutional, Funding: Pfizer;Financial Interests, Institutional, Funding: Lilly;Financial Interests, Institutional, Funding: Astra Zeneca;Financial Interests, Institutional, Funding: Amgen;Financial Interests, Institutional, Funding: MSD;Financial Interests, Institutional, Funding: Bristol-Myers Squibb;Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Invited Speaker: Pfizer;Financial Interests, Personal, Invited Speaker: Novartis;Financial Interests, Personal, Invited Speaker: Lilly;Financial Interests, Personal, Invited Speaker: AstraZeneca;Financial Interests, Personal, Invited Speaker: MSD;Financial Interests, Personal, Invited Speaker: Merck;Other, Personal, Other, Travel, accommodations: Roche;Other, Personal, Other, Travel, accomodations: Pfizer. M.E. Elez Fernandez: Financial Interests, Personal, Advisory Board: Amgen;Financial Interests, Personal, Advisory Board: Array Biopharma;Financial Interests, Personal, Advisory Board: Bayer;Financial Interests, Personal, Advisory Board: Bristol Myers Squibb;Financial Interests, Personal, Advisory Board: Hoffman La- Roche;Financial Interests, Personal, Advisory Board: Merck serono;Financial Interests, Personal, Advisory Board: Sanofi;Financial Interests, Personal, Advisory Board: Servier;Financial Interests, Institutional, Research Grant: Abbvie;Financial Interests, Institutional, Research Grant: Amgen;Financial Interests, Institutional, Research Grant: Array Pharmaceuticals;Financial Interests, Institution l, Research Grant: AstraZeneca;Financial Interests, Institutional, Research Grant: Boehringer Ingelheim;Financial Interests, Institutional, Research Grant: Bristol-Myers Squibb;Financial Interests, Institutional, Research Grant: GlaxoSmithKline;Financial Interests, Institutional, Research Grant: Hoffman La-Roche;Financial Interests, Institutional, Research Grant: Medimmune;Financial Interests, Institutional, Research Grant: Merck Serono;Financial Interests, Institutional, Research Grant: MSD;Financial Interests, Institutional, Research Grant: Novartis;Financial Interests, Institutional, Research Grant: Pierre-Fabre;Financial Interests, Institutional, Research Grant: Sanofi Aventis. All other authors have declared no conflicts of interest.
ABSTRACT
BACKGROUND: Young oncologists are at particular risk of professional burnout, and this could have a significant impact on their health and care of their patients. The coronavirus disease 2019 (COVID-19) pandemic has forced rapid changes in professionals' jobs and training, with the consequent physical and psychological effects. We aimed to characterize burnout levels and determinants in young oncologists, and the effects of the pandemic on their training and health. METHODS: Two online surveys were conducted among oncology residents and young oncology specialists in Spain. The first addressed professional burnout and its determinants before the COVID-19 pandemic, while the second analyzed the impact of the pandemic on health care organization, training, and physical and psychological health in the same population. RESULTS: In total, 243 respondents completed the first survey, and 263 the second; 25.1% reported significant levels of professional burnout. Burnout was more common among medical oncology residents (28.2%), mainly in their second year of training. It was significantly associated with a poor work-life balance, inadequate vacation time, and the burnout score. Nearly three-quarters of respondents (72%) were reassigned to COVID-19 care and 84.3% of residents missed part of their training rotations. Overall, 17.2% of this population reported that they had contracted COVID-19, 37.3% had scores indicating anxiety, and 30.4% moderate to severe depression. Almost a quarter of young oncologists (23.3%) had doubts about their medical vocation. CONCLUSIONS: Burnout affects a considerable number of young oncologists. The COVID-19 pandemic has had a profound impact on causes of burnout, making it even more necessary to periodically monitor it to define appropriate detection and prevention strategies.
Subject(s)
Burnout, Professional , COVID-19 , Oncologists , Burnout, Professional/epidemiology , Burnout, Psychological/epidemiology , Burnout, Psychological/prevention & control , Humans , Medical Oncology , Pandemics , SARS-CoV-2ABSTRACT
BACKGROUND: Studies evaluating the effects of the COVID-19 pandemic on public healthcare systems are limited, particularly in cancer management. As no such studies have been carried out in Spain, our objective is to describe and quantify the impact of the COVID-19 pandemic on cancer patients in Spanish hospitals during the first wave of the pandemic. MATERIALS AND METHODS: This retrospective, multicenter, nationwide study collected information from hospital departments treating oncology patients. An electronic questionnaire comparing outcomes and management of oncohematological patients for the March-June 2019 and March-June 2020 periods was used. RESULTS: Information from 78 departments (36 tertiary hospitals) was analyzed. Forty-four departments implemented adapted protocols during March 2020. Most of these (n = 38/44; 86.4%) carried out COVID-19 triage, while 26 of 44 (59.1%) carried out onsite polymerase chain reaction tests for clinically suspected cases. A shift from in-person to telephone visits was observed in 43 of 44 (97.7%) departments. Comparing the March-June 2019 and March-June 2020 periods, the number of new patients decreased by 20.8% (from 160.2 to 126.4). Decreases were also seen in the mean number of total (2858.2 versus 1686.1) and cancer (465.5 versus 367.2) biopsies, as well as the mean number of bone marrow biopsies (30.5 versus 18.6). Concerning the number of patients visiting specific cancer care departments, a decrease from 2019 to 2020 was seen for mean number of chemotherapy treatments (712.7 versus 643.8) and radiation therapy (2169.9 versus 2139.9). Finally, a reduction from 2019 to 2020 of 12.9% (from 8.6 to 7.4) in the mean number of patients included in clinical trials was noted. CONCLUSIONS: This study provides the first comprehensive data concerning the impact of COVID-19 on cancer care in Spain. The pandemic caused a 20.8% decrease in newly diagnosed patients, which may impact future outcomes. Measures must be taken to ensure cancer management receives priority in times of healthcare emergencies.