RESUMEN
Immunotherapy has demonstrated efficacy in non-small cell lung cancer (NSCLC) in the first-line setting as well as in further lines. Duration of immunotherapy is still discussed, taking into account constraints related to long term efficacy, toxicity and cost. Use of standardized flat dose became a standard. It is more flexible but also associated with a higher risk of overdose and overcost Pharmacological studies allow us to space infusions of immunotherapy. It was particularly useful in the period of pandemic. Immunotherapy is not associated with a higher risk of severe COVID19 infection. RNAm based vaccination is recommended in patients before or during treatment. A third dose can be discussed for some patients. Rechallenge of immunotherapy following previous toxicity is tricky and should be discussed in MTB. © 2021 SPLF. Published by Elsevier Masson SAS. All rights reserved.
RESUMEN
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.