Impact of the COVID-19 pandemic on clinical lung cancer management

ABSTRACT

Background and importance The SARS-CoV-2 pandemic could have changed the clinical management of cancer patients because of travel restrictions, overloading of hospital systems and disruption of treatment. Lung cancer patients constitute a vulnerable population due to the particular risk of their disease, chemotherapy or immunotherapy. Aim and objectives To analyse disease management and the clinical impact of the COVID-19 pandemic on non-small cell lung cancer (NSCLC) patients receiving intravenous treatment during the social isolation period compared with the normal situation. Material and methods This retrospective observational cohort study included a 21 random sample of NSCLC patients in the 'COVID cohort' (patients in isolation February 2020 to June 2020) and the 'no COVID cohort' (patients treated between February 2019 and June 2019). Collected variables from digital clinical history were age, sex, stage, previous lines, type of treatment, number of medical visits and telephone consults, cycles received, worsening of performance status (PS), respiratory infection (COVID-19 and others), delays, therapeutic rest break, disease progression and deaths. Results COVID cohort (CC) 40 patients, 31 (78%) men;mean 67 years (59-84). Cancer stage IV (69%), IIIB (28%), IIIA (2%) and IIIC (1%). 12 (30%) patients had not received lines previously. 38% of the population received immunotherapy. Median number of medical visits was 3 (14-1) and median number of telephone consults was 3 (1-8). Median number of cycles was 4 (1-16). PS 0 (58%) and PS 1 (42%). No patient had COVID-19. No COVID cohort' (NCC) 20 patients, 15 (75%) men, mean 67 years (54-85). Cancer stage stage IV (75%), IIIB (25%). All patients had received lines previously and none had received immunotherapy. Median medical visits was 7 (3- 11) with no telephone consults. Median number of cycles was 3 (1-11). PS 0 (70%) and PS1-2 (30%). The rest of the variables are shown in table 1. Conclusion and relevance In spite of the limitations of the study, the new strategies of clinical management during the COVID-19 pandemic (telephone consults and therapeutic tire) did not appear to affect disease progression and NSCLC patient survival although worsening of performance status was observed.