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Impact of the COVID-19 Pandemic on Treatment Patterns for Patients With Metastatic Solid Cancer in the United States.
Parikh, Ravi B; Takvorian, Samuel U; Vader, Daniel; Paul Wileyto, E; Clark, Amy S; Lee, Daniel J; Goyal, Gaurav; Rocque, Gabrielle B; Dotan, Efrat; Geynisman, Daniel M; Phull, Pooja; Spiess, Philippe E; Kim, Roger Y; Davidoff, Amy J; Gross, Cary P; Neparidze, Natalia; Miksad, Rebecca A; Calip, Gregory S; Hearn, Caleb M; Ferrell, Will; Shulman, Lawrence N; Mamtani, Ronac; Hubbard, Rebecca A.
  • Parikh RB; Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, USA.
  • Takvorian SU; Division of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • Vader D; Division of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • Paul Wileyto E; Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia, PA, USA.
  • Clark AS; Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia, PA, USA.
  • Lee DJ; Division of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • Goyal G; Division of Urology, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • Rocque GB; Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Dotan E; Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Geynisman DM; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
  • Phull P; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
  • Spiess PE; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
  • Kim RY; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA.
  • Davidoff AJ; Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • Gross CP; Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA.
  • Neparidze N; Cancer Outcomes Public Policy and Effectiveness Research, Yale School of Medicine, New Haven, CT, USA.
  • Miksad RA; Cancer Outcomes Public Policy and Effectiveness Research, Yale School of Medicine, New Haven, CT, USA.
  • Calip GS; Flatiron Health, New York, NY, USA.
  • Hearn CM; Flatiron Health, New York, NY, USA.
  • Ferrell W; Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, USA.
  • Shulman LN; Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, USA.
  • Mamtani R; Division of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • Hubbard RA; Division of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
J Natl Cancer Inst ; 114(4): 571-578, 2022 Apr 11.
Article in English | MEDLINE | ID: covidwho-1566036
ABSTRACT

BACKGROUND:

The COVID-19 pandemic has led to delays in patients seeking care for life-threatening conditions; however, its impact on treatment patterns for patients with metastatic cancer is unknown. We assessed the COVID-19 pandemic's impact on time to treatment initiation (TTI) and treatment selection for patients newly diagnosed with metastatic solid cancer.

METHODS:

We used an electronic health record-derived longitudinal database curated via technology-enabled abstraction to identify 14 136 US patients newly diagnosed with de novo or recurrent metastatic solid cancer between January 1 and July 31 in 2019 or 2020. Patients received care at approximately 280 predominantly community-based oncology practices. Controlled interrupted time series analyses assessed the impact of the COVID-19 pandemic period (April-July 2020) on TTI, defined as the number of days from metastatic diagnosis to receipt of first-line systemic therapy, and use of myelosuppressive therapy.

RESULTS:

The adjusted probability of treatment within 30 days of diagnosis was similar across periods (January-March 2019 = 41.7%, 95% confidence interval [CI] = 32.2% to 51.1%; April-July 2019 = 42.6%, 95% CI = 32.4% to 52.7%; January-March 2020 = 44.5%, 95% CI = 30.4% to 58.6%; April-July 2020 = 46.8%, 95% CI= 34.6% to 59.0%; adjusted percentage-point difference-in-differences = 1.4%, 95% CI = -2.7% to 5.5%). Among 5962 patients who received first-line systemic therapy, there was no association between the pandemic period and use of myelosuppressive therapy (adjusted percentage-point difference-in-differences = 1.6%, 95% CI = -2.6% to 5.8%). There was no meaningful effect modification by cancer type, race, or age.

CONCLUSIONS:

Despite known pandemic-related delays in surveillance and diagnosis, the COVID-19 pandemic did not affect TTI or treatment selection for patients with metastatic solid cancers.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Neoplasms, Second Primary / COVID-19 Limits: Humans Country/Region as subject: North America Language: English Journal: J Natl Cancer Inst Year: 2022 Document Type: Article Affiliation country: Jnci

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Neoplasms, Second Primary / COVID-19 Limits: Humans Country/Region as subject: North America Language: English Journal: J Natl Cancer Inst Year: 2022 Document Type: Article Affiliation country: Jnci