Review Article
Treatment Guidance for Patients With Lung Cancer During the Coronavirus 2019 Pandemic

https://doi.org/10.1016/j.jtho.2020.05.001Get rights and content
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Abstract

The global coronavirus disease 2019 pandemic continues to escalate at a rapid pace inundating medical facilities and creating substantial challenges globally. The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with cancer seems to be higher, especially as they are more likely to present with an immunocompromised condition, either from cancer itself or from the treatments they receive. A major consideration in the delivery of cancer care during the pandemic is to balance the risk of patient exposure and infection with the need to provide effective cancer treatment. Many aspects of the SARS-CoV-2 infection currently remain poorly characterized and even less is known about the course of infection in the context of a patient with cancer. As SARS-CoV-2 is highly contagious, the risk of infection directly affects the cancer patient being treated, other cancer patients in close proximity, and health care providers. Infection at any level for patients or providers can cause considerable disruption to even the most effective treatment plans. Lung cancer patients, especially those with reduced lung function and cardiopulmonary comorbidities are more likely to have increased risk and mortality from coronavirus disease 2019 as one of its common manifestations is as an acute respiratory illness. The purpose of this manuscript is to present a practical multidisciplinary and international overview to assist in treatment for lung cancer patients during this pandemic, with the caveat that evidence is lacking in many areas. It is expected that firmer recommendations can be developed as more evidence becomes available.

Keywords

COVID-19
Lung cancer
SARS-CoV-2
Patient care

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Disclosure: Dr. Dingemans reports receiving personal fees from Roche, Pharma Mar, Boehringer Ingelheim, Eli Lilly, and Merck Sharp and Dohme; and grants from Bristol-Myers Squibb outside of the submitted work. Dr. Soo reports receiving grants and personal fees from AstraZeneca and Boehringer Ingelheim; and personal fees from Bristol-Myers Squibb, Eli Lilly, Merck, Novartis, Pfizer, Roch0065, Taiho, Takeda, Yuhan, and Amgen outside of the submitted work. Dr. Jazieh reports receiving grants from Merck Sharp and Dohme and other fees from Bristol-Myers Squibb outside of the submitted work. Dr. Aerts reports receiving personal fees and nonfinancial support from Merck Sharp and Dohme; received personal fees from Bristol-Myers Squibb, Boehringer Ingelheim, Amphera, Eli Lilly, Takeda, Bayer, Roche, and AstraZeneca outside of the submitted work; has a patent allogenic tumor cell lysate licensed to Amphera; has a patent combination immunotherapy in cancer pending; and has a patent biomarker for immunotherapy pending. Dr. Yoon reports receiving research grants from GE Healthcare outside of the submitted work. Dr. Veronesi reports receiving grants from Associazione Italiana per la Ricerca sul Cancro, the Ministry of Health, and Istituto Nazionale Assicurazione Infortuni sul Lavoro outside of the submitted work; and received honoraria from Ab Medica SpA, Medtronic, and Verb Medical. Dr. Ramalingam reports receiving grants and other fees from Amgen, AstraZeneca, and Bristol-Myers Squibb; received other fees from Abbvie, Genentech, and Roche; and received grants from Merck, Takeda, Tesaro, and Advaxis outside of the submitted work. Dr. Garassino reports receiving personal fees from Bayer Incyte, Sanofi-Aventis, Inivata Takeda, Boehringer Ingelheim, Otsuka Pharma, Seattle Genetics, and Daiichi Sankyo; personal fees and other fees from AstraZeneca, Eli Lilly, Novartis, Bristol-Myers Squibb, Roche, Pfizer, and Celgene; and other fees from Tiziana Sciences, Clovis GlaxoSmithKline, Spectrum Pharmaceuticals, Blueprint Medicine, Bayer Healthcare Pharmaceuticals, Janssen, and GlaxoSmithKline outside of the submitted work. Dr. Haanen reports receiving grants from Bristol-Myers Squibb, Merck, Sharp and Dohme, Novartis, and Neon Therapeutics outside of the submitted work; and advisory roles for AIMM, Amgen, Achilles Tx, AstraZeneca, Bristol-Myers Squibb, Bayer, Celsius Tx, GSK, Gadeta, Immunocore, MSD, Merck Serono, Neon Tx, Neogene Tx, Novartis, Pfizer, Roche/Genentech, Sanofi, Seattle Genetics, Third Rock Ventures, and Vaximm. Dr. Peters reports receiving personal fees from Abbvie, Amgen, AstraZeneca, Bayer, Biocartis, Boehringer Ingelheim, and Bristol-Myers Squibb; personal fees from Clovis, Daiichi Sankyo, Debiopharm, Eli Lilly, F. Hoffmann-La Roche, Foundation Medicine, Illumina, Janssen, Merck Sharp, and Dohme, Merck Serono, Merrimack, Novartis, Pharma Mar, Pfizer, Regeneron, Sanofi, Seattle Genetics, Takeda, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, and Eli Lilly; nonfinancial support from Amgen, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Clovis, F. Hoffmann-La Roche, Illumina, Merck Sharp, and Dohme, Merck Serono, Novartis, Pfizer, and Sanofi; and fees for the institution from Bioinvent outside of the submitted work. Dr. Scagliotti reports receiving personal fees from AstraZeneca, Roche, Merck Sharp, and Dohme, Takeda, and Eli Lilly outside of the submitted work. Dr. Belani reports receiving personal fees from Genentech outside of the submitted work. The remaining authors declare no conflict of interest.