Virtual Management of Patients With Cancer During the COVID-19 Pandemic: Web-Based Questionnaire Study.

During the coronavirus disease (COVID-19) pandemic, patients with cancer in rural settings and distant geographical areas will be affected the most by curfews. Virtual management (telemedicine) has been shown to reduce health costs and improve access to care. The aim of this survey is to understand oncologists' awareness of and views on virtual management, challenges, and preferences, as well as their priorities regarding the prescribing of anticancer treatments during the COVID-19 pandemic. We created a self-administrated electronic survey about the virtual management of patients with cancer during the COVID-19 pandemic. We evaluated its clinical sensibility and pilot tested the instrument. We surveyed practicing oncologists in Gulf and Arab countries using snowball sampling via emails and social media networks. Reminders were sent 1 and 2 weeks later using SurveyMonkey. We received 222 responses from validated oncologists from April 2-22, 2020. An awareness of virtual clinics, virtual multidisciplinary teams, and virtual prescriptions was reported by 182 (82%), 175 (79%), and 166 (75%) respondents, respectively. Reported challenges associated with virtual management were the lack of physical exam (n=134, 60%), patients' awareness and access (n=131, 59%), the lack of physical attendance of patients (n=93, 42%), information technology (IT) support (n=82, 37%), and the safety of virtual management (n=78, 35%). Overall, 111 (50%) and 107 (48%) oncologists did not prefer the virtual prescription of chemotherapy and novel immunotherapy, respectively. However, 188 (85%), 165 (74%), and 127 (57%) oncologists preferred the virtual prescription of hormonal therapy, bone modifying agents, and targeted therapy, respectively. In total, 184 (83%), 183 (83%), and 176 (80%) oncologists preferred to continue neoadjuvant, adjuvant, and perioperative treatments, respectively. Overall, 118 (53%) respondents preferred to continue first-line palliative treatment, in contrast to 68 (30%) and 47 (21%) respondents indicating a preference to interrupt second- and third-line palliative treatment, respectively. For administration of virtual prescriptions, all respondents preferred the oral route and 118 (53%) preferred the subcutaneous route. In contrast, 193 (87%) did not prefer the intravenous route for virtual prescriptions. Overall, 102 (46%) oncologists responded that they would "definitely" prefer to manage patients with cancer virtually. Oncologists have a high level of awareness of virtual management. Although their survey responses indicated that second- and third-line palliative treatments should be interrupted, they stated that neoadjuvant, adjuvant, perioperative, and first-line palliative treatments should continue. Our results confirm that oncologists' views on the priority of anticancer treatments are consistent with the evolving literature during the COVID-19 pandemic. Challenges to virtual management should be addressed to improve the care of patients with cancer.

Tashkandi E ，Zeeneldin A ，AlAbdulwahab A ，Elemam O ，Elsamany S ，Jastaniah W ，Abdullah S ，Alfayez M ，Jazieh AR ，Al-Shamsi HO ... -  《JOURNAL OF MEDICAL INTERNET RESEARCH》

Gynaecologic cancer care during COVID-19 pandemic in India: a social media survey.

Health care services across the globe are undergoing a major transformation to combat the coronavirus disease 2019 (COVID-19) pandemic. Regardless of the strength of health care infrastructure across different economies, all countries are diverting their resources toward care for COVID-19 patients. The aim of this survey was to evaluate the pattern of care of gynaecologic cancers in a developing country during the COVID-19 pandemic. An anonymous survey consisting of 20 questions intended for the gynaecologic cancer care providers with emphasis on their current practice and approach to their patients was distributed online via social media from April 30 to May 31, 2020. Basic descriptive statistics were applied. Among a total of 61 respondents, 63.9% were gynaecologic oncologists, 18.0% were radiation oncologists and 18.0% were medical oncologists. Majority, that is, 95.1% health care professionals felt that COVID-19 pandemic has had a significant change on their practice pattern and 56.2% practitioners had stopped registering new cases of cancer. In 75.4% centers surgery was being done for gynaecologic cancer cases and among them 60.8% were doing surgery only for cases requiring immediate intervention. Among the centers providing chemotherapy, 39.1% had switched to oral drugs. Among the centers providing radiation, 40.9% were providing radiation to cases based on their type and urgency and 9.0% had implemented hypofractionation. In early stage low risk cases, majority, that is, 34.0% centers were managing as before. In early stage high-risk cases, 32.6% centers were managing as before. In advanced stage endometrial cancer cases, 28.8% had postponed any treatment and 28.8% administered chemotherapy. In early stage, epithelial ovarian cancer 65.9% centers were performing complete staging of the disease. In advanced stage epithelial ovarian cancer, 65.9% centers preferred biopsy followed by neoadjuvant chemotherapy and 11.3% centers performed primary debulking surgery. In cases of interval debulking surgery, 73.3% centers deferred surgery till all six cycles of chemotherapy was completed. In cases of recurrent ovarian cancer amenable for secondary debulking surgery, 38.6% preferred chemotherapy. In early stage cervical cancer, surgical treatment was provided in 46.5% centers. In locally advanced cervical cancer, chemoradiation was given in 65.9% centers. In cases of metastatic cervical cancer, 46.6% centers were performing palliative radiation. COVID-19 has affected the treatment of gynecologic cancers patients and health care professionals are trying to mitigate the damage by incorporating new elements which are suited to the current scenario.

Kumari S 《-》

Impact of COVID-19 outbreak on cancer immunotherapy in Italy: a survey of young oncologists.

The coronavirus disease 2019 (COVID-19) pandemic has overwhelmed the health systems worldwide. Data regarding the impact of COVID-19 on cancer patients (CPs) undergoing or candidate for immune checkpoint inhibitors (ICIs) are lacking. We depicted the practice and adaptations in the management of patients with solid tumors eligible or receiving ICIs during the COVID-19 pandemic, with a special focus on Campania region. This survey (25 questions), promoted by the young section of SCITO (Società Campana di ImmunoTerapia Oncologica) Group, was circulated among Italian young oncologists practicing in regions variously affected by the pandemic: high (group 1), medium (group 2) and low (group 3) prevalence of SARS-CoV-2-positive patients. For Campania region, the physician responders were split into those working in cancer centers (CC), university hospitals (UH) and general hospitals (GH). Percentages of agreement, among High (H) versus Medium (M) and versus Low (L) group for Italy and among CC, UH and GH for Campania region, were compared by using Fisher's exact tests for dichotomous answers and χ2 test for trends relative to the questions with 3 or more options. This is the first Italian study to investigate the COVID-19 impact on cancer immunotherapy, unique in its type and very clear in the results. The COVID-19 pandemic seemed not to affect the standard practice in the prescription and delivery of ICIs in Italy. Telemedicine was widely used. There was high consensus to interrupt immunotherapy in SARS-CoV-2-positive patients and to adopt ICIs with longer schedule interval. The majority of the responders tended not to delay the start of ICIs; there were no changes in supportive treatments, but some of the physicians opted for delaying surgeries (if part of patients' planned treatment approach). The results from responders in Campania did not differ significantly from the national ones. Our study highlights the efforts of Italian oncologists to maintain high standards of care for CPs treated with ICIs, regardless the regional prevalence of COVID-19, suggesting the adoption of similar solutions. Research on patients treated with ICIs and experiencing COVID-19 will clarify the safety profile to continue the treatments, thus informing on the most appropriate clinical conducts.

Ottaviano M ，Curvietto M ，Rescigno P ，Tortora M ，Palmieri G ，Giannarelli D ，Aieta M ，Assalone P ，Attademo L ，Avallone A ，Bloise F ，Bosso D ，Borzillo V ，Buono G ，Calderoni G ，Caputo F ，Cartenì G ，Cavallero D ，Cavo A ，Ciardiello F ，Conca R ，Conteduca V ，De Falco S ，De Felice M ，De Laurentiis M ，De Placido P ，De Placido S ，De Santo I ，De Stefano A ，Della Corte CM ，Di Franco R ，Di Lauro V ，Fabbrocini A ，Federico P ，Festino L ，Giordano P ，Giuliano M ，Gridelli C ，Grimaldi AM ，Lia M ，Marretta AL ，Massa V ，Mennitto A ，Merler S ，Merz V ，Messina C ，Messina M ，Milano M ，Minisini AM ，Montesarchio V ，Morabito A ，Morgillo F ，Mucci B ，Nappi L ，Napolitano F ，Paciolla I ，Pagliuca M ，Palmieri G ，Parola S ，Pepe S ，Petrillo A ，Piantedosi F ，Piccin L ，Picozzi F ，Pietroluongo E ，Pignata S ，Prati V ，Riccio V ，Rosanova M ，Rossi A ，Russo A ，Salati M ，Santabarbara G ，Sbrana A ，Simeone E ，Silvestri A ，Spada M ，Tarantino P ，Taveggia P ，Tomei F ，Vincenzo T ，Trapani D ，Trojanello C ，Vanella V ，Vari S ，Ventriglia J ，Vitale MG ，Vitiello F ，Vivaldi C ，von Arx C ，Zacchi F ，Zampiva I ，Zivi A ，Daniele B ，Ascierto PA ，SCITO (Società Campana di ImmunoTerapia Oncologica) ... -  《Journal for ImmunoTherapy of Cancer》

Survey of the Impact of COVID-19 on Oncologists' Decision Making in Cancer.

Ürün Y ，Hussain SA ，Bakouny Z ，Castellano D ，Kılıçkap S ，Morgan G ，Mckay RR ，Pels K ，Schmidt A ，Doroshow DB ，Schütz F ，Albiges L ，Lopes G ，Catto JWF ，Peters S ，Choueiri TK ... -  《-》

Impact of COVID-19 on Canadian medical oncologists and cancer care: Canadian Association of Medical Oncologists survey report.

The covid-19 pandemic has presented unprecedented professional and personal challenges for the oncology community. Under the auspices of the Canadian Association of Medical Oncologists, we conducted an online national survey to better understand the impact of the pandemic on the medical oncology community in Canada. An English-language multiple-choice survey, including questions about demographics, covid-19 risk, use of personal protective equipment (ppe), personal challenges, and chemotherapy management was distributed to Canadian medical oncologists. The survey was open from 30 March to 4 April 2020, and attracted 159 responses. More than 70% of medical oncologists expressed moderate-to-extreme concern about personally contracting covid-19 and about family members or patients (or both) contracting covid-19 from them. Despite that high level of concern, considerable variability in the use of ppe in direct cancer care was reported at the time of this survey, with 33% of respondents indicating no routine ppe use at their institutions and 69% indicating uncertainty about access to adequate ppe. Of the respondents, 54% were experiencing feelings of nervousness or anxiety on most days, and 52% were having feelings of depression or hopelessness on at least some days. Concern about aging parents or family and individual wellness represented the top personal challenges identified. The management of cancer patients has been affected, with adoption of telemedicine reported by 82% of respondents, and cessation of clinical trial accrual reported by 54%. The 3 factors deemed most important for treatment decision-making were■ cancer prognosis and anticipated benefit from treatment,■ risk of treatment toxicity during scarce health care access, and■ patient risk of contracting covid-19. This report describes the results of the first national survey assessing the impact of the covid-19 on Canadian medical oncologists and how they deliver systemic anticancer therapies. We hope that these data will provide a framework to address the challenges identified.

Gill S ，Hao D ，Hirte H ，Campbell A ，Colwell B ... -  《-》