Oncology and Therapy (Oct 2023)

Early Systemic Anti-neoplastic Treatment Post SARS-CoV-2 Infection in Patients with Breast Cancer

  • Naama Halpern,
  • Ben Boursi,
  • Einat Shacham-Shmueli,
  • Einav Nili Gal-Yam,
  • Ofer Margalit,
  • Talia Golan,
  • Tamar Beller,
  • Gal Strauss,
  • Dafna Yahav,
  • Eyal Leshem

DOI
https://doi.org/10.1007/s40487-023-00247-2
Journal volume & issue
Vol. 11, no. 4
pp. 513 – 519

Abstract

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Abstract Introduction It is unclear how soon after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection it is safe to resume systemic anti-neoplastic treatment in patients with cancer. We assessed the risk of admissions or postponed treatment cycle in vaccinated patients with breast cancer receiving early systemic anti-neoplastic treatment following SARS-CoV-2 infection. Methods This was a retrospective cohort study conducted during Omicron SARS-CoV-2 outbreak in Israel, January–July 2022. SARS-CoV-2 cohort included 30 vaccinated patients with breast cancer with SARS-CoV-2 infection 7–14 days prior to systemic treatment. All patients had resolved symptoms and a negative antigen detection test on the day of treatment. The pre-coronavirus disease 2019 (COVID-19) pandemic cohort consisted of 49 matched patients with breast cancer treated with systemic anti-neoplastic agents during 2019. Results In 30 vaccinated patients with breast cancer who received systemic anti-neoplastic treatment 7–14 days following SARS-CoV-2 infection, compared with 49 matched patients treated in 2019, the rates of emergency department (ED) visits (13% versus 6%, respectively), hospitalizations (3% versus 4%), next cycle of treatment given per protocol (90% versus 88%), and death (0% versus 0%) were similar. Conclusion In a cohort of vaccinated patients with breast cancer who received systemic anti-neoplastic treatment 7–14 days after SARS-CoV-2 infection, we did not observe substantially higher rates of ED visits, hospitalizations, or deaths compared with a similar cohort of pre-COVID-19 patients with breast cancer. Most patients received the next planned cycle on time. Early resumption of systemic anti-neoplastic treatment following SARS-CoV-2 infection in vaccinated patients with breast cancer with a negative antigen test at the day of treatment appeared to be safe. Additional data on larger cohorts and other malignancies are needed to support clinical guidelines.

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