Journal for ImmunoTherapy of Cancer (Oct 2020)

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

  • Valentina Massa,
  • Andrea Sbrana,
  • Fortunato Ciardiello,
  • Carminia Maria Della Corte,
  • Floriana Morgillo,
  • Dario Trapani,
  • Sandro Pignata,
  • Antonio Avallone,
  • Vincenzo Montesarchio,
  • Marco Messina,
  • Paolo Antonio Ascierto,
  • Ester Simeone,
  • Antonio Maria Grimaldi,
  • Marcello Curvietto,
  • Lucia Festino,
  • Michela Lia,
  • Giacomo Cartenì,
  • Luisa Piccin,
  • Bruno Daniele,
  • Sabino De Placido,
  • Cesare Gridelli,
  • Stefano Pepe,
  • Vito Vanella,
  • Giuseppe Palmieri,
  • Maria Grazia Vitale,
  • Alessandro Morabito,
  • Margaret Ottaviano,
  • Pasquale Rescigno,
  • Marianna Tortora,
  • Giovannella Palmieri,
  • Michele Aieta,
  • Pasquale Assalone,
  • Laura Attademo,
  • Francesco Bloise,
  • Davide Bosso,
  • Valentina Borzillo,
  • Giuseppe Buono,
  • Giuseppe Calderoni,
  • Francesca Caputo,
  • Diletta Cavallero,
  • Alessia Cavo,
  • Raffaele Conca,
  • Vincenza Conteduca,
  • Stefano De Falco,
  • Marco De Felice,
  • Michelino De Laurentiis,
  • Pietro De Placido,
  • Irene De Santo,
  • Alfonso De Stefano,
  • Rossella Di Franco,
  • Vincenzo Di Lauro,
  • Antonietta Fabbrocini,
  • Piera Federico,
  • Pasqualina Giordano,
  • Mario Giuliano,
  • Antonella Lucia Marretta,
  • Alessia Mennitto,
  • Sara Merler,
  • Valeria Merz,
  • Carlo Messina,
  • Monica Milano,
  • Alessandro Marco Minisini,
  • Brigitta Mucci,
  • Lucia Nappi,
  • Fabiana Napolitano,
  • Immacolata Paciolla,
  • Martina Pagliuca,
  • Sara Parola,
  • Angelica Petrillo,
  • Francovito Piantedosi,
  • Fernanda Picozzi,
  • Erica Pietroluongo,
  • Veronica Prati,
  • Vittorio Riccio,
  • Mario Rosanova,
  • Alice Rossi,
  • Anna Russo,
  • Massimiliano Salati,
  • Giuseppe Santabarbara,
  • Antonia Silvestri,
  • Massimiliano Spada,
  • Paolo Tarantino,
  • Paola Taveggia,
  • Federica Tomei,
  • Tortora Vincenzo,
  • Claudia Trojanello,
  • Sabrina Vari,
  • Jole Ventriglia,
  • Fabiana Vitiello,
  • Caterina Vivaldi,
  • Claudia von Arx,
  • Francesca Zacchi,
  • Ilaria Zampiva,
  • Andrea Zivi

DOI
https://doi.org/10.1136/jitc-2020-001154
Journal volume & issue
Vol. 8, no. 2

Abstract

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Background 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.Methods 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.Results 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.Conclusion 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.