Abstract P18: Radical cancer treatment is safe during COVID-19: The experience of a large London-based Comprehensive Cancer Centre

Abstract

Background: The provision of cancer services has been strongly impacted by the outbreak of SARS-CoV-2. Our Cancer Centre in South-East London treats about 8,800 patients annually (incl. 4,500 new diagnoses) and is one of the largest Comprehensive Cancer Centres in the UK. The first COVID-19 positive cancer patient was reported on 29 Feb 2020. Whilst we are dealing with the second wave of COVID-19, it is important to further evaluate safety of cancer treatments whilst balancing risks of COVID-19 infection and complications. Methods: Using descriptive statistics, we report on the patient/tumour characteristics as well as short-term clinical outcomes of those patients undergoing radical treatment (i.e. systemic anticancer treatment (SACT), surgery, or radiotherapy (RT)) for their cancer during the first wave as to help establish the clinical guidelines for the management of cancer patients in a SARS-CoV-2 epidemic. Results: Between March-July 2020, 1,553 patients underwent surgery, 1,125 received SACT, and 814 had RT. Compared to the same period in 2019, there was a decrease of 28% for surgery, 15% for SACT, and 10% for radiotherapy. Whilst surgery was performed on more male patients (58%), more women received SACT (75%) and RT (58%). The age distribution was similar between treatment arms, with the majority of patients aged 50 to 80 years. The most common tumour types were breast (21%), thoracic (20%), and urological (29%) for surgical treatment; breast (49%), gastrointestinal (18%), and gynaecological (10%) for SACT; and breast (40%), urology (25%), and head & neck (11%) for RT. Within SACT, 36% received combination therapy, 35% received systemic chemotherapy, 23% targeted therapy, 5% immunotherapy, and 2% biological therapy. In terms of oncological outcomes, outcomes were similar to pre-COVID-19 times; with 6 deaths at 30 days (<1%) for surgical patients and 36 readmissions (2%), 10 deaths (<1%) for SACT patients, and 52% of RT delivered with radical intent (which was the same in 2019). The COVID-19 infection rates for our patients were very low: 12 patients were positive pre-surgery (1%), 7 post-surgery (<1%), 17 SACT patients (2%) and 3 RT patients (<1%). No COVID-19 related deaths were registered for the surgical, SACT and RT patients. Conclusion: Whilst there was a decline in overall radical treatment, likely due to a delay in cancer diagnoses, those who did undergo their treatment were treated in a safe COVID-19 managed environment. Our findings highlight that cancer patients should have the confidence to attend hospitals and be reassured of the safety measurements taken. Citation Format: Beth Russell, Victoria Harris, Harvey Dickinson, Charlotte Moss, Graham Roberts, Kate Haire, Eirini Tsotra, Harris Gousis, Debra Josephs, Deborah Enting, Ailsa Sita-Lumsden, Jose Roca, Vasilliki Michalaera, Mary Lei, Angela Swampillai, Eleanor Sawyer, Daniel Smith, Irene De Francesco, Teresa Guerrero-Urbano, Mieke Van Hemelrijck, Saoirse Dolly, Guy's Cancer Real World Evidence. Radical cancer treatment is safe during COVID-19: The experience of a large London-based Comprehensive Cancer Centre [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr P18.

The Impact of Hospital Attendance on COVID-19 Infection in Cancer Patients: An Assessment of Data from Guy’s Cancer

“…There have been concerns around iatrogenic spread of COVID-19 across all specialties within healthcare, with some clinical care being delayed during the pandemic and some being transferred to virtual/telephone settings to reduce patient in-person attendances [ 5 , 6 , 7 ]. This has likely contributed to the delay in cancer diagnoses and a higher stage of cancer at diagnosis [ 10 , 11 ].…”

“…Therefore, some cancer patients were identified as vulnerable to COVID-19 and its complications and were advised to shield – in particular, those undergoing chemotherapy or immunotherapy and those with hematological cancers [ 4 ]. Many cancer centers reduced their in-person delivery of care during the COVID-19 pandemic, partly to reduce the spread of COVID-19 in this vulnerable population [ 5 , 6 , 7 ]. As in-person cancer care increases back to pre-pandemic levels, it is important to understand the risks of iatrogenic spread of COVID-19 to this clinical population [ 8 ].…”