Assessing the Impact of the COVID-19 Outbreak on the Attitudes and Practice of Italian Oncologists Toward Breast Cancer Care and Related Research Activities

Abstract

PURPOSE: To investigate the impact of the COVID-19 outbreak on the attitudes and practice of Italian oncologists toward breast cancer care and related research activities. METHODS: A 29-question anonymous online survey was sent by e-mail to members of the Italian Association of Medical Oncology and the Italian Breast Cancer Study Group on April 3, 2020. Only medical oncologists (both those in training and specialists) were invited to complete the questionnaire. RESULTS: Out of 165 responding oncologists, 121 (73.3.%) worked in breast units. In the (neo)adjuvant setting, compared with before the emergency, fewer oncologists adopted weekly paclitaxel (68.5% v 93.9%) and a dose-dense schedule for anthracycline-based chemotherapy (43% v 58.8%) during the COVID-19 outbreak. In the metastatic setting, compared with before the emergency, fewer oncologists adopted first-line weekly paclitaxel for HER2-positive disease (41.8% v 53.9%) or CDK4/6 inhibitors for luminal tumors with less-aggressive characteristics (55.8% v 80.0%) during the COVID-19 outbreak. A significant change was also observed in delaying the timing for monitoring therapy with CDK4/6 inhibitors, assessing treatment response with imaging tests, and flushing central venous devices. Clinical research and scientific activities were reduced in 80.3% and 80.1% of respondents previously implicated in these activities, respectively. CONCLUSION: Medical oncologists face many challenges in providing cancer care during the COVID-19 outbreak. Although most of the changes in their attitudes and practice were reasonable responses to the current health care emergency without expected major negative impact on patient outcomes, some potentially alarming signals of undertreatment were observed.

Impact of solid cancer on in-hospital mortality overall and among different subgroups of patients with COVID-19: a nationwide, population-based analysis

“…The COVID-19 outbreak provoked a dramatic disruption in cancer care around the globe, leading to delays in diagnosis, treatment and follow-up and to reductions in the intensity of cancer treatment. [18][19][20] Additionally, several recommendations on how to manage cancer care during the COVID-19 outbreak have been published by oncological societies and by national groups, but given the absence of evidence on this subject, they are only expert-based. [21][22][23] Therefore, our results have implications for clinicians and public health authorities and they may inform future recommendations about cancer care during the COVID-19 outbreak.…”

SARS-CoV-2 seroprevalence in oncology healthcare professionals and patients with cancer at a tertiary care centre during the COVID-19 pandemic

“…Multiple recommendations on this topic have been published so far. [25][26][27] The majority of those guidelines/surveys advocate for treatment modifications such as extending the cycles of immunotherapy administrations, simplification of radiotherapy duration or implementing telemedicine procedures. [27][28][29][30] However, the importance of regular testing of both oncological HCP and patients with cancer is rarely stressed.…”

Impact of COVID-19 Outbreak on Cancer Patient Care and Treatment: Data from an Outpatient Oncology Clinic in Lombardy (Italy)

“…This study retrospectively obtained data from the time-related analysis of conversations via a phone messenger-based group chat between oncologists and patients, and concluded that the use of an instant-messaging system seemed to be a useful tool to share news and reactions between medical oncologists to rapidly implement necessary health measures and provide answers to most cancer patients’ needs. A recent paper investigated the impact of the COVID-19 pandemic on the attitudes and practice of Italian oncologists toward breast cancer and related research activities [ 21 ]. In particular, this work analyzed the results of a 29-question anonymous online survey that was sent by email to members of the Italian Association of Medical Oncology and the Italian Breast Cancer Study Group.…”