The Impact of COVID-19 on the Diagnosis and Treatment of Lung Cancer at a Canadian Academic Center: A Retrospective Chart Review

Kasymjanova, G.; Anwar, Aksa; Cohen, Victor; Sultanem, Khalil; Pepe, C.; Sakr, Lama; Friedmann, Jennifer; Agulnik, J.

doi:10.3390/curroncol28060360

Cited by 41 publications

(55 citation statements)

References 23 publications

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“… 8 A slight reduction in newly diagnosed lung cancer cases was observed in 2020 compared to 2019 in several other studies. 28 , 29 , 30 , 31 However, some studies have observed relevant decrease in lung cancer diagnoses 32 , 33 likely due to the disruption of lung cancer screening 34 , 35 , 36 or to the different setting of the study (hospital vs population‐based). Lung cancer screening is not available in Italy.…”

Section: Discussionmentioning

confidence: 99%

COVID‐19 outbreak in Lombardy: Impact on reducing solid cancer diagnoses in 2020

Trama

Bernasconi

Botta

et al. 2022

Intl Journal of Cancer

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Our aim was to analyse, on a population level, the year‐long decline in cancer diagnoses in the region of Lombardy (Italy), and to characterise the tumours with the greatest reduction in diagnosis by patient age, sex and tumour stage at diagnosis. We used the health care utilisation databases of the Lombardy region to identify cancer patients' characteristics (eg, sex, age) and cancer‐related information (eg, cancer site, stage at diagnosis). The frequency of new cancer diagnoses in 2019 and 2020 were compared in terms of percentage differences in undiagnosed cases. We observed two peaks in the decline in cancer diagnoses: March to May 2020 (−37%) and October to December 2020 (−19%). The decline persisted over the course of 2020 and was higher in males and patients aged 74+. Diagnoses of all four common cancers analysed (female breast, lung, colorectal and prostate) remained below pre‐pandemic levels. For breast and colorectal cancers, the decline in diagnoses was high in the age groups targeted by population‐based screening programmes. We observed a reduction in localised stage cancer diagnoses for all four cancers. Our data confirm that timely monitoring of cancer diagnoses and interventions to prevent disruption of routine diagnostic services are needed to mitigate the impact of emergencies on cancer patients.

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Section: Discussionmentioning

confidence: 99%

COVID‐19 outbreak in Lombardy: Impact on reducing solid cancer diagnoses in 2020

Trama

Bernasconi

Botta

et al. 2022

Intl Journal of Cancer

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“…As approximately 25% of advanced NSCLC have high PD-L1 expression, these findings suggest a general reduction in pathologic diagnoses of all lung cancers. A retrospective study in Quebec, Canada, observed a 34.7% decrease in all lung cancer diagnosed at a single institution between March 2020 and February 2021 (Kasymjanova et al 2021 ). Similarly, in a bicenter retrospective study from Spain, new NSCLC and small cell lung cancer diagnoses were 38% lower between January and June 2020 than a baseline period of January to June 2019 (Reyes et al 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of pembrolizumab for advanced nonsmall cell lung cancer: before and during the COVID-19 pandemic

Ksienski

Gupta²,

Truong

et al. 2022

J Cancer Res Clin Oncol

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Purpose The COVID-19 pandemic changed diagnostic and treatment pathways in oncology. We compared the safety and efficacy of pembrolizumab amongst advanced nonsmall cell lung cancer (NSCLC) patients with a PD-L1 tumor proportion score (TPS) ≥ 50% before and during the pandemic. Methods Advanced NSCLC patients initiating pembrolizumab between June 2015 and December 2019 (“pre-pandemic cohort”) and between March 2020 and March 2021 (“pandemic cohort”) at BC Cancer were identified retrospectively. Multivariable logistic regression evaluated risk factors for immune-related adverse events (irAE) ≥ grade 3 at the 6 week, 3 month, and 6 month landmarks. Cox regression models of overall survival (OS) were constructed. Results The study population comprised 417 patients in the pre-pandemic cohort and 111 patients in the pandemic cohort. Between March and May 2020, 48% fewer advanced NSCLC cases with PD-L1 TPS ≥ 50% were diagnosed compared to similar intervals in 2018–2019. Telemedicine assessment [new patient consultations ( p < 0.001) and follow-up ( p < 0.001)] and extended interval pembrolizumab dosing ( p < 0.001) were more common in the pandemic cohort. Patients initiating pembrolizumab after February 2020 (vs. before January 2020) experienced similar odds of developing severe irAE. 2/111 (1.8%) patients receiving pembrolizumab during the pandemic tested positive for COVID-19. On multivariable analysis, no association between pembrolizumab treatment period (before vs. during the COVID-19 pandemic) and OS was observed ( p = 0.18). Conclusion Significant changes in healthcare delivery in response to the pandemic did not result in increased high grade toxicity or lower survival outcomes in patients with advanced NSCLC treated with pembrolizumab. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-022-04181-0.

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“…Moreover, access to health care services has been significantly limited as almost all healthcare workers are employed in the management of COVID-19 patients. Delays were also observed in cancer patients starting anticancer therapy or under follow-up [ 96 , 97 , 98 ]. Notably, patients who experienced either an interruption or failure to start therapy because of COVID-19 had a statistically shorter overall survival than those who remained on treatment [ 97 ].…”

Section: The Impact Of Covid-19 On Cancer Patientsmentioning

confidence: 99%

Delineating the SARS-CoV-2 Induced Interplay between the Host Immune System and the DNA Damage Response Network

et al. 2022

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COVID-19 is an infectious disease caused by the SARS-CoV-2 coronavirus and characterized by an extremely variable disease course, ranging from asymptomatic cases to severe illness. Although all individuals may be infected by SARS-CoV-2, some people, including those of older age and/or with certain health conditions, including cardiovascular disease, diabetes, cancer, and chronic respiratory disease, are at higher risk of getting seriously ill. For cancer patients, there are both direct consequences of the COVID-19 pandemic, including that they are more likely to be infected by SARS-CoV-2 and more prone to develop severe complications, as well as indirect effects, such as delayed cancer diagnosis or treatment and deferred tests. Accumulating data suggest that aberrant SARS-CoV-2 immune response can be attributed to impaired interferon signaling, hyper-inflammation, and delayed adaptive immune responses. Interestingly, the SARS-CoV-2-induced immunological abnormalities, DNA damage induction, generation of micronuclei, and the virus-induced telomere shortening can abnormally activate the DNA damage response (DDR) network that plays a critical role in genome diversity and stability. We present a review of the current literature regarding the molecular mechanisms that are implicated in the abnormal interplay of the immune system and the DDR network, possibly contributing to some of the COVID-19 complications.

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The Impact of COVID-19 on the Diagnosis and Treatment of Lung Cancer at a Canadian Academic Center: A Retrospective Chart Review

Cited by 41 publications

References 23 publications

COVID‐19 outbreak in Lombardy: Impact on reducing solid cancer diagnoses in 2020

COVID‐19 outbreak in Lombardy: Impact on reducing solid cancer diagnoses in 2020

Safety and efficacy of pembrolizumab for advanced nonsmall cell lung cancer: before and during the COVID-19 pandemic

Delineating the SARS-CoV-2 Induced Interplay between the Host Immune System and the DNA Damage Response Network

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