Managing COVID-19 Among Cancer Patients: Risk & Response

April 7, 2020
COTA Team

New research shows that cancer patients may be more susceptible to COVID-19 than individuals without cancer, and have poorer outcomes. On behalf of the National Clinical Research Center for Respiratory Disease, a group of researchers worked with the National Health Commission of the People’s Republic of China to establish a prospective cohort to monitor COVID-19 cases throughout China.

They found that after excluding 417 cases due to insufficient medical history, 18 of the remaining 1,590 COVID-19 cases had a history of cancer. This is slightly higher than the instance of cancer in the overall Chinese population, and may offer insights into which populations are most at risk. Of these 18 patients, five had lung cancer, and 12 were cancer survivors in routine follow-up care. Researchers also found these patients were older than the broader COVID-19 pool, and had a higher risk of severe events compared to patients without cancer.

After screening for other factors, researchers found cancer history represented the highest risk for severe events with COVID-19 when “severe events” were defined by both objective events and physician evaluation. Additionally, patients with cancer deteriorated more rapidly than those without cancer.

Recommendations to Protect Cancer Patients During Pandemics

With this heightened risk, researchers proposed three strategies for patients with cancer during the current COVID-19 pandemic.

  • In areas that are highly affected, researchers urge for intentional postponing of adjuvant chemotherapy or elective surgery for stable cancer. 
  • Despite resource shortages, stronger personal protection provisions should be made for patients with cancer or cancer survivors. 
  • If patients with cancer are infected with COVID-19, more intensive surveillance or treatment should be considered when possible, particularly in older patients or those with additional comorbidities. 

We already know patients with susceptible lungs or respiratory issues are at increased risk of contracting COVID-19, but this study shows cancer patients – regardless of the type of cancer or treatment phase – may also be at heightened risk.

The Future of Treatment

Beyond the findings of the study, the COVID-19 pandemic presents a challenging situation for future cancer care and treatment. Many facilities are cancelling non-emergency treatments in an effort to slow the spread of the virus. This may include clinical research visits or clinical trial intake appointments.

In the absence of this information, it’s important to understand how real-world evidence may be able to support ongoing research. The FDA is also committed to supporting these trials, and issued new guidance documentation indicating it is open to clinical trial modifications caused by coronavirus. By proactively addressing these issues and taking the proper social distancing measures, we can keep patients safe today and ensure treatment proceeds for future cancer patients.