The COVID-19 pandemic, characterised by a fast and global spread during the first months of 2020, has prompted the development of a structured set of recommendations for cancer care management, to maintain the highest possible standards. Within this framework, it is crucial to ensure no disruption to essential oncological services and guarantee the optimal care.This is a structured proposal for the management of lung cancer, comprising three levels of priorities, namely: tier 1 (high priority), tier 2 (medium priority) and tier 3 (low priority)-defined according to the criteria of the Cancer Care Ontario, Huntsman Cancer Institute and Magnitude of Clinical Benefit Scale.The manuscript emphasises the impact of the COVID-19 pandemic on lung cancer care and reconsiders all steps from diagnosis, staging and treatment.These recommendations should, therefore, serve as guidance for prioritising the different aspects of cancer care to mitigate the possible negative impact of the COVID-19 pandemic on the management of our patients.As the situation is rapidly evolving, practical actions are required to guarantee the best patients' treatment while protecting and respecting their rights, safety and well-being. In this environment, cancer practitioners have great responsibilities: provide timely, appropriate, compassionate and justified cancer care, while protecting themselves and their patients from being infected with COVID-19. In case of shortages, resources must be distributed fairly. Consequently, the following recommendations can be applied with significant nuances, depending on the time and location for their use, considering variable constraints imposed to the health systems. An exceptional flexibility is required from cancer caregivers.
- Passaro, A.
- Addeo, A.
- Von Garnier, C.
- Blackhall, F.
- Planchard, D.
- Felip, E.
- Dziadziuszko, R.
- de Marinis, F.
- Reck, M.
- Bouchaab, H.
- Peters, S.
Keywords
- Ambulatory Care
- Betacoronavirus
- Carcinoma, Non-Small-Cell Lung/pathology/*therapy
- Chemoradiotherapy
- Coronavirus Infections/*epidemiology
- Delivery of Health Care/*methods
- Humans
- Lung Neoplasms/pathology/*therapy
- Medical Oncology
- Neoplasm Staging
- Pandemics
- Pneumonectomy
- Pneumonia, Viral/*epidemiology
- Practice Guidelines as Topic
- Radiation Oncology
- Radiosurgery
- Small Cell Lung Carcinoma/pathology/*therapy
- Surgical Oncology
- Telemedicine
- Time-to-Treatment
- Tomography, X-Ray Computed
- Triage
- *covid19
- *SARS-CoV-2
- *lung cancer
- AstraZeneca, Agilent/Dako, Bristol-Myers Squibb, Eli Lilly, Merck Sharp & Dohme
- and Roche Genentech. AA: honoraria for consulting, advisory role from
- AstraZeneca, Bristol-Myers Squibb, Merck Sharpe & Dohme, Takeda, Pfizer, Roche
- Genentech and Boehringer Ingelheim. CvG: honoraria for consulting, advisory role
- or lectures from AstraZeneca, Boehringer Ingelheim, GSK, Mundipharma, Novartis,
- Pfizer, PneumRx et Pulmonx. FB: honoraria for consulting, advisory role or
- lectures from AstraZeneca, Abbvie, Bayer, Roche Genentech, Pfizer, Cell Medica,
- Celgene, Takeda. DP: honoraria for consulting, advisory role or lectures from
- AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Daiichi Sankyo,
- Eli Lilly, Merck, Novartis, Pfizer, prIME Oncology, Peer CME, Roche Genentech,
- Samsung Honoraria: AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim,
- Celgene, Eli Lilly, Merck, Novartis, Pfizer, prIME Oncology, Peer CME, Roche. EF:
- advisory role or speaker's bureau from AbbVie, AstraZeneca, Blueprint medicines,
- Boehringer Ingelheim, Bristol-Myers Squibb, GSK, Eli Lilly, Guardant Health,
- Janssen, Medscape, Merck KGaA, Merck Sharp & Dohme, Novartis, Pfizer, prIME
- Oncology, Roche Genentech, Samsung, Springer, Takeda, Touchime. Board: Grifols,
- independent member Research funding: Fundacion Merck Salud, Grant for Oncology
- Innovation EMD Serono. RD: honoraria for consulting, advisory role or lectures
- from from AstraZeneca, Roche, Pfizer, Novartis, Seattle Genetics, Foundation
- Medicine, Bristol-Myers Squibb, Takeda. FdM: honoraria for consulting, advisory
- role or lectures from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb,
- Celgene, Merck Sharp & Dohme, Novartis, Roche Genentech, Takeda and Pfizer. MR:
- honoraria for consulting, advisory role or lecture from Amgen, AstraZeneca, BMS,
- Boehringer-Ingelheim, Lilly, Merck, MSD, Novartis, Pfizer, Roche, Samsung.
- Support for clinical research from BMS. HB: honoraria for consulting, advisory
- role or lecture for AstraZeneca, Bristol-Myers Squibb, Merck Sharp & Dohme, and
- Roche Genentech. SP: received education grants, provided consultation, attended
- advisory boards, or provided lectures for Abbvie, Amgen, AstraZeneca, Bayer,
- Biocartis, Bioinvent, Blueprint Medicines, Boehringer Ingelheim, Bristol-Myers
- Squibb, Clovis, Daiichi Sankyo, Debiopharm, Eli Lilly, F Hoffmann-La Roche,
- Foundation Medicine, Illumina, Janssen, Merck Sharp & Dohme, Merck Serono,
- Merrimack, Novartis, Pharma Mar, Pfizer, Regeneron, Sanofi, Seattle Genetics,
- Takeda and Vaccibody, from whom she has received honoraria (all fees to
- institution).