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Oncology and COVID-19

Educational Objective
To understand how COVID-19 is affecting the field of oncology
1 Credit CME

People who have cancer are at risk for multiple health problems. Active treatment of the disease with chemotherapy can lead to immune suppression, failure to thrive, a decrease in physical and cognitive function, and other treatment-related toxicities. Some patients who have been previously treated for cancer are also predisposed to an increased incidence of cardiovascular disease, abnormal kidney function, and pulmonary insufficiency, all of which may affect the severity of coronavirus disease 2019 (COVID-19) infection and complications. The COVID-19 pandemic has highlighted the issue of whether patients with cancer, either receiving active treatment or having survived cancer, are more vulnerable to the virus and its sequela than people without cancer. Due to the complexity of health issues in patients with cancer, the diversity of malignancies and treatments, and the limited number of individuals with both COVID-19 infection and cancer, the risk of death and serious complications due to the virus has been a challenge to define. Oncologists and their patients have had to make difficult decisions aimed at limiting potential exposure to the COIVD-19 virus that have influenced treatment choices and, in some cases, clinical outcomes based on scant evidence.

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Article Information

Corresponding Author: Mary L. Disis, MD, Fred Hutchinson Cancer Research Center, University of Washington, 850 Republican St, Brotman 221, Box 358050, Seattle, WA 98195 (ndisis@uw.edu).

Conflict of Interest Disclosures: Dr Disis reported grants from Pfizer, Bavarian Nordisk, Janssen, and Precigen; being the founder of Epithany; and listed on patents with the University of Washington outside the submitted work.

References
1.
Gupta  S , Hayek  SS , Wang  W ,  et al; STOP-COVID Investigators.  Factors associated with death in critically ill patients with coronavirus disease 2019 in the US.   JAMA Intern Med. Published online July 15, 2020;e203596. doi:10.1001/jamainternmed.2020.3596PubMedGoogle Scholar
2.
Kuderer  NM , Choueiri  TK , Shah  DP ,  et al; COVID-19 and Cancer Consortium.  Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study.   Lancet. 2020;395(10241):1907-1918. doi:10.1016/S0140-6736(20)31187-9PubMedGoogle ScholarCrossref
3.
Lee  LY , Cazier  JB , Starkey  T ,  et al; UK Coronavirus Cancer Monitoring Project Team.  COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study.   Lancet. 2020;395(10241):1919-1926. doi:10.1016/S0140-6736(20)31173-9PubMedGoogle ScholarCrossref
4.
Elkrief  A, , Kazandjian  S, , Bouganim  N, .  Changes in lung cancer treatment as a result of the COVID-19 pandemic: a prospective observational study.   JAMA Oncology. Published online September 17, 2020. doi:10.1001/jamaoncol.2020.4408Google Scholar
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Goldstein  DA , Ratain  MJ , Saltz  LB .  Weight-based dosing of pembrolizumab every 6 weeks in the time of COVID-19.   JAMA Oncol. Published online May 27, 2020. doi:10.1001/jamaoncol.2020.2493PubMedGoogle Scholar
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Papautsky  EL , Hamlish  T .  Patient-reported treatment delays in breast cancer care during the COVID-19 pandemic.   Breast Cancer Res Treat. 2020;1-6. doi:10.1007/s10549-020-05828-7PubMedGoogle Scholar
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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