Abstract PO-029: Operationalizing a prioritized COVID-19 testing strategy at a Canadian tertiary care cancer center
Authors: Hildebrand April A. , Hao Desiree , Karim Safiya , Cheung Winson Y. , Morris Don , Heng Daniel Y. C. 
Published: December 2020

Abstract
Background: Available data suggest that cancer patients who contract COVID-19 may have worse outcomes, including a higher mortality compared to noncancer patients. In an effort to inform and guide our clinicians in the ongoing management of cancer patients during the COVID-19 pandemic, CancerControl Alberta (CCA) implemented targeted fast-track testing for symptomatic, immunocompromised cancer patients in the ambulatory setting. We report the results of the first 7 weeks of testing at the Tom Baker Cancer Centre (TBCC), a comprehensive tertiary cancer center serving southern Alberta (population approximately 2 million).
Methods: Referral for prioritized COVID-19 testing (results within 24 hours) was intended for ambulatory cancer patients who were identified to have symptoms consistent with an influenza-like illness and confirmed to meet at least one of the following criteria: stem cell transplant recipient, hematologic malignancy, cancer diagnosis receiving &gt;0.5 mg/kg/day of prednisone or equivalent, patients on immunotherapy treatment, patients on active chemotherapy within the last 3 weeks, neutropenia (ANC &lt;500), lung cancer, chronic lung disease (e.g., COPD), or patients receiving curative radiation. Testing occurred on site at the TBCC at a designated drive-through testing area where staff, using PPE, tested patients who remained in their cars. The assay for COVID-19 was nucleic acid-based test, and patients were also tested for a standard respiratory virus panel. Patients received either a nasopharyngeal or throat swab, for hematologic and solid tumors diagnoses, respectively. Descriptive analyses were performed.
Results: Between April 15th and June 1st, 2020, 80 patients received prioritized testing at the Tom Baker Cancer Centre. Patients who were tested for COVID-19 had the following characteristics: median age of 60.5 years (range 19, 85) and 31% were male. The majority of tested patients (80%) met the criteria as outlined to prioritize testing. Patients with the following tumor types comprised over 80% of those tested: breast (n=22), hematologic (n=16), lung (n=9), gynecologic (n=9), and GI (n=9). The average time from screening to testing was 26.5 hours, and the average time from test to result was 12.8 hours. At the time of reporting, only one breast cancer patient, who just finished chemotherapy, tested positive via the fast-track testing process; this patient received repeat clearance testing, undergoing a total of 6 tests over one month before achieving 2 negative tests.
Conclusions: Our experience demonstrates that prioritized testing for COVID-19 among those who are potentially the most susceptible, namely immunocompromised cancer patients, is feasible. Very few (1%) positive cases of COVID-19 were identified, among 80 patients tested in the first 47 days of operationalizing the fast-track testing process. Expedited testing should be considered as an ongoing strategy to provide guidance to clinicians in managing cancer patients during the COVID-19 pandemic.
Citation Format: April A. Hildebrand, Desiree Hao, Safiya Karim, Winson Y. Cheung, Don Morris, Daniel Y. C. Heng. Operationalizing a prioritized COVID-19 testing strategy at a Canadian tertiary care cancer center [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-029.