Impact of COVID-19 outbreak on cancer immunotherapy in Italy: a survey of young oncologists
Authors: Margaret Ottaviano, Marcello Curvietto, Pasquale Rescigno, Marianna Tortora, Giovannella Palmieri, Diana Giannarelli, Michele Aieta, Pasquale Assalone, Laura Attademo, Antonio Avallone, Francesco Bloise, Davide Bosso, Valentina Borzillo, Giuseppe Buono, Giuseppe Calderoni, Francesca Caputo, Giacomo Cartenì, Diletta Cavallero, Alessia Cavo, Fortunato Ciardiello, Raffaele Conca, Vincenza Conteduca, Stefano De Falco, Marco De Felice, Michelino De Laurentiis, Pietro De Placido, Sabino De Placido, Irene De Santo, Alfonso De Stefano, Carminia Maria Della Corte, Rossella Di Franco, Vincenzo Di Lauro, Antonietta Fabbrocini, Piera Federico, Lucia Festino, Pasqualina Giordano, Mario Giuliano, Cesare Gridelli, Antonio Maria Grimaldi, Michela Lia, Antonella Lucia Marretta, Valentina Massa, Alessia Mennitto, Sara Merler, Valeria Merz, Carlo Messina, Marco Messina, Monica Milano, Alessandro Marco Minisini, Vincenzo Montesarchio, Alessandro Morabito, Floriana Morgillo, Brigitta Mucci, Lucia Nappi, Fabiana Napolitano, Immacolata Paciolla, Martina Pagliuca, Giuseppe Palmieri, Sara Parola, Stefano Pepe, Angelica Petrillo, Francovito Piantedosi, Luisa Piccin, Fernanda Picozzi, Erica Pietroluongo, Sandro Pignata, Veronica Prati, Vittorio Riccio, Mario Rosanova, Alice Rossi, Anna Russo, Massimiliano Salati, Giuseppe Santabarbara, Andrea Sbrana, Ester Simeone, Antonia Silvestri, Massimiliano Spada, Paolo Tarantino, Paola Taveggia, Federica Tomei, Tortora Vincenzo, Dario Trapani, Claudia Trojanello, Vito Vanella, Sabrina Vari, Jole Ventriglia, Maria Grazia Vitale, Fabiana Vitiello, Caterina Vivaldi, Claudia von Arx, Francesca Zacchi, Ilaria Zampiva, Andrea Zivi, Bruno Daniele, Paolo Antonio Ascierto
Journal: Journal for ImmunoTherapy of Cancer (2020)

Background The coronavirus disease 2019 (COVID-19) pandemic has overwhelmed the health systems worldwide. Data regarding the impact of COVID-19 on cancer patients (CPs) undergoing or candidate for immune checkpoint inhibitors (ICIs) are lacking. We depicted the practice and adaptations in the management of patients with solid tumors eligible or receiving ICIs during the COVID-19 pandemic, with a special focus on Campania region. Methods This survey (25 questions), promoted by the young section of SCITO (Società Campana di ImmunoTerapia Oncologica) Group, was circulated among Italian young oncologists practicing in regions variously affected by the pandemic: high (group 1), medium (group 2) and low (group 3) prevalence of SARS-CoV-2–positive patients. For Campania region, the physician responders were split into those working in cancer centers (CC), university hospitals (UH) and general hospitals (GH). Percentages of agreement, among High (H) versus Medium (M) and versus Low (L) group for Italy and among CC, UH and GH for Campania region, were compared by using Fisher’s exact tests for dichotomous answers and χ 2 test for trends relative to the questions with 3 or more options. Results This is the first Italian study to investigate the COVID-19 impact on cancer immunotherapy, unique in its type and very clear in the results. The COVID-19 pandemic seemed not to affect the standard practice in the prescription and delivery of ICIs in Italy. Telemedicine was widely used. There was high consensus to interrupt immunotherapy in SARS-CoV-2–positive patients and to adopt ICIs with longer schedule interval. The majority of the responders tended not to delay the start of ICIs; there were no changes in supportive treatments, but some of the physicians opted for delaying surgeries (if part of patients’ planned treatment approach). The results from responders in Campania did not differ significantly from the national ones. Conclusion Our study highlights the efforts of Italian oncologists to maintain high standards of care for CPs treated with ICIs, regardless the regional prevalence of COVID-19, suggesting the adoption of similar solutions. Research on patients treated with ICIs and experiencing COVID-19 will clarify the safety profile to continue the treatments, thus informing on the most appropriate clinical conducts.