Abstract 1700P
Background
During the COVID-19 outbreak oncological care has been reorganized to face the emergency. Cancer patients have been reported to be at higher risk of severe events related to SARS-CoV-2. Moreover, there are concerns of a possible interference between immune checkpoint inhibitors (ICIs) and the pathogenesis of the infection.
Methods
A 22-item questionnaire was shared with Italian physicians managing ICIs, between May 6 and 16, 2020. This survey aimed at exploring the perception about SARS-CoV-2 related risks in cancer patients receiving ICIs, and whether the management of these patients has been modified during COVID-19 outbreak.
Results
Respondents were 104, with a median age of 35.5 years, mainly females (58.7%), mainly working in Northern Italy (71%). 47.1% of respondents were afraid that a synergism could exist between ICIs mechanism of action and SARS-CoV-2 pathogenesis, leading to worse outcomes. 97.1% of respondents would not deny an ICI only for the possible occurrence of COVID-19. Measures for reducing hospital visits have been adopted by choosing the ICIs schedule with fewer administrations, adopting the highest labeled dose of each drug (55.8%) and/or choosing, among different ICIs for the same indication, the one with the longer interval between cycles (30.8%). 53.8% of respondents suggested the need to test for SARS-CoV-2 every cancer patient candidate to ICIs. Regarding differential diagnosis between immune-related adverse events (irAEs) and COVID-19 manifestations, 71.2% of respondents declared to manage a patient with onset of dyspnea and cough like a COVID-19 patient until otherwise proven (ie, waiting for the result of SARS-CoV-2 test before doing other diagnostic or therapeutic procedures); however, 96.2% did not reduce the use of steroids to manage irAEs during the pandemic. No major impact of COVID-19 on physicians’ attitudes towards the use of ICIs to manage specific clinical situations in different cancer types (ie, lung, breast, melanoma, urothelial) was observed.
Conclusions
These results highlight the uncertainty of physicians dealing with ICIs in cancer patients during COVID-19 outbreak, supporting the need of dedicated studies on this regard.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
M. Tagliamento: Travel/Accommodation/Expenses: Roche, Bristol-Myers Squibb, Astra Zeneca, Takeda. F. Poggio: Travel/Accommodation/Expenses: Takeda, Ely Lilly; Honoraria (self): Merck Sharp & Dohme, Ely Lilly, Novartis. L. Del Mastro: Honoraria (self): Roche, Pfeizer, Ipsen, Eli Lilly, Novartis, Takeda, Merck Sharp & Dohme, Genomic Health, Seattle Genetics; Non-remunerated activity/ies: Celgene. M. Di Maio: Advisory/Consultancy: Eisai, Takeda, Janssen, Astellas, Pfizer, AstraZeneca. M. Lambertini: Advisory/Consultancy: Roche and Ely Lilly; Speaker Bureau/Expert testimony: Roche, Takeda and Theramex. All other authors have declared no conflicts of interest.