Emergency approval of vaccines against COVID-19 provides an opportunity for us to return to pre-pandemic oncology care. However, safety data in cancer patients is lacking due to their exclusion from most phase III trials. We included all patients aged less than 65 years who received a COVID-19 vaccine from 8 December 2020 to 28 February 2021 at our London tertiary oncology centre. Solicited and unsolicited vaccine-related adverse events (VRAEs) were collected using telephone or face-to-face consultation. Within the study period, 373 patients received their first dose of vaccine: Pfizer/BioNTech (75.1%), Oxford/AstraZeneca (23.6%), Moderna (0.3%), and unknown (1.1%). Median follow-up was 25 days (5–85). Median age was 56 years (19–65). Of the patients, 94.9% had a solid malignancy and 76.7% were stage 3–4. The most common cancers were breast (34.0%), lung (13.4%), colorectal (10.2%), and gynaecological (10.2%). Of the patients, 88.5% were receiving anti-cancer treatment (36.2% parenteral chemotherapy and 15.3% immunotherapy), 76.1% developed any grade VRAE of which 2.1% were grade 3. No grade 4/5 or anaphylaxis were observed. The most common VRAEs within 7 days post-vaccination were sore arm (61.7%), fatigue (18.2%), and headaches (12.1%). Most common grade 3 VRAE was fatigue (1.1%). Our results demonstrate that COVID-19 vaccines in oncology patients have mild reactogenicity.

11015 Background: Burnout is a syndrome defined by emotional exhaustion, depersonalisation and loss of personal accomplishment. It is a growing concern amongst doctors, particularly in oncology, who face the added stress of delivering life changing results to patients and managing end of life care. This has potential for negatively impacting mental health, job satisfaction and ultimately patient care. This has been compounded by the COVID-19 pandemic and the uncertainty around complex oncological treatment decisions, longer working hours, redeployment, and constant changes to working patterns to meet the evolving clinical need. In response to this, a novel wellbeing intervention was designed by the educational lead consultant and psychologists to prevent burnout during the pandemic. Methods: Junior doctors working at a single UK cancer centre during the COVID-19 pandemic were invited to attend weekly 30 minute wellbeing sessions facilitated by a clinical psychologist throughout their oncology placement (average 4-6 months). Sessions had an average attendance of 3-6 doctors and began with a 5 minute breathing and relaxation exercise followed by a mixture of clinical debriefing, reflective practice, and mindfulness strategies. Trainees were invited to have individual sessions if required. Surveys based on the 14 point Warwick Edinburgh Well Being Scale (WEMWBS) were conducted at the start and end of placement. Additional qualitative feedback was collated. Results: Throughout a 6 month period, 10 doctors participated in this study. Baseline WEMWBS scores revealed average mental wellbeing (n = 8), high mental wellbeing (n = 1) and probable depression (n = 1). Median baseline WEMWBS score was 52(41-62). Median number of sessions attended was 11(3-14). Post intervention, there was no significant deterioration in baseline WEMWBS score (mean change +2.2; p= 0.34). When doctors were asked about their optimism for the future, there was a significant increase by +0.4 points ( p= 0.037). With respect to participant feedback, 100% were either ‘satisfied’ (n = 1) or ’very satisfied’ (n = 9) with the group facilitation and 100% found the group sessions either ‘helpful’ (n = 7) or ‘very helpful’ (n = 3). Trainee feedback described the benefits of reflecting in a structured and safe environment, breathing exercises, and learning mindfulness strategies. Conclusions: Burnout is a serious concern amongst junior oncologists and is rising as a result of COVID-19. We present a novel intervention that promoted psychological flexibility and importantly maintained mental wellbeing throughout the pandemic. Further studies are planned to develop evidence based interventions to tackle this important issue.

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Background Safe provision of systemic anti-cancer treatment (SACT) during the COVID-19 pandemic remains an ongoing concern amongst clinicians. Methods Retrospective analysis on uro-oncology patients who continued or started SACT between 1st March and 31st May 2020 during the pandemic (with 2019 as a comparator). Results 441 patients received SACT in 2020 (292 prostate, 101 renal, 38 urothelial, 10 testicular) compared to 518 patients in 2019 (340 prostate, 121 renal, 42 urothelial, 15 testicular). In 2020, there were 75.00% fewer patients with stage 3 cancers receiving SACT (p<0.0001) and 94.44% fewer patients receiving radical treatment (p=0.0019). The number of patients started on a new line of SACT was similar between both years (118 in 2019 vs 102 in 2020; p=N.S) but with 53.45% fewer patients started on chemotherapy in 2020 (p=0.00067). Overall, 5 patients tested positive for COVID-19 (one asymptomatic, two moderate pneumonitis, one severe pneumonitis). Compared to 2019, 30-day mortality was similar (1.69% in 2019 vs 0.98% in 2020; p=N.S) whereas the 6-month mortality was lower (9.32% in 2019 vs 1.96% in 2020; p=0.023) in 2020. Conclusion This single-centre study demonstrated that uro-oncology patients can safely receive SACT during COVID-19 pandemic with a low incidence of infection and mortality.

Background Safe provision of systemic anti-cancer treatment (SACT) during the COVID-19 pandemic remains an ongoing concern amongst clinicians. Methods Retrospective analysis on uro-oncology patients who continued or started SACT between 1st March and 31st May 2020 during the pandemic (with 2019 as a comparator). Results 441 patients received SACT in 2020 (292 prostate, 101 renal, 38 urothelial, 10 testicular) compared to 518 patients in 2019 (340 prostate, 121 renal, 42 urothelial, 15 testicular). In 2020, there were 75.00% fewer patients with stage 3 cancers receiving SACT (p < 0.0001) and 94.44% fewer patients receiving radical treatment (p = 0.00194). The number of patients started on a new line of SACT was similar between both years (118 in 2019 vs 102 in 2020; p = 0.898) but with 53.45% fewer patients started on chemotherapy in 2020 (p < 0.001). Overall, 5 patients tested positive for COVID-19 (one asymptomatic, one mild, two moderate, one severe resulting in death). Compared to 2019, 30-day mortality was similar (1.69% in 2019 vs 0.98% in 2020; p = 0.649) whereas 6-month mortality was lower (9.32% in 2019 vs 1.96% in 2020; p = 0.0209) in 2020. Conclusion This study suggests that delivery of SACT to uro-oncology patients during COVID-19 pandemic may be safe in high-incidence areas with appropriate risk-reduction strategies.