Prioritizing systemic therapies for genitourinary malignancies: Canadian recommendations during the COVID-19 pandemic

Lalani, Aly-Khan A.; N., Kim; Heng, Daniel Yick Chin; Kollmannsberger, Christian; Sridhar, Srikala S.; Blais, Normand; Canil, Christina; Czaykowski, Piotr; Hotte, Sébastien J.; Iqbal, Nayyer; Soulières, Denis; Bossé, Dominick; Alimohamed, Nimira; Basappa, Naveen S.; Mukherjee, Som D.; Winquist, Eric; Wood, Lori; North, Scott

doi:10.5489/cuaj.6595

Cited by 15 publications

(38 citation statements)

References 7 publications

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“…33,34 In addition, an American multiorganizational panel has published recommendations on the triage, prioritization, and treatment of breast cancer 53 and an international group has also published recommendations on the same topic. 54 Currently, cancer type specific guidance has been developed for a number of cancers including gastrointestinal cancer, 55,56 genitourinary cancers, 57,58,60 gynecological cancers, 59,60 head and neck cancer, 61,62 hematological malignancy, 63,64 hepatocellular carcinoma, 65 lung cancer, 66 neuroncology, 67 and skin cancer. 68 The Society of Surgical Oncology has published a brief guidance on surgery which is specific for each type of cancer.…”

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confidence: 99%

Developing a holistic contingency plan: Challenges and dilemmas for cancer patients during the COVID‐19

et al. 2020

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During the first quarter of 2020 the world is experiencing a pandemic of Severe Acute Respiratory Syndrome‑Coronavirus‑2 (SARS‑CoV‑2), a novel beta coronavirus that is responsible for the 2019 novel coronavirus disease (COVID‐19). The COVID‐19 pandemic revealed that healthcare systems around the world were not prepared to deal with either the direct effects of the pandemic or with the indirect effects that are imposed on the health of patients with chronic disorders such as cancer patients. Some challenges and dilemmas currently faced during the pandemic include the management of cancer patients during the treatment and follow‐up phases, the assessment of the safety of treatments currently used for the management of SARS‑CoV‑2 for use in cancer patients, the development of psychoeducation and emotional support for cancer patients and the safe conduct of clinical trials involving participation of cancer patients. Evidence from the literature supports the need for the urgent development of a holistic contingency plan which will include clear guidelines for the protection and comprehensive care of cancer patients. The implementation of such a plan is expected to have many beneficial effects by mainly minimizing the increased morbidity and mortality of cancer patients that could result as an adverse consequence of the COVID‐19 or future pandemics.

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confidence: 99%

Developing a holistic contingency plan: Challenges and dilemmas for cancer patients during the COVID‐19

et al. 2020

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“…Kokorovic et al Managing prostate cancer during COVID-19 7 © 2020 Canadian Urological Association There are several filter devices available on the market, and they have been summarized elsewhere 16 .…”

Section: Cuaj -Consensus Statementmentioning

confidence: 99%

“…In addition, intubation is a procedure that carries high risk of spreading the virus to members of the healthcare team present in the operating room. These complexities in cancer care have resulted in the release of several guidelines regarding management of oncology patients during the COVID-19 era [5][6][7][8][9] . Two recent Canadian Urological Association (CUA) publications outline recommendations on surgical Screening and detection 1.…”

Section: Introductionmentioning

confidence: 99%

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A Canadian framework for managing prostate cancer during the COVID-19 pandemic: Recommendations from the Canadian Urologic Oncology Group and the Canadian Urological Association

Kokorovic

Hotte

et al. 2020

CUAJ

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triaging and the use of systemic therapies in genitourinary malignancies 7,9 . The purpose of this publication is to provide a multidisciplinary framework focused on prostate cancer management in the setting of the COVID-19 global pandemic within the Canadian context. General principles1. This consensus statement is a guide to help physicians manage prostate cancer during the acute phase of a pandemic. Treatment prioritization must take into account regional differences in infection rates, resource capacity and mitigation efforts. The current pandemic has had a widespread reach across all Canadian communities, but we recognize that the degree of impact varies, and that provincial and institutional policies are not uniform. Physicians must continue to monitor a continuously evolving situation and make adjustments to clinical decisions as deemed appropriate. The risk of serious morbidity resulting from SARS-CoV-2 infection may outweigh thecompeting risk of prostate cancer in many men. Observation of prostate cancer in carefully selected patients does not increase long-term mortality 10,11 , and therefore shortterm treatment delays are unlikely to lead to disease progression and worse outcomes . All management decisions should be based on this core principle. Appropriate patient counseling and shared decision making is strongly encouraged.Men diagnosed with prostate cancer have increased anxiety and psychological distress 12,13 . This will undeniably become amplified in the setting of a global health crisis. Despite resource restrictions and changes in treatment recommendations, physicians must continue to address the needs of patients and involve them in the decision-making process. This approach may decrease patient anxiety levels and improve outcomes once regular practice resumes. Prioritization must be given to limiting exposures of patients and healthcare workers toSARS-CoV-2. Implementation of telehealth visits significantly reduces the risk of infection among frontline personnel and patients, but also preserves critically needed hospital resources. For these reasons, telehealth visits are strongly encouraged. In-person consultations should be limited to men with new symptoms, those requiring a physical examination and for the evaluation and management of treatment-related serious adverse events. In men who require an in-person assessment, consideration should be given to not repeating visits when two specialists are consulted, nor when pre-operative assessment is needed. The healthcare provider should coordinate their needs to minimize patient's visits. CUAJ -Consensus Statement Kokorovic et al Managing prostate cancer during COVID-193

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“…They also recommend the use of virtual care of cancer patients at this time to minimize visits. 75 The National Institute for Health and Care Excellence (NICE) and the European society of medical oncology (ESMO) issued tiered approach guidelines in delivering cancer care during the COVID-19 pandemic. It's designed on three levels: high, medium, and low priority using the criteria of the Cancer Care Ontario and Magnitude of Clinical Benefit Scale (MCBS), as described in Table 2.…”

Section: Recommendationsmentioning

confidence: 99%

<p>The Landscape of COVID-19 in Cancer Patients: Prevalence, Impacts, and Recommendations</p>

Abdihamid¹,

Cai²,

Kapesa³

et al. 2020

CMAR

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Cancer patients are susceptible groups to COVID-19, and risk-adjusted models show that most cancer patients have a 25-39% mortality risk if infected with COVID-19. The infection rate of SARS-CoV-2 in cancer patients in China was 0.79% (12 of 1524 patients; 95% CI, 0.31.2%). The case fatality rate of COVID-19 in the overall population ranges from 2.3 to 8.0%; among these, the case fatality rate for cancer patients is at 5.6%. In a retrospective cohort study of 28 COVID-19-infected cancer patients, a total of 15 (53.6%) patients had severe outcomes with a mortality rate of 28.6%. In a pooled analysis by Aakash et al, a 2% cancer prevalence was found among admitted patients with COVID-19. In Italy, a report shows that among the 3200 patients who died of SARS-CoV-2, 19.4% were patients with cancer. In New York, 61 (28%) cancer patients succumbed to COVID-19 with a case fatality rate of 37% (20/54) and 25% (41/164) for hematologic and solid malignancies, respectively. Impacts of COVID-19 in cancer care include interruptions of life-saving therapies, distraction effects, and diagnostic overshadowing that involve diverting attention to the pandemic rather than to cancer patients and disruptions of primary palliative care to patients due to forced quarantine. Herein, we review the landscape of COVID-19 in cancer care. We also briefly share our experience and the measures in place to protect cancer patients against COVID-19 in our center.

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Prioritizing systemic therapies for genitourinary malignancies: Canadian recommendations during the COVID-19 pandemic

Cited by 15 publications

References 7 publications

Developing a holistic contingency plan: Challenges and dilemmas for cancer patients during the COVID‐19

Developing a holistic contingency plan: Challenges and dilemmas for cancer patients during the COVID‐19

A Canadian framework for managing prostate cancer during the COVID-19 pandemic: Recommendations from the Canadian Urologic Oncology Group and the Canadian Urological Association

<p>The Landscape of COVID-19 in Cancer Patients: Prevalence, Impacts, and Recommendations</p>

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