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    Modification to Systemic Anticancer Therapy at the Start of the COVID-19 Pandemic and its Overall Impact on Survival Outcomes in Patients with Colorectal Cancer

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    Authors
    Kamposioras, K.
    Lim, K. H. J.
    Williams, J.
    Alani, M.
    Barriuso, J.
    Collins, J.
    Marti, K.
    Braun, M.
    Mullamitha, S.
    Hasan, J.
    Alam, N.
    Mahmood, S.
    Finch, S.
    Bayles, L.
    King, J.
    Saunders, M.
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    Affiliation
    Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
    Issue Date
    2021
    
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    Abstract
    Background Since the beginning of the COVID-19 pandemic, multiple changes to the provision of cancer care has been introduced to maximize patient safety and protect staff. We aimed to identify factors influencing clinicians’ decision on treatment modification during the initial phase of the pandemic, and to assess its impact on outcomes in patients with colorectal cancer. Patients and Methods Electronic records of patients seen in a large United Kingdom tertiary cancer center was reviewed. The frequency and type of changes to systemic anticancer therapy , as well as the factors predicting clinicians’ decision were assessed. Results A total of 418 patients; mean age 63 ± 12 years and 57% male were included. More than half of the patients had modification to their treatment; with treatment delay (21%) or cancellation (10%), being the most common. Majority of patients on neoadjuvant treatment (97%) proceeded with treatment, with some form of treatment modification in 20%. Half of patients on adjuvant treatment had their treatment plan modified. Overall, a change in treatment was more likely in older patients (OR 1.028 [95% CI 1.010-1.047]; P = .002), and in patients who had already received higher number of cycles of systemic anticancer therapy (OR 1.040 [95% CI 1.016-1.065]; P = .001). A change in treatment was less likely further out of the first national lockdown (OR 0.837 [95% CI 0.758-0.925]; P < .001). Patients on third-line treatment were most likely to have alterations to their treatment plan (69%, n=33/48). Conclusion During the first wave of COVID-19 in the United Kingdom, clinicians adapted clinical practice in accordance to local and national guidance, especially amongst older patients and those on third-line treatment. Further real-world data are needed to document the important impact of changes to treatment on outcomes in patients with cancer.
    Citation
    Kamposioras K, Lim KHJ, Williams J, Alani M, Barriuso J, Collins J, et al. Modification to Systemic Anticancer Therapy at the Start of the COVID-19 Pandemic and its Overall Impact on Survival Outcomes in Patients with Colorectal Cancer. Clin Colorectal Cancer. 2021.
    Journal
    Clin Colorectal Cancer
    URI
    http://hdl.handle.net/10541/625022
    DOI
    10.1016/j.clcc.2021.11.010
    PubMed ID
    34953674
    Additional Links
    https://dx.doi.org/10.1016/j.clcc.2021.11.010
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.clcc.2021.11.010
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