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妇科肿瘤患者在 COVID-19 大流行期间的抗癌治疗和临床试验考虑。

Anti-cancer therapy and clinical trial considerations for gynecologic oncology patients during the COVID-19 pandemic crisis.

机构信息

NYU Langone Health, Perlmutter Cancer Center, New York University School of Medicine, New York, NY, United States.

Duke Cancer Institute, Duke University Health System, Durham, NC, United States.

出版信息

Gynecol Oncol. 2020 Jul;158(1):16-24. doi: 10.1016/j.ygyno.2020.04.694. Epub 2020 Apr 23.


DOI:10.1016/j.ygyno.2020.04.694
PMID:32386911
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7177100/
Abstract

OBJECTIVES: The COVID-19 pandemic has consumed considerable resources and has impacted the delivery of cancer care. Patients with cancer may have factors which place them at high risk for COVID 19 morbidity or mortality. Highly immunosuppressive chemotherapy regimens and possible exposure to COVID-19 during treatment may put patients at additional risk. The Society of Gynecologic Oncology convened an expert panel to address recommendations for best practices during this crisis to minimize risk to patients from deviations in cancer care and from COVID-19 morbidity. METHODS: An expert panel convened to develop initial consensus guidelines regarding anti-neoplastic therapy during the COVID-19 pandemic with respect to gynecologic cancer care and clinical trials. RESULTS: COVID-19 poses special risks to patients who are older, have medical co-morbidities, and cancer. In addition, this pandemic will likely strain resources, making delivery of cancer care or conduct of clinical trials unpredictable. Recommendations are to limit visits and contact with health care facilities by using telemedicine when appropriate, and choosing regimens which require less frequent visits and which are less immunosuppressive. Deviations will occur in clinical trials as a result of limited resources, and it is important to understand regulatory obligations to trial sponsors as well as to the IRB to ensure that clinical trial and patient safety oversight are maintained. CONCLUSIONS: The ongoing crisis will strain resources needed to deliver cancer care. When alterations to the delivery of care are mandated, efforts should be taken to minimize risks and maximize safety while approximating standard practice.

摘要

目的:COVID-19 大流行消耗了大量资源,并影响了癌症治疗的开展。癌症患者可能存在使他们面临 COVID-19 发病率或死亡率高风险的因素。高度免疫抑制的化疗方案以及治疗期间可能接触到 COVID-19,可能会使患者面临额外的风险。妇科肿瘤学协会召集了一个专家小组,针对这一危机期间的最佳实践提出建议,以尽量减少癌症治疗和 COVID-19 发病率偏差对患者的风险。

方法:召集了一个专家小组,就 COVID-19 大流行期间妇科癌症治疗和临床试验中的抗肿瘤治疗制定初步共识指南。

结果:COVID-19 对年龄较大、有合并症和癌症的患者构成特殊风险。此外,这场大流行很可能会使资源紧张,使癌症治疗或临床试验的开展变得不可预测。建议通过适当使用远程医疗来限制与医疗机构的接触和访问,并选择需要较少频繁访问和较少免疫抑制的方案。由于资源有限,临床试验将出现偏差,了解试验赞助商以及 IRB 的监管义务对于确保临床试验和患者安全监督至关重要。

结论:持续的危机将使提供癌症治疗所需的资源紧张。当需要对护理的提供进行修改时,应努力将风险降到最低,同时最大限度地提高安全性,同时接近标准实践。

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Anti-cancer therapy and clinical trial considerations for gynecologic oncology patients during the COVID-19 pandemic crisis.

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引用本文的文献

[1]
Screening log: Challenges in community patient recruitment for gynecologic oncology clinical trials.

Contemp Clin Trials Commun. 2024-9-29

[2]
Patient care and access to clinical trials in gynaecological oncology: global implications of the early phase of the COVID-19 pandemic.

Arch Gynecol Obstet. 2024-7

[3]
TBCRC 057: Survey about willingness to participate in cancer clinical trials during the pandemic.

Cancer Med. 2024-3

[4]
Telehealth utilization in gynecologic oncology clinical trials.

Gynecol Oncol. 2023-10

[5]
Impact of the COVID-19 pandemic on training conditions and education in oncologic disciplines: a survey-based analysis.

Strahlenther Onkol. 2023-9

[6]
Maintenance therapy for long-term control of high-grade endometrial stromal sarcoma.

BMJ Case Rep. 2022-5-12

[7]
Impact of the COVID-19 pandemic on referral to and delivery of gynecologic oncology care.

Gynecol Oncol Rep. 2022-2

[8]
Nationwide Survey of German Outpatient Gynecologic Oncology Practices during the Coronavirus Disease 2019 Pandemic: Reactions to the First Wave and Future Perspectives.

Breast Care (Basel). 2021-9-10

[9]
Virtual visits among gynecologic oncology patients during the COVID-19 pandemic are accessible across the social vulnerability spectrum.

Gynecol Oncol. 2021-7

[10]
Financial toxicity, mental health, and gynecologic cancer treatment: The effect of the COVID-19 pandemic among low-income women in New York City.

Cancer. 2021-7-15

本文引用的文献

[1]
Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study.

Signal Transduct Target Ther. 2020-3-27

[2]
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Lancet. 2020-2-29

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Lancet Oncol. 2020-3

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