Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
Nat Med. 2020 May;26(5):665-671. doi: 10.1038/s41591-020-0874-8. Epub 2020 Apr 16.
The current COVID-19 pandemic challenges oncologists to profoundly re-organize oncological care in order to dramatically reduce hospital visits and admissions and therapy-induced immune-related complications without compromising cancer outcomes. Since COVID-19 is a novel disease, guidance by scientific evidence is often unavailable, and impactful decisions are inevitably made on the basis of expert opinions. Here we report how the seven comprehensive cancer centers of Cancer Core Europe have organized their healthcare systems at an unprecedented scale and pace to make their operations 'pandemic proof'. We identify and discuss many commonalities, but also important local differences, and pinpoint critical research priorities to enable evidence-based remodeling of cancer care during the COVID-19 pandemic. Also, we discuss how the current situation offers a unique window of opportunity for assessing the effects of de-escalating anticancer regimens, which may fast-forward the development of more-refined and less-toxic treatments. By sharing our joint experiences, we offer a roadmap for proceeding and aim to mobilize the global research community to generate the data that are critically needed to offer the best possible care to patients.
当前的 COVID-19 大流行使肿瘤学家面临巨大挑战，需要对肿瘤治疗进行深刻的重新组织，以大幅减少医院就诊和住院次数，降低治疗引起的免疫相关并发症，同时又不影响癌症治疗效果。由于 COVID-19 是一种新型疾病，科学证据的指导通常不可用，因此不可避免地需要根据专家意见做出重大决策。在这里，我们报告了欧洲癌症核心的七个综合癌症中心以前所未有的规模和速度组织其医疗保健系统，使其运作“具有抗大流行能力”。我们确定并讨论了许多共同之处，但也有重要的地方差异，并指出了关键的研究重点，以在 COVID-19 大流行期间实现基于证据的癌症治疗模式重塑。此外，我们还讨论了当前情况为评估降低抗癌方案强度的效果提供了一个独特的机会窗口，这可能会加速开发更精细、毒性更低的治疗方法。通过分享我们的联合经验，我们提供了一个前进的路线图，并旨在动员全球研究界生成急需的数据，为患者提供最佳的治疗。
