Urgent Considerations for the Neuro-oncologic Treatment of Patients with Gliomas During the COVID-19 Pandemic

Nimish A Mohile; Jaishri O Blakeley; Na Tosha N Gatson; Andreas F Hottinger; Andrew B Lassman; Douglas E Ney; Adriana Olar; David Schiff; Helen A Shih; Roy Strowd; Martin J van den Bent; Mateo Ziu

doi:10.1093/neuonc/noaa090

Urgent Considerations for the Neuro-oncologic Treatment of Patients with Gliomas During the COVID-19 Pandemic

Neuro Oncol. 2020 Apr 11;22(7):912-917. doi: 10.1093/neuonc/noaa090. Online ahead of print.

Authors

Affiliations

¹ Department of Neurology, University of Rochester Medical Center.
² Department of Neurology, Johns Hopkins University.
³ Geisinger Health, Neuroscience and Cancer Institutes, and Geisinger Commonwealth School of Medicine.
⁴ CHUV Lausanne University Hospital & University of Lausanne, Departments of Clinical Neurosciences & Oncology, Lausanne, Switzerland.
⁵ Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center.
⁶ Departments of Neurology and Neurosurgery, University of Colorado School of Medicine; Aurora, CO.
⁷ Departments of Pathology and Neurosurgery, Medical University of South Carolina and Hollings Cancer Center, Charleston, SC.
⁸ University of Virginia, Departments of Neurology, Neurological Surgery.
⁹ Department of Radiation Oncology, Massachusetts General Hospital.
¹⁰ Wake Forest School of Medicine, Department of Neurology, Internal Medicine, Section on Hematology and Oncology.
¹¹ Brain Tumor Center at Erasmus MC Cancer Center, Rotterdam, the Netherlands.
¹² Department of Neurosurgery, Inova Neuroscience and Spine Institute, Virginia Commonwealth University.

Abstract

The COVID-19 outbreak is posing unprecedented risks and challenges for all communities and healthcare systems, worldwide. There are unique considerations for many adult patients with gliomas who are vulnerable to the novel coronavirus due to older age and immunosuppression. As patients with terminal illnesses, they present ethical challenges for centers that may need to ration access to ventilator care due to insufficient critical care capacity. It is urgent for the neuro-oncology community to develop a pro-active and coordinated approach to the care of adults with gliomas in order to provide them with the best possible oncologic care while also reducing their risk of viral infection during times of potential healthcare system failure. In this article, we present an approach developed by an international multi-disciplinary group to optimize the care of adults with gliomas during this pandemic. We recommend measures to promote strict social distancing and minimize exposures for patients, address risk and benefit of all therapeutic interventions, pro-actively develop end of life plans, educate patients and caregivers and ensure the health of the multi-disciplinary neuro-oncology workforce. This pandemic is already changing neuro-oncologic care delivery around the globe. It is important to highlight opportunities to maximize the benefit and minimize the risk of glioma management during this pandemic and potentially, in the future.

Keywords: Adult glioma; COVID-19; Pandemic.