Systemic Treatment of Patients With Gastrointestinal Cancers During the COVID-19 Outbreak: COVID-19-adapted Recommendations of the National Cancer Institute of Milan

Clin Colorectal Cancer. 2020 Sep;19(3):156-164. doi: 10.1016/j.clcc.2020.05.004. Epub 2020 May 23.

Abstract

The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak poses a major challenge in the treatment decision-making of patients with cancer, who may be at higher risk of developing a severe and deadly SARS-CoV-2 infection compared with the general population. The health care emergency is forcing the reshaping of the daily assessment between risks and benefits expected from the administration of immune-suppressive and potentially toxic treatments. To guide our clinical decisions at the National Cancer Institute of Milan (Lombardy region, the epicenter of the outbreak in Italy), we formulated Coronavirus-adapted institutional recommendations for the systemic treatment of patients with gastrointestinal cancers. Here, we describe how our daily clinical practice has changed due to the pandemic outbreak, with the aim of providing useful suggestions for physicians that are facing the same challenges worldwide.

Keywords: Colorectal cancer; Gastric cancer; Hepatobiliary cancer; Pancreatic cancer; SARS-CoV-2 pandemic.

MeSH terms

  • COVID-19
  • Clinical Decision-Making
  • Coronavirus Infections / epidemiology*
  • Decision Making
  • Delivery of Health Care / organization & administration*
  • Disease Outbreaks
  • Gastrointestinal Neoplasms / therapy*
  • Humans
  • Italy / epidemiology
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Risk Assessment
  • Severity of Illness Index