Cancer, immune suppression and Coronavirus Disease-19 (COVID-19): Need to manage drug safety (French Society for Oncology Pharmacy [SFPO] guidelines)

Cancer Treat Rev. 2020 Aug:88:102063. doi: 10.1016/j.ctrv.2020.102063. Epub 2020 Jun 23.

Abstract

The Coronavirus disease (COVID-19) pandemic is disrupting our health environment. As expected, studies highlighted the great susceptibility of cancer patients to COVID-19 and more severe complications, leading oncologists to deeply rethink patient cancer care. This review is dedicated to the optimization of care pathways and therapeutics in cancer patients during the pandemic and aims to discuss successive issues. First we focused on the international guidelines proposing adjustments and alternative options to cancer care in order to limit hospital admission and cytopenic treatment in cancer patients, most of whom are immunocompromised. In addition cancer patients are prone to polypharmacy, enhancing the risk of drug-related problems as adverse events and drug-drug interactions. Due to increased risk in case of COVID-19, we reported a comprehensive review of all the drug-related problems between COVID-19 and antineoplastics. Moreover, in the absence of approved drug against COVID-19, infected patients may be included in clinical trials evaluating new drugs with a lack of knowledge, particularly in cancer patients. Focusing on the several experimental drugs currently being evaluated, we set up an original data board helping oncologists and pharmacists to identify promptly drug-related problems between antineoplastics and experimental drugs. Finally additional and concrete recommendations are provided, supporting oncologists and pharmacists in their efforts to manage cancer patients and to optimize their treatments in this new era related to COVID-19.

Keywords: COVID-19; Clinical trials; Drug safety; Drug-drug interactions; Drug-related problems; Herb-Drug interactions; Immune depression.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Betacoronavirus / isolation & purification
  • COVID-19
  • Clinical Trials as Topic / methods
  • Clinical Trials as Topic / standards
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / immunology*
  • Coronavirus Infections / virology
  • Humans
  • Medical Oncology / methods
  • Medical Oncology / standards*
  • Neoplasms / drug therapy*
  • Neoplasms / immunology*
  • Neoplasms / virology
  • Pandemics
  • Pharmacy / methods
  • Pharmacy / standards*
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / immunology*
  • Pneumonia, Viral / virology
  • Practice Guidelines as Topic
  • SARS-CoV-2

Substances

  • Antineoplastic Agents