Recommendations for Testing and Treating Outpatient Cancer Patients in the Era of COVID-19

J Natl Cancer Inst. 2020 Aug 14;djaa111. doi: 10.1093/jnci/djaa111. Online ahead of print.

Abstract

The clinical spectrum of COVID-19 is still not fully understood. Cancer patients are uniquely vulnerable to COVID-19 and many have been or will be infected. Although an unfortunate minority will die from the infection, most will recover. This poses a challenge in which clinicians must weigh the benefits of initiation or resumption of antineoplastic therapy against the risks that antineoplastic treatment may worsen outcomes related to COVID-19 infection. A recent study of 423 patients at our institution found that patients in active cancer treatment who develop COVID-19 infection did not fare any worse than other hospitalized patients yet guidance as to who requires testing prior to antineoplastic therapy and when to resume therapy post-COVID diagnosis remains unknown. Our institution, therefore, commissioned a task force to help create guidelines for treating oncologists using available published literature. The taskforce focused on the ambulatory care testing guidelines only, as all inpatients receiving antineoplastic therapy are tested for COVID-19 prior to hospital admission. The guidelines focus solely on the safety and well-being of the individual patient undergoing antineoplastic therapy and are not designed to address infection control issues.