COVID-19: Lung cancer patients are (rarely) treated in intensive care

21/08/2020 09:39

Milan - Lung cancer patients may be at a disadvantage compared to other patients with COVID-19. The results of a patient registry in Lancet Oncology (2020; DOI: 10.1016 / S1470-2045 (20) 30314-4) show that only every tenth person who met the criteria for intensive care was also treated in an intensive care unit. Lung cancer patients have chances of surviving the disease, even if the death rate is high.

The survival times of lung cancer patients have improved in recent years thanks to new treatments (tyrosine kinase inhibitors, immunotherapy). As a result, lung cancer patients are treated more often in the clinics during the current COVID-19 pandemic. However, many doctors rate the prognosis of these patients as so poor that they do not consider treatment in an intensive care unit.

The "Thoracic Cancers International COVID-19 Collaboration" (TERAVOLT) has therefore set up an international patient registry, in which 42 centers in 8 countries participate. By April 12, data had been collected on 200 patients that Marina Garassino of the Istituto Nazionale dei Tumori in Milan and co-workers have now evaluated.

Most patients (76%) suffered from non-small cell lung cancer (NSCLC), the most common type of lung cancer for which tobacco smoking is the primary risk factor. The other patients had small cell bronchial carcinoma (15%) or some rare types of tumor in the thoracic area (thymoma, carcinoid or mesothelioma). Most patients received their first-line therapy at the time of their COVID-19 disease, which can now significantly extend their survival time.

According to Garassino, 134 (88%) of the 152 patients treated in a hospital met the criteria for referral to an intensive care unit. However, only 13 patients (10%) were actually treated there, 9 of whom were mechanically ventilated. The reasons were usually not communicated by the doctors. However, only 6 patients had refused intensive care.

Garassino suspects that the limited capacity at the height of the epidemic - most of the patients were from Italy, France and Spain - led to lung cancer patients in a triage being excluded from intensive care because the doctors believed that the patients would hardly have any chance of survival anyway.


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