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Oncology in the time of COVID

Mélanie Moxhet

July 15, 2020


The partial suspension of routine clinical services has impacted the diagnosis and treatment of cancer around the world.

In the UK, urgent referrals for suspected cancer are down by 60%1. Delays in diagnosis and surgery are predicted to result in increased cancer mortality, which risks cancelling out lives saved by the diversion of healthcare resource to COVID-192,3. In specific situations, surgical delays may be mitigated by neoadjuvant interventions, for example hormone therapy for ER+ breast cancer4, although this kind of approach is not widely applicable.

Despite early concerns around the safe delivery of cancer therapies during the pandemic, prospective data from the UK indicates that recent chemotherapy is not associated with worse outcomes from COVID-195. In many places, however, access to chemotherapy is still limited. Healthcare systems with be stretched in the coming months as the backlog of delayed cancer diagnoses is cleared.

In times of limited resources, prioritisation and improved efficiency are increasingly important. Comprehensive molecular
profiling can assist in several ways, including:

• Flagging patients who are less likely to respond to conventional therapy
• Identification of those suitable for targeted therapy (thus reducing the need for resource-intensive chemotherapy)
• Early detection of resistancemechanisms in order to optimise therapeutic selection

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1 https://www.bmj.com/content/369/bmj.m2386
2 Ann Oncol. 2020 May 16:S0923-7534(20)39825-2. PMID: 32442581
3 https://www.m4edrxiv.org/content/10.1101/2020.05.27.20083287v1
4 Ann Surg. 2020 May 20:10. ePub. PMID: 32433283
5 Lancet. 2020. ePub. PMID: 32473682