New guidance for treating patients with lung cancer and COVID-19.

Abstract

Treating patients with lung cancer who also have COVID-19 is a unique hurdle for oncologists who must address not 1 but 2 potentially severe, life-threatening diseases. In light of this, the Journal of Thoracic Oncology published a review of treatments for this patient group in its May issue.1 The work is a practical, multidisciplinary, and international overview. However, researchers note that evidence is still lacking in many areas, says lead author Chandra Belani, MD, chief science officer for the International Association for the Study of Lung Cancer, which publishes the journal, and professor of medicine and oncology at the Penn State College of Medicine and Cancer Institute in Hershey, Pennsylvania. Patients with lung cancer tend to be older and at greater risk for relative immunosuppression from both their malignancy and anticancer treatments. They also may have comorbid conditions such as a smoking history or preexisting lung disease, which make them even more vulnerable to COVID-19 complications. Balancing the risk between treatment and exposure to infection is always top of mind, Dr. Belani notes, and the risk of rapid COVID-19 onset requires oncologists to make urgent treatment decisions. There are also contradictions to consider: self-isolation, for example, runs contrary to best-practice care for patients with cancer, who benefit from joining support groups, receiving help from loved ones, and staying active. The overview offers advice to clinicians on treating all stages and types of lung cancer and on dealing with COVID-19 and immunotherapy.