Abstract
The COVID-19 pandemic continues to evolve. In addition to serious implications for people's health and economy, COVID-19 is having a growing impact on cancer care. This study aimed to evaluate the impact of COVID-19 on the diagnosis of metastatic non-small cell lung cancer (mNSCLC) and the utilization of extended interval immunotherapy in the real world. Patients who were newly diagnosed with mNSCLC from January 2020 to June 2020 were identified from the iKnowMed oncology electronic health records database. Patient dosing schedules were tracked over time from January 2020 to June 2020 for the following immunotherapy agents in the metastatic setting: pembrolizumab, atezolizumab, and nivolumab. The corresponding treated patients were characterized as a switcher to the extended interval immunotherapy if they previously received a shorter dosing schedule and subsequently adjusted to an approved extended dosing schedule. The overall number of newly diagnosed mNSCLC patients has continuously decreased from 752 in January 2020 to 623 in June 2020. A total of 148 NSCLC patients initiated Pembrolizumab Q6W, Atezolizumab Q4W, and Nivolumab Q4W dosing schedule in the metastatic setting from January 2020 to June 2020. Of those, 71 (48%) patients were previously treated with a shorter dosing schedule. The number of switchers has increased significantly from 18% (3 out of 17) in January 2020 to 63% (29 out of 46) in June 2020. A decreasing trend in the diagnosis of mNSCLC indicates missed or delayed diagnoses potentially caused by the COVID-19 pandemic. Adjustments in dosing schedule may have been considered and utilized to reduce the frequency of clinic visits and minimize potential viral exposure.
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