SO-1 The impact of COVID-19 on daily practice patterns in the third-line setting for patients with metastatic colorectal cancer: Results of a real-world survey

Abstract

The emergence of the COVID-19 virus in 2020 led to unprecedented challenges in the way oncologic care is organized to guarantee treatment continuation for patients with cancer. The SCOPE COVID-19 survey aimed to assess the impact of the COVID-19 pandemic on third-line treatment goals in patients with metastatic colorectal cancer (mCRC) and compare it with daily practice patterns from the pre–COVID-19 era. An expert panel of gastrointestinal oncologists developed the survey, which was undertaken between October 2020–January 2021. Questions were designed to evaluate the practice patterns during this time and assess the future impact of COVID-19 on treatment decisions. The survey was conducted online using FocusVision Decipher. Oncologists from 14 countries, the majority of which were in Europe, participated. As of 31 January 2021, there were 228 respondents. The majority were medical oncologists (89%), aged between 35–55 years (62%), practiced in a university hospital (49%), and saw between 10–29 patients with mCRC/month (53%). Overall, few restrictions affecting cancer patient management, such as staff being redeployed, were reported by the majority of oncologists (84%). That said, there were a number of changes to practice patterns: the most frequent were a reduction in the number of hospital visits (83%), increased use of virtual consultations/telemedicine (82%), increased frequency of prescribing oral versus intravenous (IV) treatments (73%), and an increase in follow-up/monitoring procedures done closer to home (73%). The third-line treatment goals remained similar to the pre-COVID era; preserving quality of life remained the singular most common primary goal (36%), while 42% of respondents cited efficacy-focused goals, such as prolonging overall survival and improving progression-free survival as their main aim. Overall, 93% of oncologists opined that treatment decisions over the next 12 months will be influenced by the pandemic. While 86% predicted a return to normal for the initial visits for new patients, thereafter and for ongoing patients, 83% foresee that there will be a continued increase in the use of virtual consultations/telemedicine, 80% envision reduced frequency of hospital visits, and 74% foresee the increased frequency of prescribing oral versus IV treatments to be maintained, as well as follow-up being undertaken closer to home. In total, 40% of oncologists believe that the changes to existing protocols, incurred as a result of the pandemic, will be in effect for at least a year. The main third-line treatment goals for patients with mCRC remained the same during the COVID-19 pandemic. However, there were changes to the daily practice patterns. There was an increased use of oral versus IV therapies, and more follow-up and monitoring procedures were undertaken closer to home. Patients visited hospitals less frequently, with a shift toward virtual consultations/telemedicine, practices that are thought to continue for the foreseeable future. The latter observation suggests there is a need to further develop and invest in all aspects of digital health.