Italian survey on managing immune checkpoint inhibitors in oncology during COVID‐19 outbreak

Abstract

Background During COVID‐19 outbreak, oncological care has been reorganized. Patients with cancer have been reported to experience a more severe COVID‐19 syndrome; moreover, there are concerns of a potential interference between immune checkpoint inhibitors (ICIs) and SARS‐CoV‐2 pathogenesis. Materials and methods Between 6 and 16 May 2020, a 22‐item survey was sent to Italian physicians involved in administering ICIs. It aimed at exploring the perception about SARS‐CoV‐2‐related risks in cancer patients receiving ICIs, and the attitudes towards their management. Results The 104 respondents had a median age of 35.5 years, 58.7% were females and 71.2% worked in Northern Italy. 47.1% of respondents argued a synergism between ICIs and SARS‐CoV‐2 pathogenesis leading to worse outcomes, but 97.1% would not deny an ICI only for the risk of infection. During COVID‐19 outbreak, to reduce hospital visits, 55.8% and 30.8% opted for the highest labelled dose of each ICI and/or, among different ICIs for the same indication, for the one with the longer interval between cycles, respectively. 53.8% of respondents suggested testing for SARS‐CoV‐2 every cancer patient candidate to ICIs. 71.2% declared to manage patients with onset of dyspnoea and cough as infected by SARS‐CoV‐2 until otherwise proven; however, 96.2% did not reduce the use of steroids to manage immune‐related toxicities. The administration of ICIs in specific situations for different cancer types has not been drastically conditioned. Conclusions These results highlight the uncertainties around the perception of a potential interference between ICIs and COVID‐19, supporting the need of focused studies on this topic.