Swab negative nsclc patients (PTS) with clinical and radiological features suggestive for covid-19: A single center experience

Background: At the end of 2019, a novel viral pneumonia, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was described in China Since then, Italy has soon become one of the most affected countries In this challenging situation, the oncological community was called to protect cancer patients (pts), especially those affected by lung cancer, considered one of the most vulnerable population due to older age, multiple comorbidities and type of infection This study aimed to investigate the clinical management of NSCLC pts, in order to provide a reliable picture of real-word practice during the COVID-19 outbreak Materials and Methods: A 29-questions survey focusing on the clinical management and therapeutic indications for NSCLC pts during COVID-19 pandemic was sent to 95 medical/thoracic oncologists across different Italian regions Results: From April 12th to May 2nd, 79 responses were received, with an overall response rate of 83% The majority (77 3%) of oncologists declared a significant change in the outpatient management of NSCLC pts The number of consultations in case of suspected NSCLC decreased in about half of cases (46 8%), with a major reduction when considering the number of pts coming from the emergency department for a first oncological evaluation (60% of cases) The total number of pts with any stage, newly diagnosed NSCLC, within the observational period, was reported to be lower than the pre-pandemic era by the 56% of oncologists For pts candidates to adjuvant chemotherapy and concurrent chemoradiation, the therapeutic indications followed guidelines in 62% and 72% of cases, respectively As regards the metastatic disease, the majority of oncologists confirmed their clinical indication to first-line treatment The collected data revealed major changes in the second line therapeutic options, most related to timing and schedules of administration Lung cancer pts' accrual in clinical trials dramatically has fallen for 79% of oncologists and follow-up consultations were mostly managed by telemedicine Conclusions: This survey showed that Italian oncologists are determined to follow the available guidelines for the clinical management of NSCLC pts during this emergency time, while more complicate is to deal with clinical trials In this tough landscape, telemedicine provides a valid support to facilitate patient-healthcare interactions