Giorgio Vittorio Scagliotti, MD, PhD, chief of the Medical Oncology Division at the S. Luigi Hospital in Orbassano; the head of the Department of Oncology, and a professor of oncology at the University of Torino, discusses the precautionary measures implemented in clinical practice to protect patients with cancer from COVID-19.

In response to the pandemic, several institutions have reshaped approaches to treatment within the field of oncology. At Scagliotti’s institution, a series of rules were put into place regarding social distancing and not permitting caregivers in the waiting room. There has also been a shift to telemedicine for patients who require regular follow-up visits as well as therapeutic discussions, says Scagliotti.

Despite the pandemic, patients with newly diagnosed cancer still require care for their disease, adds Scagliotti. To this end, his ward has established a second-level triage in which patients are checked for symptoms of COVID-19, such as fever. Patients are asked to wear surgical masks while in clinic and to stay home unless they need to undergo blood tests or chest x-rays, says Scagliotti. If patients are negative for the virus, they are moved into the consultation or chemotherapy administration rooms.

Despite being "in the middle of a storm," Scagliotti and his team are still delivering as many as 70 chemotherapy treatments daily, which is down from 200 daily treatments, and consulting between 40 to 50 patients. In order to maintain a COVID-19—free environment, strict rules must be implemented, stresses Scagliotti. All physicians and surgeons should be wearing surgical masks and gloves and social distancing measures should be practiced.

Scagliotti explains that his team encounters at least 1 patient every day who could possibly be positive for the virus. To this end, an oncology ward is being developed with the intention to treat patients who have tested positive for COVID-19, while patients who test negative are brought to the hematology or internal medicine departments to receive treatment, concludes Scagliotti.

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Giorgio Vittorio Scagliotti, MD, PhD, discusses the precautionary measures implemented in clinical practice to protect patients with cancer from COVID-19.

Dr. Scagliotti on Preventive Measures to Reduce COVID-19 Risk in Oncology

Giorgio Vittorio Scagliotti, MD, PhD, chief of the Medical Oncology Division at the S. Luigi Hospital, Orbassano (Torino), and head of the Department of Oncology at University of Torino, Italy, discusses immunotherapy in the context of precision medicine in lung cancer.

In the oncology space, there is a movement toward precision medicine as a means to tailor treatment to a patient’s particular disease characteristics. Immunotherapy is an emerging pillar in the systemic treatment of non—small cell lung cancer in general, says Scagliotti, and is appropriately considered to be in the realm of precision medicine. This is because immunotherapy is not a one-size-fits-all approach, and precision medicine is based on tailoring therapy to the particular patient.

Currently, PD-L1 expression is one of the biomarkers that is often used to indicate that a patient will respond, as it is easily assessed in clinical practice, explains Scagliotti. Based on current data, it can be considered as an enrichment factor, he adds. Overall response rates and durations of response observed in clinical trials have been shown to be more favorable in patients who are PD-L1—positive.

Giorgio Vittorio Scagliotti, MD, PhD

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