Lung Cancer Experts Share Insight on Rapidly Evolving COVID-19 Pandemic

During the 2020 OncLive^® State of the Science Summit^™ on Lung Cancer, experts from Mayo Clinic, Ironwood Cancer and Research Centers, and Banner MD Anderson Cancer Center Clinic discussed the impact of the COVID-19 pandemic on cancer care and shared what advice they have been giving their patients.

Panayiotis Savvides, MD, PhD

Panayiotis Savvides, MD, PhD

Medical Oncologist, Mayo Clinic

“The situation with COVID-19 is rapidly evolving and we’re all trying to observe the information and rapidly communicate with one another as we try to extrapolate the data from the immunologic observations. It seems clear that those who are more susceptible to severe, and maybe even lethal, infection have certain characteristics: the elderly, those with significant comorbidities, and the immunosuppressed. Of course, many of our patients are included in [the latter]. As a group, all patients with cancer who are undergoing active treatment and are immunosuppressed have to be more careful and try to minimize exposure.”

Chad Cherington, MD

Chad Cherington, MD

Community Medical Oncologist, Ironwood Cancer & Research Centers

“[Toward the end of February] I had a few patients who had asked me to write letters in an attempt to cancel either cruises or different airline trips for vacation travel. Some of these patients are on treatment and are immunocompromised so [they should] stay away from areas where we’re hearing a lot about COVID-19.

Just from my own reading and looking at the news, I’m just advising people to practice a lot of good handwashing and to avoid crowded places. I fear that if too many people become too afraid and go to the hospital, that we could overwhelm some of our healthcare systems. Many people may not be that sick and [going to the hospital] could just be another nidus for spreading the virus. If people aren’t too sick, they should just stay at home.”

Jonathan DCunha, MD, PhD, FACS

Jonathan DCunha, MD, PhD, FACS

Thoracic Surgeon, Mayo Clinic

“We’re [obviously] getting many questions [from our patients with regard to COVID-19]. One [of my patients] messaged me through the portal [because he] as was worried about this. He just received his second round of adjuvant chemotherapy following a lung cancer resection and so [he is] worried about COVID-19. The best I can say is what we all know from reading the Centers for Disease Control and Prevention guidelines: Be smart. If you’re immunosuppressed, take precautions. Follow the travel advisories and other guidance that have been put out. Don’t panic, just follow that advice. Like many things that we have encountered in our healthcare system, [I believe] this will pass with time.”

Nitika Thawani, MD

Nitika Thawani, MD

Research Member, Therapeutic Development Program and the Cancer Biology Program, University of Arizona Cancer Center

“From the radiation standpoint, the only way it affects patients [who have received radiation] is that if they have adverse events from the therapy or they have a [COVID-19] infection, it’s hard to differentiate 1 from the other; it’s very confusing. You need to be really diligent about testing and looking where your fields of radiation were. Could [whatever the patient is feeling] be related to the radiation?

The other thing is, radiation is immunogenic. Some viral vaccines [are being examined in combination with radiation] to kill cancer and that’s an interesting approach. Of course, this is not applicable to COVID-19, but in general, that is what we are looking at and hopefully we will have future trials to prove or disprove the combination therapy.”

Jason Niu, MD, PhD

Jason Niu, MD, PhD

Director, Lung Cancer Program, and Thoracic Oncologist, Banner MD Anderson Cancer Center

“Of course, I do have some concerns [about COVID-19]. Obviously, everyone is concerned [about the virus]. Back in 2009, we had the H1N1 flu [pandemic]. Three years later, the FDA published data showing that the mortality rate was 2% to 3% in the United States population; it was actually as high as 20% to 30% outside the country. Based on the results from China, I believe the mortality rate, if anything, is much lower [with COVID-19] compared with what was seen with H1N1.

That being said, I do believe [COVID-19] is a concern, particularly for the lung cancer population. This virus seems to have a preference to target the lungs, causing acute respiratory distress syndrome, and sometimes it almost seems to present as a cytokine release syndrome—like picture requiring intubation. We need to observe good hygiene.

I [obviously have been speaking with] my patients about the virus. [A few weeks ago, I was telling] them that I don’t believe it’s a bad idea for them to come to our center wearing some of the masks. Patients who really require hospitalization and intensive care should come to the emergency room to be treated.”

Editor's Note: These interviews were conducted on March 5, 2020. The situation regarding the COVID-19 pandemic is rapidly evolving. For more information on COVID-19, check out our COVID-19 Research Center.