Impact of the COVID-19 Pandemic on Treatment Patterns for Patients With Metastatic Solid Cancer in the United States. (10th December 2021)

• Record Type: Journal Article
• Authors: Parikh, Ravi B; Takvorian, Samuel U; Vader, Daniel; Paul Wileyto, E; Clark, Amy S; Lee, Daniel J; Goyal, Gaurav; Rocque, Gabrielle B; Dotan, Efrat; Geynisman, Daniel M; Phull, Pooja; Spiess, Philippe E; Kim, Roger Y; Davidoff, Amy J; Gross, Cary P; Neparidze, Natalia; Miksad, Rebecca A; Calip, Gregory S; Hearn, Caleb M; Ferrell, Will; Shulman, Lawrence N; Mamtani, Ronac; Hubbard, Rebecca A
• Is Part Of: Journal of the National Cancer Institute. Volume 114:Number 4(2022)
• Page Start: 571
• Page End: 578
• Publication Date: 2021-12-10
• Subjects: Cancer -- Periodicals; Cancer -- Research -- Periodicals; 616.994
• DOI: 10.1093/jnci/djab225
• Languages: English
• ISSNs: 0027-8874

Abstract

Abstract: Background: The COVID-19 pandemic has led to delays in patients seeking care for life-threatening conditions; however, its impact on treatment patterns for patients with metastatic cancer is unknown. We assessed the COVID-19 pandemic's impact on time to treatment initiation (TTI) and treatment selection for patients newly diagnosed with metastatic solid cancer. Methods: We used an electronic health record–derived longitudinal database curated via technology-enabled abstraction to identify 14 136 US patients newly diagnosed with de novo or recurrent metastatic solid cancer between January 1 and July 31 in 2019 or 2020. Patients received care at approximately 280 predominantly community-based oncology practices. Controlled interrupted time series analyses assessed the impact of the COVID-19 pandemic period (April-July 2020) on TTI, defined as the number of days from metastatic diagnosis to receipt of first-line systemic therapy, and use of myelosuppressive therapy. Results: The adjusted probability of treatment within 30 days of diagnosis was similar across periods (January-March 2019 = 41.7%, 95% confidence interval [CI] = 32.2% to 51.1%; April-July 2019 = 42.6%, 95% CI = 32.4% to 52.7%; January-March 2020 = 44.5%, 95% CI = 30.4% to 58.6%; April-July 2020 = 46.8%, 95% CI= 34.6% to 59.0%; adjusted percentage-point difference-in-differences = 1.4%, 95% CI = −2.7% to 5.5%). Among 5962 patients who received first-line systemic therapy, there was no association between the pandemic period and use of myelosuppressive therapy (adjusted percentage-point difference-in-differences = 1.6%, 95% CI = −2.6% to 5.8%). There was no meaningful effect modification by cancer type, race, or age. Conclusions: Despite known pandemic-related delays in surveillance and diagnosis, the COVID-19 pandemic did not affect TTI or treatment selection for patients with metastatic solid cancers.