Curative treatments for colon cancer during the COVID-19 pandemic era

During the coronavirus disease 2019 (COVID-19) pandemic, to protect patients with cancer, reduction in hospital access, reduction in myelosuppression risk, and postponing/withholding unnecessary treatments were important in order to reduce risk of infection. Little is known about the risk burden for patients with resected colorectal cancer (CRC). Use of an oral chemotherapy regimen represents a convenient, safe, and manageable therapy for both fit and elderly patients. In the metastatic setting, treatment of solitary metastases may be performed, omitting postresection chemotherapy due to lack of literature data. In case of unresectable CRC, short induction chemotherapy, followed by a maintenance phase, may improve compliance and reduce toxicity. In the adjuvant setting, a shorter duration (3 months) may be discussed with patients except in very high-risk cases. Clinical judgment may reduce the risk of COVID-19 exposure in patients with CRC. Oral regimens, treatment delay, and chemotherapy holiday are ways to minimize the global risk for patients during the COVID-19 era.

1. Grothey, A, Sobrero, AF, Shields, AF, et al. Duration of adjuvant chemotherapy for stage III colon cancer. N Engl J Med 2018; 378: 1177–1188.
Google Scholar | Crossref | Medline2. Kerr, DJ, Kerr, RS. Colorectal cancer: proposed treatment guidelines for the COVID-19 era, https://www.medscape.com/viewarticle/928133 (2020, accessed 15 June 2017).
Google Scholar3. van de Haar, J, Hoes, LR, Coles, CE, et al. Caring for patients with cancer in the COVID-19 era. Nat Med 2020; 26: 665–671.
Google Scholar | Crossref | Medline4. Baratelli, C, Zichi, C, Di Maio, M, et al. A systematic review of the safety profile of the different combinations of fluoropyrimidines and oxaliplatin in the treatment of colorectal cancer patients. Crit Rev Oncol Hematol 2018; 122: 21–29.
Google Scholar | Crossref | Medline5. Zhang, GQ, Zhao, H, Wen, XY, et al. [Changes of lymphocyte subsets before and after chemotherapy in colorectal carcinoma patients.] Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2013; 35: 155–160.
Google Scholar | Medline6. Galaine, J, Turco, C, Vauchy, C, et al. CD4 T cells target colorectal cancer antigens upregulated by oxaliplatin. Int J Cancer 2019; 145: 3112–3125.
Google Scholar | Crossref | Medline7. Hirata, F, Ishiyama, K, Tanaka, Y, et al. Effect of bevacizumab plus XELOX (CapeOX) chemotherapy on liver natural killer cell activity in colorectal cancer with resectable liver metastasis. Ann Gastroenterol Surg 2018; 2: 383–393.
Google Scholar | Crossref | Medline8. Pietrantonio, F, Morano, F, Niger, M, et al. Systemic treatment of patients with gastrointestinal cancers during the COVID-19 outbreak: COVID-19-adapted recommendations of the National Cancer Institute of Milan. Clin Colorectal Cancer 2020; 19: 156–164.
Google Scholar | Crossref | Medline

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