COVID-19 may not preclude continuation of lung cancer therapy
medwireNews: The continuation of anticancer therapy may be feasible in patients who acquire severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), say the authors of a case report of a patient with advanced adenocarcinoma and COVID-19.
They explain that SARS-CoV 2 – the novel virus that emerged in Wuhan, China, in December 2019 – has been spreading globally, with research suggesting that people with cancer have an increased risk for developing a severe form of COVID-19, the name given to the disease caused by the virus.
In light of the severity of the viral disease, “most patients with cancer were recommended to withdraw cancer treatment after infection,” the investigators write in the Journal of Thoracic Oncology.
“However, the risks of cancer progression make this issue controversial,” they add.
The team reports on a 57-year-old Chinese man who initiated treatment with gefitinib for EGFR L858R-mutant advanced adenocarcinoma in February 2016, followed by a switch to osimertinib in August 2017 after mutation analysis at disease progression showed the presence of the EGFR T790M mutation.
The patient developed enlarged lymph nodes and was admitted to the hospital in December 2019 to receive radiotherapy, following which he reported fever (38.6°C), cough, shortness of breath, myalgia, and diarrhea, and a computed tomography (CT) scan showed “patchy shadows in both lungs,” say the study authors.
The patient was initially treated with broad spectrum antibiotics and oseltamivir, and his fever was reduced.
As the patient had contact with people with COVID-19, he was tested for the presence of SARS-CoV2 by reverse transcription-polymerase chain reaction (RT-PCR), with positive results. Antiviral therapy with lopinavir/ritonavir was initiated, and a CT scan after 2 weeks showed that the pneumonia had improved, while four consecutive RT-PCR tests were negative for the virus.
Notably, the patient continued osimertinib treatment and follow-up CT scans showed stable lesions in both lungs, report Conghua Xie, from Zhongnan Hospital of Wuhan University, and colleagues.
Despite the positive outcome of the patient, they stress that “[a]lthough this case firstly demonstrated the potential of maintaining targeted treatment in patients with good condition, further studies are in urgent need.”
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