Journal article
Impact of the COVID-19 Pandemic on Treatment Patterns for Patients With Metastatic Solid Cancer in the United States
JNCI : Journal of the National Cancer Institute, v 114(4), pp 571-578
11 Apr 2022
PMID: 34893865
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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.
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.
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.
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.
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Details
- Title
- Impact of the COVID-19 Pandemic on Treatment Patterns for Patients With Metastatic Solid Cancer in the United States
- Creators
- Ravi B Parikh - University of PennsylvaniaSamuel U Takvorian - University of PennsylvaniaDaniel Vader - University of PennsylvaniaE Paul Wileyto - University of PennsylvaniaAmy S Clark - University of PennsylvaniaDaniel J Lee - University of PennsylvaniaGaurav Goyal - University of Alabama at BirminghamGabrielle B Rocque - University of Alabama at BirminghamEfrat Dotan - Fox Chase Cancer CenterDaniel M Geynisman - Fox Chase Cancer CenterPooja Phull - Fox Chase Cancer CenterPhilippe E Spiess - Moffitt Cancer CenterRoger Y Kim - University of PennsylvaniaAmy J Davidoff - National Cancer InstituteCary P Gross - Yale School of MedicineNatalia Neparidze - Yale School of MedicineRebecca A Miksad - Flatiron HealthGregory S Calip - Flatiron HealthCaleb M Hearn - University of PennsylvaniaWill Ferrell - University of PennsylvaniaLawrence N Shulman - University of PennsylvaniaRonac Mamtani - University of PennsylvaniaRebecca A Hubbard - University of PennsylvaniaPRACTICE Investigators
- Publication Details
- JNCI : Journal of the National Cancer Institute, v 114(4), pp 571-578
- Publisher
- Oxford University Press
- Grant note
- KL2 TR002002 / NCATS NIH HHS T32 CA009615 / NCI NIH HHS T32 HL007891 / NHLBI NIH HHS K08 CA263541 / NCI NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000781383000012
- Scopus ID
- 2-s2.0-85128488488
- Other Identifier
- 991021965454004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology