Should we consider deferring adjuvant chemotherapy for resected early-stage NSCLC in light of COVID-19?

Topics: Thoracic Malignancies • Medical Oncology • NCI-CCC Tumor Board Question • Yale • Non-small cell lung cancer • COVID-19

If so, how long is too long to wait?

Question Created by Frederick H. Wilson

Nasser Hanna, Indiana University School of Medicine

Added March 24, 2020

6 people found this helpful

1 person agreed with this answer

This is a great and timely question! The absolute benefit observed with adjuvant chemotherapy in surgically resected NSCLC is greatest in those patients with stage II and III disease. The question is how long can one wait to give adjuvant chemotherapy and maintain its benefits.

Salazar and colleagues reported data from a retrospective observational study from the National Cancer Database. The association between time to initiation of adjuvant chemotherapy and survival was evaluated. Over 12,000 patients were identified. They concluded that adjuvant chemotherapy remained efficacious when started 7 to 18 weeks after surgical resection. So, in a high risk population in which the COVID-19 virus is a major threat to their health, I would delay adjuvant chemotherapy for up to 18 weeks.

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