Prioritizing systemic therapies for genitourinary malignancies: Canadian recommendations during the COVID-19 pandemic.

The global outbreak of the novel coronavirus disease (COVID- 19) is characterized by rapid human-to-human transmission of the severe adult respiratory syndrome coronavirus 2 (SARS-CoV-2) from droplet contamination.1 Initial reports from epicenters of the pandemic suggest that patients with a diagnosis of cancer may harbor a higher risk of SARS-CoV-2 infection.2 Data also highlights that hospital admission and recurrent hospital visits are risk factors for SARS-CoV-2 infection, and that receipt of anti-cancer therapy within 14 days of presentation is associated with higher rates of intensive care admission, mechanical ventilation, or death.3-5 Coupled with the significant constraints at upstream healthcare systems levels, it is incumbent upon oncologists to adopt prioritization strategies in order to deliver safe, effective, and feasible care in the setting of a pandemic. We sought to develop recommendations to assist in prioritizing systemic therapies for patients with genitourinary cancers in Canada. 



Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 2020 Apr 05 [Epub]

Aly-Khan A Lalani, Kim N Chi, Daniel Y C Heng, Christian K Kollmannsberger, Srikala S Sridhar, Normand Blais, Christina Canil, Piotr Czaykowski, Sebastien J Hotte, Nayyer Iqbal, Denis Soulières, Dominick Bossé, Nimira S Alimohamed, Naveen S Basappa, Som D Mukherjee, Eric Winquist, Lori A Wood, Scott A North Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada., BC Cancer Agency, Vancouver Cancer Center, Vancouver, BC, Canada., Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada., Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada., Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada., The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON, Canada., Cancer Care Manitoba, University of Manitoba, Winnipeg, MB, Canada., Saskatoon Cancer Centre, University of Saskatchewan, Saskatoon, SK, Canada., Cross Cancer Institute, University of Alberta, Edmonton AB, Canada., London Health Sciences Centre, Western University, London, ON, Canada., Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS, Canada.

References
1. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J of Med 2020. [Epub ahead of print]. 
2. Yu J, Ouyang W, Chua MLK, et al. SARS-CoV-2 transmission in patients with cancer at a tertiary care hospital in Wuhan, China. JAMA Onc 2020. [Epub ahead of print]. https://doi.org/10.1001/jamaoncol.2020.0980
3. Ng OT, Marimuthu K, Chia PY, et al. SARS-CoV-2 infection among travelers returning from Wuhan, China. N Engl J Med 2020. [Epub ahead of print]. https://doi.org/10.1056/NEJMc2003100
4. Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA 2020. [Epub ahead of print]. https://doi.org/10.1001/jama.2020.4683
5. Zhang L, Zhu F, Xie L, et al. Clinical characteristics of COVID-19-infected cancer patients: A retrospective case study in three hospitals within Wuhan, China. Ann Oncol 2020. [Epub ahead of print]. https://doi.org/10.1016/j.annonc.2020.03.296

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