Safe prescribing in cancer patients during the COVID-19 pandemic and outcomes following restart of cancer care following SARS-CoV-2 infection: The COV-SPOT initiative

<p dir="ltr">SARS‐CoV‐2 continues to spread across the world as a highly transmissible endemic disease. For many cancer patients, SARS‐CoV‐2 infection is unavoidable. It continues to disrupt cancer care, causing treatment delays and major psycho‐socio‐medical issues. At present, there is limited evidence on safe prescribing of anti‐cancer therapy, and safe treatment restart following SARS‐CoV‐2 infection. We conducted a prospective cohort study involving 406 COVID‐19‐positive cancer patients across five UK cancer centres and collected data on delay durations, COVID‐19 symptoms and mortality, to ascertain the effect of treatment interruptions. Patients were studied between May 2022 and March 2023, during which Omicron variants of SARS‐CoV‐2 were predominant. Mean treatment interruption was 12.7 days (standard deviation 47.3 days). Upon resuming anti‐cancer therapy, 8.5% experienced COVID‐19 symptom progression, and 1.2% succumbed to COVID‐19‐related mortality. Patients with haematological cancers had a 3.4‐fold increased risk of severe symptoms at 4 weeks compared to solid tumour patients. Higher symptom burden at COVID‐19 diagnosis was associated with a 3.0‐fold increase in symptom severity at 4 weeks following treatment restart. At 8 weeks following restart, 2.1% had increased morbidity or mortality. We highlight the ongoing impact of COVID‐19 on patients and cancer care, and the risk of resuming cancer treatments in patients with symptomatic COVID‐19. Although the risk of mortality is relatively low upon treatment resumption, personalised approaches assessing cancer diagnosis and SARS‐CoV‐2 status are crucial. Treatments are also stopped due to other infectious conditions and our results could be reviewed in the context of yearly influenza pandemics.