Association of COVID-19 Lockdown With the Tumor Burden in Patients With Newly Diagnosed Metastatic Colorectal Cancer
The COVID-19 pandemic has been associated with substantial reduction in screening, case identification, and hospital referrals among patients with cancer. However, no study has quantitatively examined the implications of this correlation for cancer patient management. To evaluate the association of...
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| Veröffentlicht in: | JAMA network open 2021-09, Vol.4 (9), p.e2124483 |
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| creator | Thierry, Alain R Pastor, Brice Pisareva, Ekaterina Ghiringhelli, Francois Bouché, Olivier De La Fouchardière, Christelle Vanbockstael, Julie Smith, Denis François, Eric Dos Santos, Mélanie Botsen, Damien Ellis, Stephen Fonck, Marianne André, Thierry Guardiola, Emmanuel Khemissa, Faiza Linot, Benjamin Martin-Babau, J Rinaldi, Yves Assenat, Eric Clavel, Lea Dominguez, Sophie Gavoille, Celine Sefrioui, David Pezzella, Veronica Mollevi, Caroline Ychou, Marc Mazard, Thibault |
| description | The COVID-19 pandemic has been associated with substantial reduction in screening, case identification, and hospital referrals among patients with cancer. However, no study has quantitatively examined the implications of this correlation for cancer patient management.
To evaluate the association of the COVID-19 pandemic lockdown with the tumor burden of patients who were diagnosed with metastatic colorectal cancer (mCRC) before vs after lockdown.
This cohort study analyzed participants in the screening procedure of the PANIRINOX (Phase II Randomized Study Comparing FOLFIRINOX + Panitumumab vs FOLFOX + Panitumumab in Metastatic Colorectal Cancer Patients Stratified by RAS Status from Circulating DNA Analysis) phase 2 randomized clinical trial. These newly diagnosed patients received care at 1 of 18 different clinical centers in France and were recruited before or after the lockdown was enacted in France in the spring of 2020. Patients underwent a blood-sampling screening procedure to identify their RAS and BRAF tumor status.
mCRC.
Circulating tumor DNA (ctDNA) analysis was used to identify RAS and BRAF status. Tumor burden was evaluated by the total plasma ctDNA concentration. The median ctDNA concentration was compared in patients who underwent screening before (November 11, 2019, to March 9, 2020) vs after (May 14 to September 3, 2020) lockdown and in patients who were included from the start of the PANIRINOX study.
A total of 80 patients were included, of whom 40 underwent screening before and 40 others underwent screening after the first COVID-19 lockdown in France. These patients included 48 men (60.0%) and 32 women (40.0%) and had a median (range) age of 62 (37-77) years. The median ctDNA concentration was statistically higher in patients who were newly diagnosed after lockdown compared with those who were diagnosed before lockdown (119.2 ng/mL vs 17.3 ng/mL; P |
| doi_str_mv | 10.1001/jamanetworkopen.2021.24483 |
| format | Article |
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To evaluate the association of the COVID-19 pandemic lockdown with the tumor burden of patients who were diagnosed with metastatic colorectal cancer (mCRC) before vs after lockdown.
This cohort study analyzed participants in the screening procedure of the PANIRINOX (Phase II Randomized Study Comparing FOLFIRINOX + Panitumumab vs FOLFOX + Panitumumab in Metastatic Colorectal Cancer Patients Stratified by RAS Status from Circulating DNA Analysis) phase 2 randomized clinical trial. These newly diagnosed patients received care at 1 of 18 different clinical centers in France and were recruited before or after the lockdown was enacted in France in the spring of 2020. Patients underwent a blood-sampling screening procedure to identify their RAS and BRAF tumor status.
mCRC.
Circulating tumor DNA (ctDNA) analysis was used to identify RAS and BRAF status. Tumor burden was evaluated by the total plasma ctDNA concentration. The median ctDNA concentration was compared in patients who underwent screening before (November 11, 2019, to March 9, 2020) vs after (May 14 to September 3, 2020) lockdown and in patients who were included from the start of the PANIRINOX study.
A total of 80 patients were included, of whom 40 underwent screening before and 40 others underwent screening after the first COVID-19 lockdown in France. These patients included 48 men (60.0%) and 32 women (40.0%) and had a median (range) age of 62 (37-77) years. The median ctDNA concentration was statistically higher in patients who were newly diagnosed after lockdown compared with those who were diagnosed before lockdown (119.2 ng/mL vs 17.3 ng/mL; P < .001). Patients with mCRC and high ctDNA concentration had lower median survival compared with those with lower concentration (14.7 [95% CI, 8.8-18.0] months vs 20.0 [95% CI, 14.1-32.0] months). This finding points to the potential adverse consequences of the COVID-19 pandemic and related lockdown.
This cohort study found that tumor burden differed between patients who received an mCRC diagnosis before vs after the first COVID-19 lockdown in France. The findings of this study suggest that CRC is a major area for intervention to minimize pandemic-associated delays in screening, diagnosis, and treatment.</description><identifier>ISSN: 2574-3805</identifier><identifier>EISSN: 2574-3805</identifier><identifier>DOI: 10.1001/jamanetworkopen.2021.24483</identifier><identifier>PMID: 34495337</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Adult ; Aged ; Biomarkers, Tumor ; Biomarkers, Tumor - genetics ; Cancer ; Circulating Tumor DNA ; Circulating Tumor DNA - blood ; Clinical Trials, Phase II as Topic ; Cohort Studies ; Colorectal cancer ; Colorectal Neoplasms ; Colorectal Neoplasms - mortality ; Colorectal Neoplasms - pathology ; Colorectal Neoplasms - therapy ; Communicable Disease Control ; Communicable Disease Control - organization & administration ; Controlled Before-After Studies ; Coronaviruses ; COVID-19 ; COVID-19 - epidemiology ; Female ; Human health and pathology ; Humans ; Hépatology and Gastroenterology ; Life Sciences ; Male ; Metastasis ; Middle Aged ; Oncology ; Online Only ; Original Investigation ; Pandemics ; Patient Acceptance of Health Care ; Randomized Controlled Trials as Topic ; Santé publique et épidémiologie ; SARS-CoV-2 ; Shelter in place ; Tumor Burden</subject><ispartof>JAMA network open, 2021-09, Vol.4 (9), p.e2124483</ispartof><rights>2021. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Attribution</rights><rights>Copyright 2021 Thierry AR et al. .</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a564t-d7a49e1ce03bf394634d02ca03cb026ac5e0cbdb0099df8a956ab31d37ce5b453</citedby><cites>FETCH-LOGICAL-a564t-d7a49e1ce03bf394634d02ca03cb026ac5e0cbdb0099df8a956ab31d37ce5b453</cites><orcidid>0000-0002-5644-9603 ; 0000-0002-8958-2793 ; 0000-0002-2117-4750 ; 0000-0003-4827-3684 ; 0000-0002-0821-5642 ; 0000-0003-2291-5693 ; 0000-0002-7718-2645</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,864,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34495337$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.umontpellier.fr/hal-03649599$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Thierry, Alain R</creatorcontrib><creatorcontrib>Pastor, Brice</creatorcontrib><creatorcontrib>Pisareva, Ekaterina</creatorcontrib><creatorcontrib>Ghiringhelli, Francois</creatorcontrib><creatorcontrib>Bouché, Olivier</creatorcontrib><creatorcontrib>De La Fouchardière, Christelle</creatorcontrib><creatorcontrib>Vanbockstael, Julie</creatorcontrib><creatorcontrib>Smith, Denis</creatorcontrib><creatorcontrib>François, Eric</creatorcontrib><creatorcontrib>Dos Santos, Mélanie</creatorcontrib><creatorcontrib>Botsen, Damien</creatorcontrib><creatorcontrib>Ellis, Stephen</creatorcontrib><creatorcontrib>Fonck, Marianne</creatorcontrib><creatorcontrib>André, Thierry</creatorcontrib><creatorcontrib>Guardiola, Emmanuel</creatorcontrib><creatorcontrib>Khemissa, Faiza</creatorcontrib><creatorcontrib>Linot, Benjamin</creatorcontrib><creatorcontrib>Martin-Babau, J</creatorcontrib><creatorcontrib>Rinaldi, Yves</creatorcontrib><creatorcontrib>Assenat, Eric</creatorcontrib><creatorcontrib>Clavel, Lea</creatorcontrib><creatorcontrib>Dominguez, Sophie</creatorcontrib><creatorcontrib>Gavoille, Celine</creatorcontrib><creatorcontrib>Sefrioui, David</creatorcontrib><creatorcontrib>Pezzella, Veronica</creatorcontrib><creatorcontrib>Mollevi, Caroline</creatorcontrib><creatorcontrib>Ychou, Marc</creatorcontrib><creatorcontrib>Mazard, Thibault</creatorcontrib><title>Association of COVID-19 Lockdown With the Tumor Burden in Patients With Newly Diagnosed Metastatic Colorectal Cancer</title><title>JAMA network open</title><addtitle>JAMA Netw Open</addtitle><description>The COVID-19 pandemic has been associated with substantial reduction in screening, case identification, and hospital referrals among patients with cancer. However, no study has quantitatively examined the implications of this correlation for cancer patient management.
To evaluate the association of the COVID-19 pandemic lockdown with the tumor burden of patients who were diagnosed with metastatic colorectal cancer (mCRC) before vs after lockdown.
This cohort study analyzed participants in the screening procedure of the PANIRINOX (Phase II Randomized Study Comparing FOLFIRINOX + Panitumumab vs FOLFOX + Panitumumab in Metastatic Colorectal Cancer Patients Stratified by RAS Status from Circulating DNA Analysis) phase 2 randomized clinical trial. These newly diagnosed patients received care at 1 of 18 different clinical centers in France and were recruited before or after the lockdown was enacted in France in the spring of 2020. Patients underwent a blood-sampling screening procedure to identify their RAS and BRAF tumor status.
mCRC.
Circulating tumor DNA (ctDNA) analysis was used to identify RAS and BRAF status. Tumor burden was evaluated by the total plasma ctDNA concentration. The median ctDNA concentration was compared in patients who underwent screening before (November 11, 2019, to March 9, 2020) vs after (May 14 to September 3, 2020) lockdown and in patients who were included from the start of the PANIRINOX study.
A total of 80 patients were included, of whom 40 underwent screening before and 40 others underwent screening after the first COVID-19 lockdown in France. These patients included 48 men (60.0%) and 32 women (40.0%) and had a median (range) age of 62 (37-77) years. The median ctDNA concentration was statistically higher in patients who were newly diagnosed after lockdown compared with those who were diagnosed before lockdown (119.2 ng/mL vs 17.3 ng/mL; P < .001). Patients with mCRC and high ctDNA concentration had lower median survival compared with those with lower concentration (14.7 [95% CI, 8.8-18.0] months vs 20.0 [95% CI, 14.1-32.0] months). This finding points to the potential adverse consequences of the COVID-19 pandemic and related lockdown.
This cohort study found that tumor burden differed between patients who received an mCRC diagnosis before vs after the first COVID-19 lockdown in France. The findings of this study suggest that CRC is a major area for intervention to minimize pandemic-associated delays in screening, diagnosis, and treatment.</description><subject>Adult</subject><subject>Aged</subject><subject>Biomarkers, Tumor</subject><subject>Biomarkers, Tumor - genetics</subject><subject>Cancer</subject><subject>Circulating Tumor DNA</subject><subject>Circulating Tumor DNA - blood</subject><subject>Clinical Trials, Phase II as Topic</subject><subject>Cohort Studies</subject><subject>Colorectal cancer</subject><subject>Colorectal Neoplasms</subject><subject>Colorectal Neoplasms - mortality</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Colorectal Neoplasms - therapy</subject><subject>Communicable Disease Control</subject><subject>Communicable Disease Control - organization & administration</subject><subject>Controlled Before-After Studies</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>Female</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Hépatology and Gastroenterology</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Online Only</subject><subject>Original Investigation</subject><subject>Pandemics</subject><subject>Patient Acceptance of Health Care</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Santé publique et épidémiologie</subject><subject>SARS-CoV-2</subject><subject>Shelter in place</subject><subject>Tumor 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Thierry</au><au>Guardiola, Emmanuel</au><au>Khemissa, Faiza</au><au>Linot, Benjamin</au><au>Martin-Babau, J</au><au>Rinaldi, Yves</au><au>Assenat, Eric</au><au>Clavel, Lea</au><au>Dominguez, Sophie</au><au>Gavoille, Celine</au><au>Sefrioui, David</au><au>Pezzella, Veronica</au><au>Mollevi, Caroline</au><au>Ychou, Marc</au><au>Mazard, Thibault</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of COVID-19 Lockdown With the Tumor Burden in Patients With Newly Diagnosed Metastatic Colorectal Cancer</atitle><jtitle>JAMA network open</jtitle><addtitle>JAMA Netw Open</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>4</volume><issue>9</issue><spage>e2124483</spage><pages>e2124483-</pages><issn>2574-3805</issn><eissn>2574-3805</eissn><abstract>The COVID-19 pandemic has been associated with substantial reduction in screening, case identification, and hospital referrals among patients with cancer. However, no study has quantitatively examined the implications of this correlation for cancer patient management.
To evaluate the association of the COVID-19 pandemic lockdown with the tumor burden of patients who were diagnosed with metastatic colorectal cancer (mCRC) before vs after lockdown.
This cohort study analyzed participants in the screening procedure of the PANIRINOX (Phase II Randomized Study Comparing FOLFIRINOX + Panitumumab vs FOLFOX + Panitumumab in Metastatic Colorectal Cancer Patients Stratified by RAS Status from Circulating DNA Analysis) phase 2 randomized clinical trial. These newly diagnosed patients received care at 1 of 18 different clinical centers in France and were recruited before or after the lockdown was enacted in France in the spring of 2020. Patients underwent a blood-sampling screening procedure to identify their RAS and BRAF tumor status.
mCRC.
Circulating tumor DNA (ctDNA) analysis was used to identify RAS and BRAF status. Tumor burden was evaluated by the total plasma ctDNA concentration. The median ctDNA concentration was compared in patients who underwent screening before (November 11, 2019, to March 9, 2020) vs after (May 14 to September 3, 2020) lockdown and in patients who were included from the start of the PANIRINOX study.
A total of 80 patients were included, of whom 40 underwent screening before and 40 others underwent screening after the first COVID-19 lockdown in France. These patients included 48 men (60.0%) and 32 women (40.0%) and had a median (range) age of 62 (37-77) years. The median ctDNA concentration was statistically higher in patients who were newly diagnosed after lockdown compared with those who were diagnosed before lockdown (119.2 ng/mL vs 17.3 ng/mL; P < .001). Patients with mCRC and high ctDNA concentration had lower median survival compared with those with lower concentration (14.7 [95% CI, 8.8-18.0] months vs 20.0 [95% CI, 14.1-32.0] months). This finding points to the potential adverse consequences of the COVID-19 pandemic and related lockdown.
This cohort study found that tumor burden differed between patients who received an mCRC diagnosis before vs after the first COVID-19 lockdown in France. The findings of this study suggest that CRC is a major area for intervention to minimize pandemic-associated delays in screening, diagnosis, and treatment.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>34495337</pmid><doi>10.1001/jamanetworkopen.2021.24483</doi><orcidid>https://orcid.org/0000-0002-5644-9603</orcidid><orcidid>https://orcid.org/0000-0002-8958-2793</orcidid><orcidid>https://orcid.org/0000-0002-2117-4750</orcidid><orcidid>https://orcid.org/0000-0003-4827-3684</orcidid><orcidid>https://orcid.org/0000-0002-0821-5642</orcidid><orcidid>https://orcid.org/0000-0003-2291-5693</orcidid><orcidid>https://orcid.org/0000-0002-7718-2645</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2574-3805 |
| ispartof | JAMA network open, 2021-09, Vol.4 (9), p.e2124483 |
| issn | 2574-3805 2574-3805 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8427376 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Aged Biomarkers, Tumor Biomarkers, Tumor - genetics Cancer Circulating Tumor DNA Circulating Tumor DNA - blood Clinical Trials, Phase II as Topic Cohort Studies Colorectal cancer Colorectal Neoplasms Colorectal Neoplasms - mortality Colorectal Neoplasms - pathology Colorectal Neoplasms - therapy Communicable Disease Control Communicable Disease Control - organization & administration Controlled Before-After Studies Coronaviruses COVID-19 COVID-19 - epidemiology Female Human health and pathology Humans Hépatology and Gastroenterology Life Sciences Male Metastasis Middle Aged Oncology Online Only Original Investigation Pandemics Patient Acceptance of Health Care Randomized Controlled Trials as Topic Santé publique et épidémiologie SARS-CoV-2 Shelter in place Tumor Burden |
| title | Association of COVID-19 Lockdown With the Tumor Burden in Patients With Newly Diagnosed Metastatic Colorectal Cancer |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T05%3A35%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Association%20of%20COVID-19%20Lockdown%20With%20the%20Tumor%20Burden%20in%20Patients%20With%20Newly%20Diagnosed%20Metastatic%20Colorectal%20Cancer&rft.jtitle=JAMA%20network%20open&rft.au=Thierry,%20Alain%20R&rft.date=2021-09-01&rft.volume=4&rft.issue=9&rft.spage=e2124483&rft.pages=e2124483-&rft.issn=2574-3805&rft.eissn=2574-3805&rft_id=info:doi/10.1001/jamanetworkopen.2021.24483&rft_dat=%3Cproquest_pubme%3E2667782264%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2667782264&rft_id=info:pmid/34495337&rfr_iscdi=true |