Virtual Library
Start Your Search
Francesco Pesola
Author of
-
+
FP06 - Palliative and Supportive Care (ID 160)
- Event: WCLC 2020
- Type: Posters (Featured)
- Track: Palliative and Supportive Care
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
-
+
FP06.04 - Psychological Distress in Outpatients with Lymphoma, Lung and Breast Cancer During COVID-19 Pandemic (ID 3676)
00:00 - 00:00 | Author(s): Francesco Pesola
- Abstract
- Presentation
Introduction
The psychological impact of the lockdown experienced during the COVID-19 pandemic has been found detrimental for the general population, but it has still not been evaluated in cancer patients. We have investigated the psychological status of outpatients receiving anti-neoplastic treatmentduring the lockdown in a non-COVID Cancer Center, with the following aims: to measure the levels of post-traumatic stress symptoms, depression and anxiety, to compare patients with different diagnosis. A further objective was to compare the anxiety and depression levels between cancer patients before and after the emergency assuming an increase in distress in cancer patients in this period due to the health emergency.
Methods
Outpatients attending the IRCCS "Giovanni Paolo II" in Bari for their therapy were asked to complete these questionnaires: The Hospital Anxiety and Depression Scale (HADs) and the Impact of Event Scale-Revised (IES-r).Worries regarding the COVID-19 on patients’ lives, socio-demographic and clinical details were investigated using a brief structured questionnaire.
Results
One-hundred seventy-six outpatients (n.59 with lung cancer, n.40 with breast cancer, n.77 with lymphoma) were enrolled. Mean age was 57.9 y.o. (SD ±14); 48% were male. We found that 54,4% of patients were above the cut-off (score≥16) for HADS general scale. The mean-IES-R score of patients was 25 (SD±17), with 22.8% indicating severe level of PTDS. The HADS-D has been found significantly correlated with IES-R (r= 0.35; p<0.005). The 70% of patients declared that their worries have increased during the pandemic; their bigger concerns were: the risk of getting infected while at hospital (51.4%); the risk of infecting relatives coming back home (38.7%), andthe risk of delaying therapy (35.3%).When comparing the level of anxiety and depression in different diagnosis it has been found that patients with lung cancer have higher distress(HADs-general scale) than patients with lymphoma (F=17.3, p<0.005) and breast cancer (F=8.86, p<0.005). Finally, cancer patients who experienced the health emergency showed higher levels of anxiety Hads-A, t (237) = 3.73 p<0.001), and general distress (Hads-G, t (237) = 2.51) than those measured 2 years ago (fig 1).
Conclusion
This study focused on the psychological aspects of cancer patients during the COVID-19 pandemic, finding that one quarter of patients has severe post-traumatic stress symptoms, and has psychological distress. Patients with lung cancer have higher distress compared to the other groups. This condition risks being overlooked by clinical concerns, so we underline the importance to place even more attention to the psychological needs of patients.
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
-
+
P75 - Immunotherapy (Phase II/III Trials) - Misc. Topics (ID 248)
- Event: WCLC 2020
- Type: Posters
- Track: Immunotherapy (Phase II/III Trials)
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
-
+
P75.21 - Impact of Diagnosis and Treatment of Concurrent Infections during Immunotherapy in Advanced Lung Cancer: A Retrospective Cohort Study (ID 3508)
00:00 - 00:00 | Author(s): Francesco Pesola
- Abstract
Introduction
Checkpoint inhibitors immunotherapy (CPI) has revolutionized lung cancer treatment, significantly increasing overall survival (OS) of patients. Although immune-related adverse events (irAEs) are the main concern of these drugs, concurrent infections could affect their efficacy. Recent studies suggested that CPI is not associated with an increased risk of opportunistic infections; nevertheless, the impact of common ones on OS is still debated.
In this report, concurrent infections occurred in lung cancer patients during CPIs are described and the impact on OS by an appropriate diagnosis and treatment of these complications has been evaluated.
Methods
From August 2015 to October 2019, 118 patients with advanced non–small cell lung cancer who received CPIs as first- or second-line therapy have been retrospectively evaluated.
Clinical characteristics, treatments and outcomes including infection rate and OS have been analyzed, as well as the impact of appropriate management of infections.
Results
74 patients in the Nivolumab group and 44 in the Pembrolizumab group were identified. In both groups, the main infection was pneumonia, followed by skin and soft tissue infections, urinary tract infections and gastroenteritis (Table 1). Crude mortality for first infection was 10.7%, followed by 25% and 40% for second and third recurrence, respectively (p for trend=.146). No opportunistic infections were recorded.
The most important predictor of mortality (Table 2) was a higher baseline ECOG PS (p<.001), while an appropriate diagnosis and treatment of concurrent infections was associated with a higher probability of survival (aHR= 0.50; 95%CI=0.30 – 0.83, p<.001). By evaluating median overall survival by Kaplan-Meier curve, a prompt management of infections was associated with a better overall survival (p=.050)
Conclusion
In advanced lung cancer patients treated with CPI, a prompt management of concurrent infections could significantly improve OS. Further studies to investigate risk factors for infections, as well as appropriate management strategies and preventive measures in this setting are warranted.
