NantHealth recently hosted a webinar entitled “An Evidence-Based Look at Oncology Care in the COVID-19 Pandemic,” with our thought leaders Chief Medical Officer, Dr. Bobby Reddy, and Eviti Chief Medical Officer, Dr. Bill Flood. If we were unable to reply to your question during the livestream, our experts answered those questions below. A stream of the complete broadcast is available here.
Do you have Multiple Myeloma specific advice?
Unfortunately, no. Patients with multiple myeloma or any cancer should discuss concerns with their health care providers.
Do you recommend empiric antibiotic therapy with or without hydroxychloriquine for stable T-LGL Pt with COVID-19 infection as an outpatient? Does Hydorcholoroquine work for cure?
To our knowledge, the role of hydroxychloroquine as a treatment or prophylactic therapy of SARS-Cov-2 has not been established. Any treatment decisions regarding SARS-CoV-2, regarding hydroxychloroquine or any other drugs, must be made between the patient and his/her health care providers. View ongoing trials regarding SARS-Cov-2 from clinical trials.gov here. Note, other trials may be available, based on additional search criteria or the change in trial status over time.
How do anti-inflammatory diets play into all of this? Meaning, how can dietitians help?
To our knowledge, the role of diet and nutrition in SARS-CoV-2 has not been established. We do not know if there is any benefit or risk associated with different dietary patterns. Nutritional professionals should follow their literature and peer groups for guidance. We do know that COVID-19 may be transmitted via the fecal-oral route. Thus it would be advisable for patients to practice good food hygiene and avoid uncooked foods that have been handled by others; generally the same recommendations we give patients receiving chemotherapy.
Considering that COVID-19 suppresses Natural Killer cell (NK) activity and changes the immune system, what treatments are available that minimize the effects on the immune system (compared to chemotherapy) but are still safe and effective during COVID-19?
This is to be determined. The issue is whether treatments are effective enough to control the cancer and also reduce the risk of COVID-19 or other severe infections. Clinical trials will help and retrospective analysis of Real World Evidence (RWE) of patients treated during the current pandemic will hopefully tell us if we can move away from current chemo and other treatment regimens. Immunotherapy is likely safe in terms of not increasing the risk of infection or severity of infection but its efficacy could be compromised in COVID-19 infected patients who are also at great risk from the complications of immunotherapy such as pneumonitis.
How many years post active chemo treatment might a survivor remain at increased risk?
We don’t know. The time from treatment noted in the infected cancer patients reported here varied from on-treatment to 16 years after therapy. This early data suggests that cancer survivors are at increased risk of infection for a prolonged period after completion of therapy.