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Resumption of Intravenous Anti-Cancer Therapy in Breast Cancer: A Real-World Experience During the SARS-CoV-2 Pandemic
Cancer Management and Research ( IF 3.3 ) Pub Date : 2024-01-03 , DOI: 10.2147/cmar.s444783 Fang Yang , Cong Li , Yuling Qiu , Xinjie Chen , Kelin Zheng , Donglin Kang , Yin Zhang , Baorui Liu , Yongzhong Yao , Li Xie
Cancer Management and Research ( IF 3.3 ) Pub Date : 2024-01-03 , DOI: 10.2147/cmar.s444783 Fang Yang , Cong Li , Yuling Qiu , Xinjie Chen , Kelin Zheng , Donglin Kang , Yin Zhang , Baorui Liu , Yongzhong Yao , Li Xie
Purpose: The coronavirus disease-2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has delayed medical consultations, especially for patients receiving intravenous anti-cancer therapy. We aim to investigate alterations in immune function among breast cancer patients who experience delayed intravenous therapy due to SARS-CoV-2 infection.
Patients and Methods: We performed an observational investigation of breast cancer patients in Nanjing Drum Tower Hospital from December 27, 2022, to January 20, 2023. Patients who recovered from SARS-CoV-2 infection were eligible for enrollment. Peripheral blood samples were taken prior to the restart of intravenous anti-cancer therapy to examine hematologic parameters.
Results: A total of 131 patients were included in the final analysis. Cough (74.0%), fever (62.6%), and expectoration (46.6%) were identified as the most presenting symptoms of SARS-CoV-2 infection in breast cancer. The average nucleic acid conversion time and delayed treatment time was 13.4 days and 13.9 days, respectively. The patients > 60 years old experienced prolonged nucleic acid conversion time (P = 0.017) and delayed treatment time (P = 0.028) compared to those <= 60 years old. Dysregulated lymphocyte subsets and cytokines were found post-SARS-CoV-2 infection. Treatment-related adverse events of grade 3 or 4 occurred in 7.6% after resuming intravenous anti-cancer therapy.
Conclusion: Our findings reveal that the SARS-CoV-2 infection led to imbalanced immune responses and postponed intravenous anti-cancer therapy in breast cancer. The safety report encourages timely resumption of intravenous anti-cancer therapy after adequately weighing the risks and benefits.
Keywords: COVID-19 pandemic, SARS-CoV-2 infection, breast cancer, immune responses, anti-cancer therapy
中文翻译：
恢复乳腺癌静脉抗癌治疗：SARS-CoV-2 大流行期间的真实经验
目的：由严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染引起的 2019 冠状病毒病 (COVID-19) 大流行导致医疗咨询延迟，特别是对于接受静脉抗癌治疗的患者。我们的目的是调查因 SARS-CoV-2 感染而延迟静脉治疗的乳腺癌患者的免疫功能变化。
患者和方法：我们对2022年12月27日至2023年1月20日南京鼓楼医院的乳腺癌患者进行了观察性调查。从SARS-CoV-2感染中康复的患者符合入组条件。在重新开始静脉抗癌治疗之前采集外周血样本以检查血液学参数。
结果：共131例患者纳入最终分析。咳嗽（74.0%）、发烧（62.6%）和咳痰（46.6%）被认为是乳腺癌中 SARS-CoV-2 感染最常见的症状。平均核酸转换时间和延迟治疗时间分别为13.4天和13.9天。与≤60岁患者相比，>60岁患者核酸转化时间延长（P=0.017），治疗时间延迟（P=0.028）。SARS-CoV-2 感染后发现淋巴细胞亚群和细胞因子失调。恢复静脉抗癌治疗后，7.6% 的患者发生 3 级或 4 级治疗相关不良事件。
结论：我们的研究结果表明，SARS-CoV-2 感染导致乳腺癌免疫反应失衡并推迟静脉抗癌治疗。安全报告鼓励在充分权衡风险和收益后及时恢复静脉抗癌治疗。
关键词： COVID-19 大流行、SARS-CoV-2 感染、乳腺癌、免疫反应、抗癌治疗
更新日期：2024-01-03
Patients and Methods: We performed an observational investigation of breast cancer patients in Nanjing Drum Tower Hospital from December 27, 2022, to January 20, 2023. Patients who recovered from SARS-CoV-2 infection were eligible for enrollment. Peripheral blood samples were taken prior to the restart of intravenous anti-cancer therapy to examine hematologic parameters.
Results: A total of 131 patients were included in the final analysis. Cough (74.0%), fever (62.6%), and expectoration (46.6%) were identified as the most presenting symptoms of SARS-CoV-2 infection in breast cancer. The average nucleic acid conversion time and delayed treatment time was 13.4 days and 13.9 days, respectively. The patients > 60 years old experienced prolonged nucleic acid conversion time (P = 0.017) and delayed treatment time (P = 0.028) compared to those <= 60 years old. Dysregulated lymphocyte subsets and cytokines were found post-SARS-CoV-2 infection. Treatment-related adverse events of grade 3 or 4 occurred in 7.6% after resuming intravenous anti-cancer therapy.
Conclusion: Our findings reveal that the SARS-CoV-2 infection led to imbalanced immune responses and postponed intravenous anti-cancer therapy in breast cancer. The safety report encourages timely resumption of intravenous anti-cancer therapy after adequately weighing the risks and benefits.
Keywords: COVID-19 pandemic, SARS-CoV-2 infection, breast cancer, immune responses, anti-cancer therapy
中文翻译：
恢复乳腺癌静脉抗癌治疗：SARS-CoV-2 大流行期间的真实经验
目的：由严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染引起的 2019 冠状病毒病 (COVID-19) 大流行导致医疗咨询延迟，特别是对于接受静脉抗癌治疗的患者。我们的目的是调查因 SARS-CoV-2 感染而延迟静脉治疗的乳腺癌患者的免疫功能变化。
患者和方法：我们对2022年12月27日至2023年1月20日南京鼓楼医院的乳腺癌患者进行了观察性调查。从SARS-CoV-2感染中康复的患者符合入组条件。在重新开始静脉抗癌治疗之前采集外周血样本以检查血液学参数。
结果：共131例患者纳入最终分析。咳嗽（74.0%）、发烧（62.6%）和咳痰（46.6%）被认为是乳腺癌中 SARS-CoV-2 感染最常见的症状。平均核酸转换时间和延迟治疗时间分别为13.4天和13.9天。与≤60岁患者相比，>60岁患者核酸转化时间延长（P=0.017），治疗时间延迟（P=0.028）。SARS-CoV-2 感染后发现淋巴细胞亚群和细胞因子失调。恢复静脉抗癌治疗后，7.6% 的患者发生 3 级或 4 级治疗相关不良事件。
结论：我们的研究结果表明，SARS-CoV-2 感染导致乳腺癌免疫反应失衡并推迟静脉抗癌治疗。安全报告鼓励在充分权衡风险和收益后及时恢复静脉抗癌治疗。
关键词： COVID-19 大流行、SARS-CoV-2 感染、乳腺癌、免疫反应、抗癌治疗
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