Suggested modifications in the management of breast cancer patients in the era of COVID-19 pandemic: a web-based survey. (Preprint)

BACKGROUND Management of cancer patients in the current era of COVID-19 pandemic poses a significant challenge on health care systems. OBJECTIVE We explored the views of oncologists for the management of breast cancer patients during COVID-19 pandemic. METHODS A web-based questionnaire using SurveyMonkey was submitted to licensed oncologists involved in breast cancer management in Saudi Arabia, Egypt and United Arab Emirates. The survey focused on characteristics of participants, infection risk among cancer patients and possible treatment modifications related to different types of breast cancer RESULTS The survey was completed by 82 participants. For early HR positive, HER2-negative breast cancer,74.4% supported using neoadjuvant hormonal therapy in selected patients, and 58.0% preferred giving 6 over 8 cycles of adjuvant chemotherapy when indicated. Only 42.7% preferred CDK4/6 inhibitor with hormonal therapy as first line in all patients with metastatic HR-positive disease. 67.1% of participants supported using adjuvant trastuzumab for 6 instead of 12 months in selected patients with HER2-positive breast cancer. For metastatic HER2-positive, HR-positive breast cancer, 80.5% of participants supported the use of hormonal therapy with dual anti-HER2 blockade in selected patients. The preferred choice of 1st line treatment in metastatic triple negative patients with BRCA mutation and PDL1<1%, was PARP inhibitor according to 42.5% of the participants, and atezolizumab with nabpaclitaxel if the PDL1>1% according to 70.4% of the participants. CONCLUSIONS Several modifications in breast cancer management is supported by the survey participants. These modifications need to be discussed on local basis taking into account the local infrastructure and available resources. CLINICALTRIAL none