Early Systemic Anti-neoplastic Treatment Post SARS-CoV-2 Infection in Patients with Breast Cancer

Naama Halpern; Ben Boursi; Einat Shacham-Shmueli; Einav Nili Gal-Yam; Ofer Margalit; Talia Golan; Tamar Beller; Gal Strauss; Dafna Yahav; Eyal Leshem

doi:10.1007/s40487-023-00247-2

Early Systemic Anti-neoplastic Treatment Post SARS-CoV-2 Infection in Patients with Breast Cancer

Oncol Ther. 2023 Dec;11(4):513-519. doi: 10.1007/s40487-023-00247-2. Epub 2023 Oct 21.

Authors

Naama Halpern^{1

2}, Ben Boursi^{3

4}, Einat Shacham-Shmueli^{3

4}, Einav Nili Gal-Yam^{3

4}, Ofer Margalit^{3

4}, Talia Golan^{3

4}, Tamar Beller^{3

4}, Gal Strauss^{3

4}, Dafna Yahav^{5

4}, Eyal Leshem^{5

4}

Affiliations

¹ Division of Oncology, Sheba Medical Center, Tel-Hashomer, Israel. Naama.halpern@sheba.gov.il.
² Tel Aviv University, Tel Aviv, Israel. Naama.halpern@sheba.gov.il.
³ Division of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.
⁴ Tel Aviv University, Tel Aviv, Israel.
⁵ Infectious Diseases Unit, Sheba Medical Center, Tel-Hashomer, Israel.

Abstract

Introduction: It is unclear how soon after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection it is safe to resume systemic anti-neoplastic treatment in patients with cancer. We assessed the risk of admissions or postponed treatment cycle in vaccinated patients with breast cancer receiving early systemic anti-neoplastic treatment following SARS-CoV-2 infection.

Methods: This was a retrospective cohort study conducted during Omicron SARS-CoV-2 outbreak in Israel, January-July 2022. SARS-CoV-2 cohort included 30 vaccinated patients with breast cancer with SARS-CoV-2 infection 7-14 days prior to systemic treatment. All patients had resolved symptoms and a negative antigen detection test on the day of treatment. The pre-coronavirus disease 2019 (COVID-19) pandemic cohort consisted of 49 matched patients with breast cancer treated with systemic anti-neoplastic agents during 2019.

Results: In 30 vaccinated patients with breast cancer who received systemic anti-neoplastic treatment 7-14 days following SARS-CoV-2 infection, compared with 49 matched patients treated in 2019, the rates of emergency department (ED) visits (13% versus 6%, respectively), hospitalizations (3% versus 4%), next cycle of treatment given per protocol (90% versus 88%), and death (0% versus 0%) were similar.

Conclusion: In a cohort of vaccinated patients with breast cancer who received systemic anti-neoplastic treatment 7-14 days after SARS-CoV-2 infection, we did not observe substantially higher rates of ED visits, hospitalizations, or deaths compared with a similar cohort of pre-COVID-19 patients with breast cancer. Most patients received the next planned cycle on time. Early resumption of systemic anti-neoplastic treatment following SARS-CoV-2 infection in vaccinated patients with breast cancer with a negative antigen test at the day of treatment appeared to be safe. Additional data on larger cohorts and other malignancies are needed to support clinical guidelines.

Keywords: Breast cancer; COVID-19; Chemotherapy; Oncology; SARS-CoV-2.