Neuro-oncology Management During the COVID-19 Pandemic With a Focus on WHO Grade III and IV Gliomas

Denise Bernhardt; Wolfgang Wick; Stephanie E Weiss; Arjun Sahgal; Simon S Lo; John H Suh; Eric L Chang; Matthew Foote; James Perry; Bernhard Meyer; Peter Vajkoczy; Patrick Y Wen; Christoph Straube; Steffi Pigorsch; Jan J Wilkens; Stephanie E Combs

doi:10.1093/neuonc/noaa113

Neuro-oncology Management During the COVID-19 Pandemic With a Focus on WHO Grade III and IV Gliomas

Neuro Oncol. 2020 May 5;22(7):928-935. doi: 10.1093/neuonc/noaa113. Online ahead of print.

Authors

Denise Bernhardt^{1

2

3}, Wolfgang Wick⁴, Stephanie E Weiss⁵, Arjun Sahgal⁶, Simon S Lo⁷, John H Suh⁸, Eric L Chang⁹, Matthew Foote¹⁰, James Perry¹¹, Bernhard Meyer¹², Peter Vajkoczy¹³, Patrick Y Wen¹⁴, Christoph Straube^{1

2

3}, Steffi Pigorsch^{1

2

3}, Jan J Wilkens¹, Stephanie E Combs^{1

2

3}

Affiliations

¹ Technical University of Munich (TUM), School of Medicine and Klinikum rechts der Isar, Department of Radiation Oncology, Munich.
² Institute of Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Neuherberg.
³ Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site Munich.
⁴ Neurology Clinic, University of Heidelberg and German Cancer Research Center, Heidelberg, Germany.
⁵ Fox Chase Cancer Center, Philadelphia, Pennsylvania.
⁶ Department of Radiation Oncology, Sunnybrook Health Science Centre, Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
⁷ Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington, USA.
⁸ Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
⁹ Department of Radiation Oncology, Keck School of Medicine at University of Southern California, Los Angeles, California, USA.
¹⁰ Department of Radiation Oncology, Princess Alexandra Hospital, University of Queensland, Woolloongabba, QLD, Australia.
¹¹ Division of Neurology, Department of MedicineOdette Cancer and Sunnybrook Health Science Centres, University of Toronto, Canada.
¹² Technical University of Munich (TUM), School of Medicine and Klinikum rechts der Isar, Department of Neurosurgery, Munich.
¹³ Department of Neurosurgery, Charité Universitätsmedizin Berlin, Berlin, Germany.
¹⁴ Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts, USA.

Abstract

Background: Because of the increased risk in cancer patients of developing complications caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), physicians have to balance the competing risks of the negative impact of the pandemic and the primary tumor. In this consensus statement, an international group of experts present mitigation strategies and treatment guidance for patients suffering from high grade gliomas (HGG) during the coronavirus disease 2019 (COVID-19) pandemic.

Method / results: 16 international experts in the treatment of HGG contributed to this consensus-based practice recommendation including neuro-oncologists, neurosurgeons, radiation -oncologists and a medical physicist. Generally, treatment of neuro-oncological patients cannot be significantly delayed and initiating therapy should not be outweighed by COVID-19. We present detailed interdisciplinary treatment strategies for molecular subgroups in two pandemic scenarios, a scale-up phase and a crisis phase.

Conclusion: This practice recommendation presents a pragmatic framework and consensus-based mitigation strategies for the treatment of HGG patients during the SARS-CoV-2 pandemic.

Keywords: COVID-19; SARS-CoV-2; glioblastoma; high-grade glioma; neuro-oncology.