ASCO Launches COVID-19 Cancer Registry, Issues Guidance for Resource Allocation

Howard A. "Skip" Burris, III, MD, FACP, FASCO

The most recent steps taken by ASCO have been launching the ASCO Survey on COVID-19 in Oncology Registry (ASCO Registry),¹ and issuing recommendations for resource allocation to ensure the oncology community has the tools it needs amid scarcity issues caused by the COVID-19 pandemic.²

COVID-19 Cancer Registry

The ASCO registry is collecting baseline and follow-up data on COVID-19 in patients with cancer for the duration of the pandemic and into next year.

“As this unprecedented public health crisis continues, we’re seeing that certain populations—including individuals with cancer—are more likely to be vulnerable to the worst outcomes from COVID-19,” ASCO President Howard “Skip” Burris III, MD, FACP, FASCO, stated in a press release.

“The cancer care community needs data on how the virus is impacting our patients, their cancer treatment, and outcomes to inform current cancer care and decision-making for future disease outbreaks. We encourage all oncology practices to participate so that we can learn from every patient, in every practice, in every state across the country,” added Burris.

ASCO plans to use the data to create periodic reports and peer-reviewed manuscripts on key topics related to the pandemic including patient outcomes regarding both COVID-19 and cancer, patterns of characteristics among patients with cancer experiencing the most severe symptoms of COVID-19, the use of telemedicine in oncology during the pandemic, delays or modifications in therapy, and data on the overall severity of COVID-19 among patients with cancer.

“We hope to learn if the virus resulted in specific complications for patients, delayed patients’ ability to get a specific type of treatment, or if certain approaches resulted in better outcomes for patients,” Burris stated in the press release.

The online registry is open to all oncology practices across the United States and is tracking data for patients with any type of cancer who have a confirmed COVID-19 diagnosis. ASCO is requesting baseline data for patients, and then follow-up data on status, treatment, and outcomes. The data from participating practices is being stored on ASCO’s CancerLinQ® platform. CancerLinQ will also be directly compiling data on COVID-19 infection in patients from those practices that are already part of the platform.

Resource Allocation

Resources allocation in the US healthcare system is becoming a growing challenge as the COVID-19 pandemic is causing scarcity issues with resources such as ventilators, critical and intensive care beds, and medications. Accordingly, ASCO has developed a set of recommendations to provide support to the oncology community.

“As healthcare institutions make difficult decisions about where and how to deploy their resources during the COVID-19 crisis, they must ensure that allocation approaches don’t unconditionally deny patients with cancer access to resources,” Burris stated in a press release. “Every person with cancer has inherent worth and dignity. A cancer diagnosis alone should not keep a patient from a fair chance to access potentially life-saving resources, even in a public health crisis.”

The guidelines, which were authored by ASCO’s Ethics Committee, have been made available online prior to the definitive final version that will be published in the Journal of Clinical Oncology. ASCO summarized the recommendations as follows:

• Institutions should develop a fair and consistent prioritization and allocation policy before allocation becomes necessary. Decisions should be made at an institution-level, rather than at the bedside, so that oncologists can continue to maintain their duty to their patient.
• Allocation of resources in a pandemic should be based on maximizing health benefits. Rationing for lifesaving critical care resources should not use assessments about the perceived quality of a patient’s life or perceptions about a patient’s social worth.
• Oncologists should work with their institutions on how best to utilize scarce resources for care and support of cancer patients.
• Oncologists should communicate allocation plans and decisions to their patients with compassion and honesty, and health care institutions should offer support to oncologists in these communications.
• Oncologists should engage in advance care planning discussions with their patients and carefully document patient preferences for goals of care, particularly end of life care.

“Oncologists have great skill and expertise in treating the individual patient in front of them, but in a public health emergency like this one, we need to expand our view to also protect the health of the larger patient population,” Jonathan M. Marron, MD, MPH, FAAP, Chair-Elect of ASCO’s Ethics Committee and lead author of the recommendations, stated in the press release. “Oncologists have an important role to play to promote resource allocation plans that fairly, objectively, and consistently consider patients with cancer, and to work with their institutions to communicate those decisions clearly to patients, families, and surrogates.”

Other ASCO Resources

In a recent webinar, ASCO experts detailed additional resources the organization has made available to its members. To start, ASCO’s 2020 Annual Meeting will now occur through a virtual format from May 29 to May 31. ASCO has provided details of the virtual program on its website. ASCO also has an entire Coronavirus (COVID-19) Oncology Resource Center on its site that is being updated on a rolling basis.

Additionally, on the webinar, Stephen S. Grubbs, MD, FASCO, ASCO’s vice president of Clinical Affairs, provided updates on key ASCO programs, including the Quality Oncology Practice Initiative (QOPI), which facilitates self-examination and improvement in outpatient-oncology practices. Regarding the QOPI certification program, Grubbs said, “Because of the pandemic, we have suspended all practice visits for audits in the foreseeable future. And practices that may be having their certifications lapse—that will not happen. The certification will remain in place until the situation improves where we can get back to doing the onsite surveys.”

Grubb’s also said that ASCO’s consulting services and engagement programs have suspended onsite visits and will now be doing tele-consulting support for practices involved with the programs.

References

1. New COVID-19 Cancer Registry Aims to Understand Impact on Patients During Pandemic, Inform Future Care. Published April 10, 2020. https://bit.ly/3b7ToZV. Accessed April 13, 2020.
2. New Guidance Released for Oncology Community on Allocation of Limited Resources During COVID-19 Pandemic. Published April 9, 2020. https://bit.ly/2XywcQE. Accessed April 13, 2020.

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The American Society of Clinical Oncology (ASCO) has been highly proactive in addressing COVID-19—related issues as the pandemic has created a global healthcare crisis.