Pneumo-oncology visits have halved in the last year in Tuscany, due to the pandemic. What should you expect? According to experts, this gap is likely to lead, in the long run, to a more advanced diagnosis. Among the alarm bells that should require a specialist visit are specific symptoms such as difficulty in breathing, emission of blood with sputum, persistent cough with peculiar characteristics and low-grade fever. “When the disease is diagnosed at an advanced stage, there is inevitably a reduction in the chances of recovery”, explains Mauro Iannopollo, oncologist AUSL Toscana Centro: “Although Tuscany is among the Italian regions in which there have been fewer reductions in activity oncological, every slightest delay must absolutely be made up, especially if we keep in mind that in non-small cell lung cancer, which represents about 85% of cases, it is possible to intervene with curative intent up to the third stage of non-metastatic disease. Our patients have to go back to hospitals for checks and treatments “.
If the cancer is discovered in a “locally advanced” stage
In Tuscany, around 2,650 new cases of lung cancer are recorded every year (1,800 men and 850 women) and about one third of patients receive a stage III diagnosis. “On the basis of staging, histological examination (ie tissue examination, ed.) And biomolecular characterization, decisions are made on therapeutic pathways, which affect the results and prognosis”, underlines Vieri Scotti, oncologist and radiotherapist of the ‘Careggi University Hospital of Florence: “To date, the therapeutic approaches for locally advanced lung cancer are chemotherapy followed by surgery or chemo-radiotherapy, or radiotherapy associated with chemotherapy, carried out concomitantly or one after the other. Furthermore, in patients already undergoing chemo-radiotherapy, it is now possible to undergo consolidation immunotherapy, which can increase the percentage of patients free from the disease and, therefore, potentially curable “.
Immunotherapy as maintenance
Confirmation came a few weeks ago, from the American Society of Clinical Oncology (ASCO) Congress: the 5-year results of the Phase III PACIFIC study showed the great benefits of immunotherapy in locally advanced non-small cell carcinoma. Specifically, there was a five-year overall survival rate of 42.9% for patients treated with durvalumab compared to 33.4% treated with placebo after chemo-radiotherapy. Five years after treatment (which lasts a maximum of one year), in one third of the patients did not progress compared to 19% in the control group. “These important results tell us that administering durvalumab as maintenance therapy, after chemo-radiotherapy treatment, leads to an increase in the long-term control of the disease and foreshadows the possibility of recovery for a class of patients with a poor prognosis”, concludes Iannopollo: ” This approach needs to be made available to all who can benefit from it. All the more so if we consider that patients with lung cancer are at greater risk of incurring respiratory complications caused by Covid-19 “.