key: cord-0999445-dztcstd6
authors: Lim, K.H.J.; Punie, K.; Oing, C.; Thorne, E.; Murali, K.; Kamposioras, K. V.; O'Connor, M.; Elez, E.; Amaral, T.M.S.; Lopez, P. Garrido; Lambertini, M.; Devnani, B.; Westphalen, C. B.; Morgan, G.; Haanen, J.B.A.G.; Hardy, C.; Banerjee, S.
title: 1561O The future of the oncology workforce since COVID-19: Results of the ESMO Resilience Task Force survey series
date: 2021-09-30
journal: Annals of Oncology
DOI: 10.1016/j.annonc.2021.08.1554
sha: f7c837072180aee450def4c5f7eff602350c05a4
doc_id: 999445
cord_uid: dztcstd6

Background: The ESMO Resilience Task Force has investigated wellbeing since COVID-19 in relation to work, lifestyle and support factors in oncology professionals globally. We reported on the significant impact of the initial surge of the pandemic on wellbeing and job performance (Banerjee et al. 2021). As the pandemic continues, it is imperative to understand experiences and concerns to better inform support measures for the oncology workforce. Methods: Three anonymous online surveys were conducted during the COVID-19 pandemic (S1, Apr/May 2020;S2, Jul/Aug 2020;S3, Feb/Mar 2021). Longitudinal analysis of responses at these timepoints were conducted. Here, we present responses to questions on job demands and resources, and perceived job performance since COVID-19 (JP-CV). Results: We analysed 3894 individual responses (S1, n=1520;S2, n=942;S3, n=1432): 53% (n=1961/3731) female, 45% (n=1679/3731) =/<40 years, 31% (n=1132/3692) non-white ethnicity, >100 countries. There has been significant increases from S1 to S3 (p<0.001) in feeling overwhelmed with workload (29% vs 45%);COVID-19-related clinical (14% vs 58%) and research (16% vs 64%) work;out-of-hours work (16% vs 41%), shift work (12% vs 26%) and overall working hours (17% vs 47%);and inadequate time for personal/family life (35% vs 45%). 59% (n=1156/1946) were unable to take allocated annual leave. While JP-CV has improved (34% vs 49%, p<0.001), there remained concerns about the negative impact of the pandemic on career development/training (43%), job security (37%) and international fellowship opportunities (76%). Overall, less than half had felt supported by their work management, professional societies or government, and/or had access to wellbeing support services. 25% (n=266/1086) were considering changing their future career with 38% (n=100/266) contemplating leaving the profession. Conclusions: Since COVID-19, oncology professionals have reported increased job demands, concerns over career development/training and job security, and inadequate time for personal life. There is a real threat of potential attrition in the current workforce. National and international stakeholders must act together to ensure robust recovery plans as we emerge from the COVID-19 crisis. Legal entity responsible for the study: The authors. Funding: ESMO. Disclosure: K.H.J. Lim: Financial Interests, Personal, Invited Speaker, Speaker honorarium: Janssen;Non-Financial Interests, Officer, Trainees committee representative for the North West deanery: Royal College of Physicians (UK);Non-Financial Interests, Officer, Trainees representative at the RCP Patient Safety Committee: Royal College of Physicians (UK);Non-Financial Interests, Officer, ACP representative at the RCP Student and Foundation Doctor Network (SFDN): Royal College of Physicians (UK);Non-Financial Interests, Officer, Trainees committee member: Association of Cancer Physicians (ACP) UK;Non-Financial Interests, Officer, Young Oncologists Committee (YOC): ESMO;Non-Financial Interests, Officer, Resilience Task Force (RTF): ESMO;Other, Currently funded by Wellcome-Imperial 4i Clinical Research Fellowship: Wellcome Trust. K. Punie: Other, Institutional, Other, institution received speaker fees or honoraria for consultancy/advisory roles: AstraZeneca, Eli Lilly, Gilead Sciences, Medscape, MSD, Novartis, Pfizer, Pierre Fabre, Hoffmann La Roche, Mundi Pharma, PharmaMar, Teva, Vifor Pharma;Other, Institutional, Research Grant: Sanofi;Other, Personal, Other, Travel support: AstraZeneca, Novartis, Pfizer, PharmaMar and Roche. C. Oing: Other, Personal, Other, research funding and honoraria: Roche;Other, Personal, Other, travel grant and honoraria: Medac Pharma and Ipsen Pharma;Other, Personal, Other, travel grant: PharmaMar. E. Elez: Other, Personal, Other, personal fees: Hoffman La - Roche, Bristol Myers Squibb, Servier, Amgen, Merck Serono, ArrayBiopharma, Sanof. T.M.S. Amaral: Other, Personal, Other, personal fees: Pierre Fabre and CeCaVa;Other, Personal, Other, personal fees and travel grants: BMS;Other, Perso al, Other, grants, personal fees and travel grants: Novartis;Other, Personal, Other, grants: Neracare, Sanofi and SkylineDx. P. Garrido Lopez: Other, Personal, Other, personal fees: Roche, MSD, BMS, Boerhinger-Ingelheim, Pfizer, AbbVie, Novartis, Lilly, AstraZeneca, Janssen, Blueprint Medicines, Takeda, Gilead, and ROVI. M. Lambertini: Other, Personal, Other, Consultant: Roche, AstraZeneca, Lilly and Novartis;Other, Personal, Other, Honoraria: Theramex, Roche, Novartis, Takeda, Pfizer, Sandoz, and Lilly. C.B. Westphalen: Other, Personal, Other, honoraria, travel support and advisory board: Bayer, BMS, Celgene, Roche, Servier, Shire/Baxalta, RedHil, and Taiho;Other, Personal, Other, speaker honoraria: Ipsen;Other, Personal, Advisory Board: GSK, Sirtex, and Rafael. J.B.A.G. Haanen: Other, Personal, Advisory Role, personal fees for advisory role: Neogene Tx;Other, Institutional, Other, grants and fees paid to institution: BMS, MSD, Novartis, BioNTech, Amgen;Other, Institutional, Other, fees paid to institution: Achilles Tx, GSK, Immunocore, Ipsen, Merck Serono, Molecular Partners, Pfizer, Roche/Genentech, Sanofi, Seattle Genetics, Third Rock Ventures, Vaximm. C. Hardy: Other, Personal, Other, Director of a private company Hardy People Ltd.: Hardy People Ltd. S. Banerjee: Other, Institutional, Research Grant: AstraZeneca, Tesaro and GSK;Other, Personal, Other, Honoraria: Amgen, AstraZeneca, MSD, GSK, Clovis, Genmab, Merck Serono, Mersana, Pfizer, Seattle Genetics, and Tesaro. All other authors have declared no conflicts of interest.

Methods: Among 2795 consecutive pts with COVID-19 and cancer registered to OnCovid between 01/2020 and 02/2021, we examined clinical outcomes of pts reassessed post COVID-19 recovery.

Results: Among 1557 COVID-19 survivors, 234 (15%) reported sequelae including respiratory symptoms (49.6%), fatigue (41%) and cognitive/psychological dysfunction (4.3%). Persisting COVID-19 sequelae were more likely found in males (p¼0.0407) aged 65 years (p¼0.0489) with 2 comorbidities (p¼0.0006) and positive smoking history (p¼0.0004). Sequelae were associated with history of prior hospitalisation (p<0.0001), complicated disease (p<0.0001) and COVID-19 therapy (p¼0.0002). With a median post-COVID-19 follow up of 128 days (95%CI 113-148), multivariable analysis of survival revealed COVID-19 sequelae to be associated with an increased risk of death (HR 1.76, 95%CI 1.16-2.66) after adjusting for sex, age, comorbidities, tumour characteristics, anticancer therapy and COVID-19 severity. Out of 473 patients who were on systemic anticancer therapy (SACT) at COVID-19 diagnosis; 62 (13.1%) permanently discontinued therapy and 75 (15.8%) received SACT adjustments, respectively. Discontinuations were due to worsening performance status (45.1%), disease progression (16.1%) and residual organ disfunction (6.3%). SACT adjustments were pursued to avoid hospital attendance (40%), prevent immunosuppression (57.3%) or adverse events (20.3%). Multivariable analyses showed permanent discontinuation to be associated with an increased risk of death (HR 4.2, 95%CI: 1.62-10.7), whereas SACT adjustments did not adversely affect survival.

Conclusions: Sequelae post-COVID-19 affect up to 15% of patients with cancer and adversely influence survival and oncological outcomes after recovery. SACT adjustments can be safely pursued to preserve oncological outcomes in patients who remain eligible to treatment.

Clinical trial identification: NCT04393974.

Legal entity responsible for the study: Imperial College London. We reported on the significant impact of the initial surge of the pandemic on wellbeing and job performance (Banerjee et al. 2021). As the pandemic continues, it is imperative to understand experiences and concerns to better inform support measures for the oncology workforce.

Methods: Three anonymous online surveys were conducted during the COVID-19 pandemic (S1, Apr/May 2020; S2, Jul/Aug 2020; S3, Feb/Mar 2021). Longitudinal analysis of responses at these timepoints were conducted. Here, we present responses to questions on job demands and resources, and perceived job performance since COVID-19 (JP-CV).

We analysed 3894 individual responses (S1, n¼1520; S2, n¼942; S3, n¼1432): 53% (n¼1961/3731) female, 45% (n¼1679/3731) ¼/<40 years, 31% (n¼1132/3692) non-white ethnicity, >100 countries. There has been significant increases from S1 to S3 (p<0.001) in feeling overwhelmed with workload (29% vs 45%); COVID-19-related clinical (14% vs 58%) and research (16% vs 64%) work; out-of-hours work (16% vs 41%), shift work (12% vs 26%) and overall working hours (17% vs 47%); and inadequate time for personal/family life (35% vs 45%). 59% (n¼1156/1946) were unable to take allocated annual leave. While JP-CV has improved (34% vs 49%, p<0.001), there remained concerns about the negative impact of the pandemic on career development/training (43%), job security (37%) and international fellowship opportunities (76%). Overall, less than half had felt supported by their work management, professional societies or government, and/or had access to wellbeing support services. 25% (n¼266/1086) were considering changing their future career with 38% (n¼100/266) contemplating leaving the profession.

Conclusions: Since COVID-19, oncology professionals have reported increased job demands, concerns over career development/training and job security, and inadequate time for personal life. There is a real threat of potential attrition in the current workforce. National and international stakeholders must act together to ensure robust recovery plans as we emerge from the COVID-19 crisis.

Legal entity responsible for the study: The authors.

Funding: ESMO. Conclusions: Vaccination is an effective strategy for preventing COVID-19 in cancer patients. However, effectiveness may be reduced in patients actively receiving immunosuppressive systemic therapy. Future study is needed to determine if these patients would benefit from post-vaccination serologies and/or a booster vaccination following completion of therapy.

Legal entity responsible for the study: Nathanael Fillmore.

Funding: Has not received any funding. 

Results: The trial was initiated on March 22 th . As of May 4 th , 152 solid cancer and 103 hematooncology patients were enrolled. From preliminary baseline data, 22% of solid cancer and 29% of hematooncology patients had detectable levels of anti-S antibodies with a median of 106 U/ml (range 1.4e3666) and 84 U/ml (range 0.75e2528), respectively (p ¼ 0.888). Surprisingly, only 44% solid cancer and 53% of hematooncology patients with detectable antibodies prior to the vaccination referred on covid-19 in medical history

Conclusions: Substantial number of cancer patients experienced SARS-CoV-2 infection during active anti-cancer treatment prior to vaccination, often with asymptomatic course. In SARS-CoV-2-immunized patients, we observed SARS-CoV-2 positive cellular response. The preliminary results with dynamics of immune response with 3-month follow-up

Clinical trial identification: EudraCT

Legal entity responsible for the study: Masaryk University. Funding: CZECRIN

Disclosure: All authors have declared no conflicts of interest