Background: The oncology community faces unprecedented challenges in balancing a delay in cancer treatment against the risk for a potential COVID-19 infection and associated complications. An early retrospective analysis reported that cancer patients with COVID-19 infection have a much higher death rate than those infected but without a cancer diagnosis, likely because of their immunocompromised disease from cancer and treatment. Even though COVID-19 is known to have a long incubation period (~14 days), there were no clear guidelines for screening asymptomatic cancer patients who are planning to have and having antitumor treatment as of April 2020.

Methods: We developed a protocol to screen asymptomatic cancer patients for COVID-19 who are scheduled to receive cancer-directed treatment (i.e., chemotherapy, targeted therapy, immunotherapy, anticancer monoclonal antibody, endocrine therapy, or investigational agent). The protocol was developed and activated within 2 weeks through the Cancer Center Investigator Initiated Trial Program. FDA-authorized CDC 2019-Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel EUA kit was performed at Sinochips Diagnostics. The primary objective was to determine COVID-19 status in participants prior to initiating anticancer treatment. The secondary objective was to evaluate COVID-19 related adverse events (AEs) in recovered COVID-19-positive participants for 30 days after initiation of anticancer therapy.

Results: We enrolled 507 patients and tested for COVID-19 from 4/28/20 to 5/8/20 through coordinated efforts within the CTO and Biospecimen Repository Core Facility. The research study was stopped when the KU Health System was able to test this population as standard of care. Median age was 65 years, 110 patients (22%) were aged 75 years or older, and 274 (54%) patients were female. 387 patients (76.3%) were Caucasians, 35 (6.9%) African American, 7 (1.4%) Asian, and 437 (86.2%) non-Hispanic. Based on the catchment of zip codes, 7% of tested patients came from more than 60 miles and 1.6% from more than 100 miles. Zero patients had a positive COVID-19 test.

Conclusions: The prevalence of COVID19 in asymptomatic cancer patients is low, likely because of good compliance with the social distance policy. Screening for COVID19 may help reduce AEs related to COVID-19 in patients receiving cancer-directed treatment. Studying COVID-19 test results in a larger patient pool is warranted. A similar study to test asymptomatic patient-facing oncology staff is pending.

Citation Format: Kathan D. Mehta, Elizabeth Wulf-Burchfield, Natalie Streeter, Anup Kasi, Adam H. AlDouri, Roy Jensen, Andrew K. Godwin, Terry Tsue, Weijing Sun. A prospective testing SARS-Cov-2/COVID-19 in cancer patients with antitumor treatment [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-043.