NICE updates COVID-19 rapid guideline on delivery of systemic anticancer treatments (NG161), following review of evidence of their effects on risk of severe illness or death

New recommendations include the addition of Covid-19 vaccination status as a factor to be considered when assessing risk (recommendation 3.3) and the importance of reaching a shared decision on risks and benefits of treatment changes/breaks (recommendation 4.5).

SPS commentary:

A new recommendation has also been added to section 1 of the guideline (communicating with patients and minimising risk) to ensure that all cancer patients are aware of risk factors that are likely to influence COVID-19 severity and mortality.

 

The evidence review identified 4 new studies, in addition to the one study informing the original guideline. The review discusses the limitations of the data (small sample sizes; possibility of bias and confounding) and the key areas of uncertainty, including lack of data in children, lack of sufficient numbers to determine whether there are specific cancer types or regimens that affect severity and mortality, and the fact that only one study was based in the UK (uncertainty about whether results from other studies can be generalised to UK practice). 

 

The panel concluded that the evidence did not support a recommendation that stated to be aware that patients with COVID-19 are at risk of severe disease following systemic anticancer treatment. However, they agreed that the uncertainty in the current evidence base should be acknowledged and two new

research recommendations are made.

 

The review panel felt the evidence for radiotherapy was too limited to change current recommendations in NG162 (Covid-19 rapid guideline: delivery of radiotherapy), however three new research recommendations have been added.

Source:

National Institute for Health and Care Excellence

Resource links:

Rapid evidence review

 

Covid-19 rapid guideline: delivery of radiotherapy