Chemotherapy in COVID-19 pandemic: to give or not to give?


  • Abhishek Pathak Department of Malignant Disease Treatment Centre, Command Hospital, Kolkata, West Bengal, India
  • Subhash Ranjan Department of Malignant Disease Treatment Centre, Command Hospital, Kolkata, West Bengal, India
  • Anvesh Rathore Department of Malignant Disease Treatment Centre, Army Hospital (Research and Referral), New Delhi, India
  • Rajan Kapoor Department of Malignant Disease Treatment Centre, Command Hospital, Kolkata, West Bengal, India
  • Alpana Gupta Department of Pathology, Transfusion Centre, Command Hospital, Kolkata, West Bengal, India



COVID 19, Cancer, Chemotherapy, SARS-cov-2, Pandemic


COVID-19 is a new pathogen for humans, not much is known how it affects cancer patients, but definitely there is high risk for cancer patients contracting this disease. So to find a solution to this very challenging situation the oncologists need to formulate certain guiding principles for cancer treatment in this pandemic era. Authors have divided this cancer patients into four categories depending upon the urgency of giving chemotherapy. The lowest priority being Priority A where delaying chemotherapy till this pandemic gets over will not harm the patients much and the highest priority being given to Priority D where authors do not want even a delay of days/ week. It is Priority B and C where the decision needs to made by the clinicians. However, in case authors decide to give chemotherapy in present setting there are certain changes that needs to be made both on patient as well as the hospital end. Like higher degree of awareness among patients, rational usage of resources of the hospital etc. It is indeed a very difficult time for cancer patients who are trying to cope up with malignancy and for most of them; the coronavirus is an extra concern and worry. Till the time authors learn how best treat and care to this patients during this pandemic era do what you can do to keep you and your family stay safe and Healthy.


World Health Organization. Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020. Available at:

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 11;395:1054-62.

Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020 Mar 1;21(3):335-7.

Chen Z, King W, Pearcey R, Kerba M, Mackillop WJ. The relationship between waiting time for radiotherapy and clinical outcomes: a systematic review of the literature. Radiother Oncol. 2008 Apr 1;87(1):3-16.

Raphael MJ, Biagi JJ, Kong W, Mates M, Booth CM, Mackillop WJ. The relationship between time to initiation of adjuvant chemotherapy and survival in breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat. 2016 Nov 1;160(1):17-28.

Unesco/Commission Mondiale de l'Ethique des Connaissances Scientifiques et des Technologies. The precautionary principle: World Commission on the Ethics of Scientific Knowledge and Technology (COMEST). Unesco; 2005.

Ueda M, Martins R, Hendrie PC, McDonnell T, Crews JR, Wong TL, McCreery B, Jagels B, Crane A, Byrd DR, Pergam SA. Managing cancer care during the COVID-19 pandemic: agility and collaboration toward a common goal. J Nat Comprehens Cancer Netw. 2020 Mar 20;1(aop):1-4.

ASCO COVID 19 Patients care information. Available at: Accessed on 09 April 2020.

Emanuel EJ, Persad G, Upshur R, Thome B, Parker M, Glickman A, et al. Fair allocation of scarce medical resources in the time of Covid-19. N Engl J Med. 2020.

Curtis JR, Kross EK, Stapleton RD. The importance of addressing advance care planning and decisions about do-not-resuscitate orders during novel coronavirus 2019 (COVID-19). JAMA. 2020 Mar 27.






Review Articles