Table 1.

Summary of International and National guidelines during COVID-19 according to the different cancer type and tumoral localisation.*

	Cancer type and/or localisation	Stage	Antineoplastic protocol	Therapeutic adjustment options in the limits and rules of the national regulatory agencies, and as per local guidelines and practice	Reference
Lung cancer	NSCLC	Adjuvant	Cisplatin – Paclitaxel	Carboplatin - Paclitaxel + G-CSF	[48], [49]
		Locally advanced	Durvalumab	Reduced frequency Q4W and double the dose	[45], [50]
		Metastatic	Nivolumab	Discontinuation of immunotherapy after 2 years of treatment should be considered. Stop (>2year) or reduced frequency Q4W and double the dose	[41], [45], [46], [48], [51]
		Metastatic	Pembrolizumab	Discontinuation of immunotherapy after 2 years of treatment should be considered. Stop (>2year) or reduced frequency Q6W and double the dose	[41], [45], [47], [48], [51]
		Metastatic	TKI targeting EGFr	Treatment continuation and monitoring using telemedicine	[48], [51]
	SCLC	Local	Cisplatin – Etoposide (± atezolizumab or durvalumab)	Carboplatin – Etoposide + G-CSF (± atezolizumab or durvalumab)	[48], [53]
Skin cancer	Melanoma	Adjuvant or advanced	Nivolumab Q2W Pembrolizumab Q3W	Reduced frequency (nivolumab Q4W and pembrolizumab Q6W) and double the dose	[46], [47], [52]
Genitourinary	Prostate	Metastatic first line	Docetaxel	Androgen deprivation + abiraterone/enzalutamide (expert consensus)	[54], [55], [56]
	Prostate	Metastatic pre-treated with second generation hormonotherapy	Docetaxel	Avoid or reduce the number of docetaxel cycles + G-CSF (expert consensus)	[54], [55]
	Seminoma	Metastatic with intermediate risk	BEP Protocol	Avoid bleomycin (VIP + G-CSF) (expert consensus)	[54], [55]
	Bladder	Metastatic first line	Intensive MVAC Protocol	Cisplatin – Gemcitabine + G-CSF (expert consensus)	[54], [55]
	Kidney	Metastatic with high or intermediate risk	Ipilimumab-Nivolumab	TKI sunitinib or pazopanib (expert consensus)	[54], [55]
Digestive	Colic	Adjuvant	FOLFOX	CapOx or capecitabine monotherapy (low risk) or no treatment (frail patients) (expert consensus)	[35], [57]
	Colorectal	Metastatic unresectable	FOLFOX or FOLFIRI ± targeted therapy	Capecitabine or CapOx or CapIri ± targeted therapy (expert consensus)	[35], [57]
	Pancreas	Local	FOLFIRINOX	FOLFOX or FOLFIRINOX without 5-FU bolus and cap irinotecan at 150 mg/m2; add G-CSF	[35], [57], [58], [59]
	Gastric	Local	FLOT perioperative	FLOT + G-CSF or CapOx (if no dysphagia)	[35], [57], [60]
	Oesogastric	Metastatic	FOLFOX ± trastuzumab	CapOx ± trastuzumab (if HER2+++) (expert consensus)	[61]
	Anal cancer	Metastatic	5FU-cisplatin or DCF protocol	CapOx or carboplatin - capecitabine (expert consensus)	[35]
	GIST	Adjuvant post-operative	TKI targeting bcr-abl	TKI continuation and monitoring using telemedicine (expert consensus)	[35]
Breast	Breast	Metastatic	CDK4/6 inhibitors	Adapt doses or postpone CDK4/6 inhibitors to avoid neutropenia (expert consensus)	[62], [63]
Upper Aero-digestive Tract	Head and Neck	Metastatic	TPEx	Adapt schedule from Q3W to Q2W with reduced doses of cisplatin and docetaxel (both 40 mg/m2) and cetuximab 500 mg/m2 (expert consensus)	[64]
Neuro-oncology	Glioma IDH-wt MGMT-methylated	High grade	Chemo-radiotherapy with temozolomide	Treatment continuation (expert consensus)	[65], [66]
	Glioma IDH-wt	High grade	Bevacizumab Q2W	Bevacizumab Q6W to Q8W (expert consensus)	[65]
	Glioma IDH-mutated	Oligo-symptomatic	Procarbazine, lomustine, vincristine	Consider to report for 6 months or more (expert consensus)	[65]
Hematology	Follicular lymphoma	Induction	Immuno-chemotherapy anti-CD20-based	Anti-CD20 alone If chemotherapy is necessary, prefer R-CHOP to R-Bendamustine (expert consensus)	[67], [68]
	Follicular lymphoma Mantle cell lymphoma	Maintenance	Anti-CD20	Consider to report or remove maintenance cycles	[67], [68], [69]
	Chronic Lymphocytic Leukaemia	Induction	Rituximab and venetoclax	Avoid anti-CD20 and venetoclax. Prefer alternative therapies (expert consensus)	[70]
	Lymphoblastic Acute Leukaemia	Maintenance	POMP	Stop vincristine and corticosteroids and maintain methotrexate and 6-mercaptopurine (expert consensus)	[71]
	Multiple Myeloma	Induction	VRD following by ASCT	Report ASCT as possible; replace by 6 or 8 cycles of VRD according to the risk stratification (expert consensus)	[72], [73]
		Induction/consolidation or relapsed/refractory	Dexamethasone 40 mg weekly	Decrease dexamethasone to 20 mg weekly or avoid if possible	[72], [73], [74]
		Relapsed and/or refractory	Carfilzomib D1-2 Daratumumab Q2W	Reduce carfilzomib frequency D1 Daratumumab monthly frequency until cycle 3 (expert consensus)	[72], [73], [75]

ASCT: Autologous Stem Cell Transplant; BEP: Bleomycin, Etoposide, CapOx: Capecitabine, Oxaliplatin; CapIri: Capecitabine, Irinotecan; Cisplatin; COVID-19: Coronavirus Disease-19; EGFr: Epidermal Growth Factor receptor; FLOT: Docetaxel, 5-fluorouracile, oxaliplatin; FOLFOX: Oxaliplatin, 5-fluorouracile; FOLFIRI: Irinotecan, 5-fluorouracile; FOLFIRINOX; Oxaliplatin, Irinotecan, 5-fluorouracile; G-CSF: Granulocyte-Colony Stimulating Factors; GIST: Gastro-Intestinal Stromal Tumor; GRAALL: Group for Research on Adul Acute Lymhoblastic Leukemia; IDH: Isocitrate deshydrogenase; MGMT: O-6-methylguanine-DNAmethyltransferase; MVAC: Methotrexate, Vinblastine, Doxorubicin, Cisplatin; NSCLC: Non-Small Cell Lung Cancer; POMP: Methotrexate, Vincristine, Prednisone, Mercaptopurine; Q2W: Every 2 weeks; Q3W: Every 3 weeks; Q6W: Every 6 weeks; Q8W: Every 8 weeks; R-CHOP: Rituximab, Cyclophosphamide, Doxorubicine, Vincristine, Prednisone; TPEx: Docetaxel, Cisplatin, Cetuximab; VRD: Velcade, Revlimid, Dexamethasone; wt: Wild Type; SCLC: Small Cell Lung Cancer; TKI: Tyrosine Kinase Inhibitor; VIP: Vinblastine, Ifosfamide, Cisplatin;