The COVID-19 pandemic has impacted virtually every aspect of cancer care and research—from introducing new risks for cancer patients to disrupting the delivery of cancer treatment and the continuity of cancer research, a review of scientific literature shows.
As described in a press release from Dana-Farber Cancer Institute, the review—compiled by researchers at that institute and other institutions and published online by Cancer Cell—suggests that while COVID-19 has complicated the treatment of cancer patients, it has also spurred creative solutions to challenges in clinical care. Further, the review suggests that research into the new disease is benefiting from insights gained over years of cancer research.
“COVID-19 has been responsible for killing more than one million people worldwide. Among those most at risk of developing severe forms of the illness are patients with cancer,” says Ziad Bakouny, MD, MSc, of Dana-Farber, the co-lead author of the study with Jessica Hawley, MD, of Columbia University Medical Center. “Research into why patients with cancer are at heightened risk is moving very quickly.”
The paper summarizes findings in four areas: the interconnected biology of cancer and COVID-19; changes in patient care prompted by the pandemic; effects on cancer research; and insights from cancer research applicable to the treatment of COVID-19.
In looking at the effects of COVID-19 on cancer research, the authors note that, to limit the opportunities for viral transmission, many research centers enacted policies limiting the number of lab workers allowed onsite, putting many studies on hold. For the most part, research projects funded by government appropriations have not been hobbled by the pandemic, but some projects supported by private philanthropy face a funding gap.
Clinical cancer research, in which potential new therapies are tested in patients, has also experienced difficulties as a result of COVID-19. Some cancer centers halted enrollment on clinical trials entirely during the height of the pandemic. A survey of dozens of clinical investigators in March found that nearly 60% of respondents had halted screening and/or enrollment in certain trials, and that half of their institutions had ceased collection of blood and other tissue for research purposes.
Despite these challenges, investigators found a variety of ways to adapt to straitened circumstances so trials could continue. These included leveraging telehealth to limit in-person visits, use of e-signatures for trial documentation, shipping oral medications to trial participants rather than requiring them to be picked up at the clinic, and allowing laboratory tests to be done at outside labs.
“The relaxation of some of the regulatory requirements associated with clinical research has been accomplished without compromising patient safety,” Bakouny remarks. “Many investigators see this as a plus—something that could be part of clinical research going forward, to reduce the cost of trials and facilitate the arrival of new therapies for patients.”
Edited by Gary Cramer