Oncology Research Must Continue to Forge Ahead Amidst COVID-19

We are all bombarded daily by a deluge of information regarding COVID-19 and its devastating global impact. Within six months, a likely single zoonotic event has spawned infections in each corner of our world.  As we observe the basic principles of biology unfold in plain view, one truth prevails: science offers the only hope of a longer-term solution, or as we say at Pfizer, Science Will Win.

For those of us fighting a completely different war, the war against cancer, we should be reminded that cancer kills 2,000 Americans each day, and after cardiovascular disease remains the leading cause of death worldwide.[1] Moreover, emerging data show cancer patients with COVID-19 have a significantly increased risk of severe illness or death, suggesting the need for proactive strategies to reduce the likelihood of infection and improve early identification of exposure in this patient population.[2]

As researchers and clinicians around the world attend the virtual scientific program of the 2020 American Society of Clinical Oncology (ASCO) Annual Meeting, an important question amongst the scientific community is how to continue to advance critical oncology research amidst the backdrop of the global COVID-19 pandemic. While much of the research world has shifted its focus to solutions to address COVID-19, now, more than ever, it is imperative that we work together to find new solutions for how to continue cancer research and forge ahead for those who are counting on tomorrow’s discoveries.

Amidst our new reality, cancer researchers have two important obligations: to the health and safety of our trial participants, and to the public health and global healthcare system.

At Pfizer, we are taking proactive steps to work with our researchers to ensure flexibility and meet the diverse needs of the patients currently participating in our clinical trials. Our goal is to ensure that our studies continue while avoiding placing additional demands on already taxed healthcare workers and ensuring the health and safety of our study participants. This requires us to make it easier for patients to participate in scheduled visits and ensure continuation of care, while also lessening their risk of contracting SARS-CoV2. 

There are three areas where we as cancer researchers could exploit this crisis to accelerate changes to cancer drug development that could have long lasting benefits to patients:

• Re-design the clinical trial experience around the participant rather than the research site: This crisis provides an opportunity to reassess and reduce the need for the ever-increasing data we routinely collect in our studies, which results in increased patient hospital visits. Additionally, the requirement for visits to a cancer center for each blood test and imaging can be particularly burdensome. Pruning protocols with an eye on excluding unnecessary tests could go a long way to simplifying studies and ultimately reducing participant burden.
• Accelerate digital and virtual tools to optimize clinical trial conduct: While some trials could be conducted entirely in a virtual environment (for example real world evidence studies), most will need a hybrid of virtual and in-person activities. These include virtual feasibility assessments and trial site initiations, remote consenting, virtual monitoring, digital data collection through patient reported adverse events and wearables, and virtual verification of trial data. E-signatures for all trial documents could also become standard practice. For some of these, national and local health authority regulations and guidelines will dictate how quickly we can adapt to a new way of executing studies.
• Select patient-centric drug administration or scheduling: During early drug development, prioritize compounds that require less frequent administration and therefore less hospital visits. Where possible, select compounds that could be developed as oral medicines rather than those needing parental administration; and for biologics, develop formulations where achievable that will allow a subcutaneous administration, rather than an intravenous route.

A recent ASCO survey highlighted the benefits of permanently implementing  COVID-19-related changes to clinical trials, including expanded use of streamlined trial designs and routinely leveraging technology to limit in-person visits.[3] ASCO also published pragmatic guidelines to cancer care delivery during the COVID-19 pandemic, including conducting clinical trials.

The outbreak of COVID-19 is an unprecedented challenge that will continue to impact healthcare systems and research communities for the foreseeable future. At the same time, the growth and aging of the global population will generate an expected 29 million new cases of cancer by 2040.[4] As cancer researchers, we need to remain vigilant and stay the course in our fight against this disease on behalf of the millions of patients who are counting on us.

With more than 2,500 presentations at this year’s ASCO meeting, scientists from around the world continue to rise to the challenge. Over the next few days, we will learn from the latest clinical trial research findings, some of which may be practice-changing results. Among the many presenters, Pfizer is proud to share important updates from our genitourinary portfolio. We are also proud that data will be shared on a challenging tumor affecting children, neuroblastoma.

This year’s unprecedented 2020 ASCO Annual Meeting reinforces to us all that nothing – not even a worldwide pandemic – can or should grind science to a halt nor prevent any of us from continuing our mission to provide breakthroughs that change patients’ lives.  

References

[1] World Health Organization. Cancer Key Facts. Available at: https://www.who.int/news-room/fact-sheets/detail/cancer. Accessed May 2020.

[2] Mehta V et al. Case Fatality Rate of Cancer Patients with COVID-19 in a New York Hospital System. Cancer Discovery. 2020. Online Publication Available at: https://cancerdiscovery.aacrjournals.org/content/early/2020/04/29/2159-8290.CD-20-0516

[3] Waterhouse DM et al. Early Impact of COVID-19 on the Conduct of Oncology Clinical Trials and Long-Term Opportunities for Transformation: Findings From an American Society of Clinical Oncology Survey. JCO Oncology Practice 2020, Online Publication Available at: https://ascopubs.org/doi/full/10.1200/OP.20.00275

[4] American Cancer Society. The Cancer Atlas. Available at: https://canceratlas.cancer.org/the-burden/the-burden-of-cancer/. Accessed May 2020.