Multiple studies launched to investigate and mitigate impact of COVID-19 on cancer treatment and care

The Royal Marsden and The Institute of Cancer Research, London (ICR), has launched several critical studies at an unprecedented pace, to investigate the impact of the COVID-19 pandemic on cancer treatment and care. 

Research will be funded by The Royal Marsden Cancer Charity, with the Charity needing to raise over £500,000 over the coming weeks to support the studies, and supported by the NIHR Biomedical Research Centre at The Royal Marsden and the ICR

Studies ranges across cancer types and services, tapping into key clinical and research strengths at the world-leading cancer centre and working with commercial and academic partners and NHS Trusts from across the country.

Professor David Cunningham, Consultant Medical Oncologist at The Royal Marsden and Director of the NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research, London, said: “We are uniquely placed to look at COVID-19 in a cancer setting, investigating the pandemic’s impact across a wide range of patients. These trials call upon our multidisciplinary expertise in areas such as systemic therapies, radiotherapy, circulating tumour DNA which is detectable in blood tests, and holistic care.”

Innovative technology

Several studies will explore the use of new, and existing innovative technology, to improve care and treatment for cancer patients during and beyond the pandemic.

One trial will seek to establish an effective and rapid diagnostic point-of-care antibody test for cancer patients, mapping out a timeline of when immunity is developed to enable the safe restarting of cancer treatments. Researchers hope it will shed light on how the pandemic impacts this particularly vulnerable group, and whether cancer patients require specific antibody tests versus the general population.  

Researchers are also investigating whether a blood test can be used to support prompt cancer diagnosis and treatment. The blood test will be used as part of a supportive package of diagnostic information. The test provides information that we cannot currently gain from invasive procedures such as endoscopy , many of which have been cancelled because they generate an aerosol containing the virus from infected patients, risking staff in the room, contamination of the diagnostic suite, and infection of other patients.

During the pandemic clinicians have faced a challenge of identifying whether lung changes in cancer patients are due to COVID-19, or if they are being caused by another infection or side effects from cancer treatment. In response, researchers will trial the use of artificial intelligence as a tool to help analyse scans from patients, providing clinicians with data quickly to help inform treatment decisions and improve outcomes for patients. 

Shedding light on COVID-19

A substantial effort is being made to understand the biology and interactions between cancer patient’s immunity, COVID-19, cancer and cancer treatment. One study will analyse data from 1200 cancer patients, which will allow analysis of the virus behaviour and its impact on cancer patients and their treatments, and serve to improve our understanding of how we can protect cancer patients and staff and inform both immediate decision making and longer term understanding. They will also investigate the interaction between immunity of healthcare workers and COVID-19, with findings intended to inform healthcare worker policy.

Another group are focussed on studying the impact of ‘radical’ changes made during the pandemic to radiotherapy treatment. These changes have included shorter, more intense treatment, delaying or even omitting radiotherapy. Researchers want to build a solid data set to understand how these changes have impacted patient outcomes and inform clinical decision for the future.  

Support for healthcare workers

In the space of only a few months, the COVID-19 pandemic has required rapid and large-scale changes across the NHS. Cancer patients are a particularly vulnerable group, with often complex treatment plans in place. Clinicians are making difficult decisions daily – made even more critical when considering risks the virus presents. With concern about burnout, resilience and wellbeing of staff caring for cancer patients, researchers are immediately launching a series of surveys, intending to capture feedback from staff. They hope results will inform policy around healthcare worker management, in the short and long term.  

Working at pace to benefit patients across the UK and internationally

Professor Cunningham highlighted that studies will provide both an immediate wave of information about COVID-19, alongside the longer-term picture:

“Teams have been working at pace to establish studies that adhere to our usual rigorous governance; each will have varying durations, with a focus on immediate impact through to longer term understanding of this novel virus. Importantly, with commercial, NHS and academic partners across the country, and thanks to fundraising from The Royal Marsden Cancer Charity and support from The NIHR Biomedical Research Centre we hope this research will have a national and international impact.” 

In addition to studies led by teams at The Royal Marsden, the Trust is involved as a participating centre in several of the national COVID-19 trials endorsed by the Chief Medical Officer.