{"id":26501,"date":"2020-11-04T10:18:46","date_gmt":"2020-11-04T10:18:46","guid":{"rendered":"https:\/\/scienceblog.cancerresearchuk.org\/?p=18092"},"modified":"2024-11-03T15:16:15","modified_gmt":"2024-11-03T15:16:15","slug":"whats-happened-to-cancer-clinical-trials-during-the-covid-19-pandemic","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/whats-happened-to-cancer-clinical-trials-during-the-covid-19-pandemic\/","title":{"rendered":"What\u2019s happened to cancer clinical trials during the COVID-19 pandemic?"},"content":{"rendered":"
\"AA research nurse processing trial samples <\/p>

” data-medium-file=”https:\/\/scienceblog.cancerresearchuk.org\/wp-content\/uploads\/2018\/07\/Research-nurse-hero-300×168.jpg” data-large-file=”https:\/\/scienceblog.cancerresearchuk.org\/wp-content\/uploads\/2018\/07\/Research-nurse-hero.jpg”><\/p>

A research nurse processing trial samples<\/p><\/div>

Clinical trials are an essential part of cancer research and care, with around 1 in 6 people with cancer taking part in research to access new methods of care and help improve the care received by future patients.<\/p>

But like cancer services<\/a>, such as screening and diagnosis, the COVID-19 pandemic has heavily disrupted cancer research. Because clinical trials are often based in hospitals, the risk of COVID-19 infection forced many researchers to pause recruitment in order to keep patients safe.<\/p>\n

This didn\u2019t happen to all cancer studies, as some trials were able to keep running<\/a> during lockdown, but most were disrupted.<\/p>\n

Thankfully, the situation is starting to improve, with a growing number of paused trials now restarting recruitment in some of their study sites. However, a second wave of COVID-19 risks disrupting cancer research again and reversing progress towards recovery.<\/p>\n

To prevent this, we need to avoid another national pause on clinical trials and support restarted trials to continue running during future waves of COVID-19. We also need Government support to protect<\/a> the UK\u2019s science base\u2019s ability to deliver life-saving research in the future.<\/p>\n

Here\u2019s what happened to clinical trials so far.<\/p>\n

How did COVID-19 affect cancer research and trials?<\/h2>\n

COVID-19 forced most clinical trials in the UK to stop recruiting patients, including 95% of our cancer trials<\/a>. The pandemic caused this disruption because:<\/p>\n

    \n
  1. Researchers needed to minimise the number of patients visiting hospitals, as these visits risked infecting their patients with COVID-19.<\/li>\n
  2. Some clinical staff usually dedicated to research needed to support frontline services as part of the NHS\u2019s response to COVID-19.<\/li>\n<\/ol>\n

    Although COVID-19 has disrupted research into all types of cancer, the pandemic\u2019s impact has varied between cancer types. For example, research into cancers affecting children and young people was less disrupted by COVID-19<\/a>. One reason for this is that children \u2013 including children with cancer \u2013 are at a lower risk of developing severe COVID-19<\/a> symptoms than adults, so some studies could safely continue recruiting patients during lockdown.<\/p>\n

    COVID-19\u2019s impact extends beyond disrupting today\u2019s cancer trials \u2013 it also threatens tomorrow\u2019s cancer research.<\/p>\n

    Due to COVID-19, we expect to lose 30% (\u00a3160m) of our income this year<\/a>. This has prevented us from funding new trials this year because we\u2019ve had to focus our finite funding on supporting the restart of existing cancer trials. For comparison, we usually fund around 10 new trials each year, in addition to funding trials already underway.<\/p>\n

    The pandemic\u2019s financial impact means we won\u2019t be able to fund as many cancer studies in the future, as we expect our income to take several years to recover. To avoid this outcome, we\u2019re seeking support from the Government<\/a>.<\/p>\n

    What\u2019s happening to clinical trials now?<\/h2>\n

    The good news is that progress is being made to restart paused clinical trials. Since May, the number of patients being recruited to clinical trials has increased, although the speed of recovery has varied between regions and cancer types.<\/p>\n

    For example, the percentage of non-commercial (e.g. charity-funded) clinical trials that are open to recruitment has risen from 12% in mid-April<\/a> to 40% in early-September<\/a>. And of the non-commercial trials open to recruitment, 42% have recruited a patient since 1 June.<\/p>\n

    While these figures are heading in the right direction, the recovery of recruitment to clinical trials has been slower than we hoped, largely due to a lack of capacity in hospitals across a range of services.<\/p>\n

    Even before the pandemic, there was not enough capacity in the system in several key functions, and COVID-19 has introduced many additional barriers:<\/p>\n

      \n
    1. COVID-19 has increased pressure on the NHS and significantly reduced the capacity of services that cancer trials need to properly function, such as radiology and pharmacy.<\/li>\n
    2. This services shortage has also created a backlog of cancer patients waiting for tests and treatments<\/a>. Reducing this backlog remains an urgent priority and it\u2019s important that the recovery of research is seen as integral to this process, rather than as an \u2018add-on\u2019.<\/li>\n
    3. Research into COVID-19, though necessary, is being over-prioritised by some local decision makers, making it harder for non-COVID clinical trials to access essential resources.<\/li>\n
    4. Patients may be reluctant to come into hospital due to fear of infection.<\/li>\n<\/ol>\n

      These barriers will become more challenging as cases of COVID-19 continue to rise once again. It\u2019s vital that we ensure that the trials that have maintained or restarted recruitment can continue to recruit during future waves of the epidemic.<\/p>\n

      \u201cWe\u2019re going over and above to ensure patient safety\u201d<\/h2>\n

      Ben Hood is a Cancer Research UK-funded clinical research nurse based in Newcastle. Hood works on an early phase cancer research unit, which runs a lot of early stage clinical trials.<\/p>\n

      \u201cWe see a lot of patients who might not have another treatment option. One of the biggest impacts of the pandemic was that patients in many cases weren\u2019t allowed to have family members come on the unit when they were receiving treatment or having initial discussions about taking part in research, which could be quite distressing.\u201d<\/p>\n

      The other big concern during the first wave was getting COVID-19. \u201cThere was quite a lot of anxiety from patients about being in a hospital setting in general.\u201d Hood says the clinical nursing team worked overtime to keep in touch with patients and families and talk through their concerns.<\/p>\n

      \u201cWhere possible, we changed things so treatments could be delivered to patients\u2019 homes, using courier services and we linked up a lot more with primary care \u2013 local GP practices and district nurses.\u201d Hood says they\u2019ve also evolved how they\u2019re consenting people into clinical trials, to reduce trips to the hospital.<\/p>\n

      \u201cEven though the world has turned on its head, within our unit and other experimental cancer centres, everybody has gone over and above to ensure that patient safety is the top priority during this time.\u201d<\/p>\n

      And although coronavirus cases are on the rise again the UK, Hood feels the unit is in a strong position. \u201cDuring the first wave nobody knew what to expect. But we\u2019re definitely a lot more prepared for the second wave \u2013 we\u2019re aware of the risk factors and the precautions we need to take to ensure patient safety.\u201d<\/p>\n

      How do we move forward?<\/h2>\n

      With 8 months\u2019 experience dealing with COVID-19, the NHS is in a better position to balance the demands of the pandemic with meeting the needs of cancer patients.<\/p>\n

      Hospitals have taken steps to allow patients to be treated as safely as possible. It\u2019s vitally important that patients go for treatment, and if anyone is worried about symptoms that you go to your GP. You may have to wait a bit longer than usual, but you will get the help you need.<\/p>\n

      Restoring and maintaining access to cancer services must remain the priority, and this should include keeping cancer trials open during future waves of COVID-19. That\u2019s why we\u2019ve revised our policy on redeploying Cancer Research UK-funded researchers<\/a>, which sets out that:<\/p>\n