COVID-19 Brings “Unexpected Silver Lining” for Cancer Clinical Trials

It’s human nature to strive, and the pandemic has no shortage of real-life examples of innovation in adversity. Despite suffering diminished enrollment in the spring, clinical trials are changing—in lasting and positive ways, according to a Dec. 9 STAT+ article. “People are talking about how the future has been accelerated by this pandemic. Cancer research has been accelerated as well,” said Joe Unger, a health services researcher and biostatistician at the Fred Hutchinson Cancer Research Center in Seattle. The COVID-19 era has heralded in efficiencies that ultimately are more convenient to patients, from the ability to get study drugs by mail to other time-saving efforts like having patients fill out consent forms online and using telemedicine. This more patient-centric approach to research is a positive consequence of the pandemic, notes a Dec. 8 report from the American Society of Clinical Oncology published in the Journal of Clinical Oncology.

SABCS Session Highlights How COVID-19 Affects People With Breast Cancer

The 2020 San Antonio Breast Cancer Symposium (SABCS) took place as a virtual meeting Dec. 8-11. SABCS dedicated a special session on the opening day of the conference to providing an on-the-ground view of the effects of the pandemic on breast cancer care. The session highlighted research on the reduced rates of mammography and a survey on the use of hormone therapy to delay surgery for early-stage estrogen receptor-positive breast cancer, according to a Dec. 9 post on the Cancer Research Catalyst blog. (Cancer Today and the Cancer Research Catalyst blog are both published by the American Association for Cancer Research, which co-sponsored the SABCS meeting.) Experts also focused on the disproportionate toll the pandemic is having on racial and ethnic minority populations. Cancer patients from these groups may be in “double jeopardy,” said Deborah Doroshow, a physician and historian at the Tisch Cancer Institute of the Icahn School of Medicine at Mount Sinai in New York City, who presented at the conference. “Ultimately, the root cause of these disparities is decades of institutionalized racism.”

Patients Receiving CAR-T Cell Therapy Underutilize Palliative and Hospice Care

Patients undergoing CAR-T cell therapy can develop life-threating side effects that lead to intensive care admissions. Research presented at the virtual 62nd American Society of Hematology (ASH) Meeting and Exposition, held Dec. 5-8, suggest that patients who receive CAR-T cell therapy are not being referred to palliative care or to hospice near the end of life. CAR-T cell therapy involves removing a patient’s own immune cells, modifying them to recognize and kill cancer cells and infusing these cells back into the body. The study, presented by Patrick Connor Johnson, an internist at Massachusetts General Hospital in Boston, included 236 patients who had received CAR-T cell therapy at two academic centers from 2016 to 2019, including 84 patients who died following the treatment. Among the patients who died, fewer than half (47.6%) had a palliative care consultation, while 30.9% of patients were referred to hospice. In addition, more than half of patients who died were hospitalized in the last thirty days of their lives, with approximately one third recei​ving chemotherapy during that period. “Care transitions and symptom monitoring interventions may be particularly useful targets for future research aimed at mitigating health care utilization in this unique population,” Johnson said, according to Cancer Therapy Advisor. These findings may not be unique to CAR-T cell therapy, as research presented at ASH also suggests that patients on Medicare with blood-related cancers may have poorer end-of-life care compared to those receiving care for solid tumors. ​​

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