COVID-19 and cancer: can pharma stymie the pandemic’s impact on mortality?
The COVID-19 pandemic may lead to increased cases of cancer mortality – what can biopharma companies do to help lessen the impact?
As we work through the COVID-19 crisis, signs are emerging of the detrimental impact the pandemic is causing more broadly for healthcare, especially for cancer care.
We could be looking at a 5% to 10% decrease in survival of cancer in high-income countries – a death toll that would exceed current COVID-19 mortality rates – according to a May report in the medical journal The Lancet.
Oncologists have been adjusting their clinical practice to avoid putting their patients at unnecessary risk of COVID-19. And patients have been staying away from hospitals, skipping screening and diagnostic procedures.
In the US, the American Cancer Society Cancer Action Network conducted a survey in late March/early April of more than 1,200 cancer patients and survivors. More than half (51%) of all those surveyed reported some impact on their care due to the virus, such as delays in treatment and access to imaging services needed to determine if a patient’s cancer had grown or returned.
In the UK, the UCL Institute of Health Informatics (IHI) analysed the weekly health records of nearly 4 million patients in England and Northern Ireland from 2018 through to April 2020. The IHI found there has been a 45% to 66% reduction in admissions for chemotherapy and a 70% to 89% reduction in urgent referrals.
The IHI, which specialises in collecting and analysing data to gain better understandings of diseases on a national and international scale, modeled the potential impact of COVID-19 in the US based on publicly available information. It estimated that in the US COVID-19 could result in 33,890 additional deaths in newly diagnosed cancer patients over the next twelve months alone.
While the models give us a sense of the potential impact on cancer patients’ lives in the next twelve months, there is another impact that can’t be modeled – the impact COVID-19 has on the timely approval of novel cancer treatments, such as precision medicine that customises treatment to each patient.
Biopharma companies had to slow down many oncology clinical programmes and indeed cancel some trials. They have focused on continuity of care for current clinical trial participants, but potential alterations to the protocol, in addition to the delays in recruiting new cancer patients, could ultimately impact the integrity of some of the studies. The domino effect is clear: delayed regulatory submissions and therefore delayed approvals.
We can also reasonably forecast stress on labs for the foreseeable future as well. In addition to increased COVID-19 testing and delayed cancer screening, there will be a surge of patients who deferred other general healthcare tests, putting further pressure on labs. In short, scarce resources at biopharma companies and amongst healthcare service providers will likely cause further delays, which is particularly detrimental to cancer patients.
The biopharma industry has a role to play in helping lessen the impact of COVID-19 on cancer care. It needs to prepare for an increase in demand for cancer treatment by ensuring manufactured supplies are available to meet immediate short-term demand, and it also needs to build capacity in the medical and patient access organisations. Patients will present with later-stage cancers and therefore the industry will need to support oncologists in discussing the scientific data and enable rapid access to novel treatments.
Biopharma companies also need to virtualise, digitise and restart clinical trials. They need to take the lessons learned from expediency in developing testing and a potential vaccine for COVID-19 cases and apply these lessons more broadly when they restart clinical trials. They should partner with the major oncology centres to restart clinical research, while also amending clinical protocols to take advantage of digital and virtual approaches. We can’t eliminate all in-person patient visits, but more can be done using digital virtual approaches.
A good sign is that the industry is working more closely to improve access to data for COVID-19 work.
TransCelerate BioPharma, a non-profit collaboration comprised of 20 of the largest biopharmaceutical companies including BMS, Pfizer and Roche, recently announced it has expanded access to COVID-19-related patient-level clinical data sharing via DataCelerate, which is a global cloud-based data sharing platform that allows for de-identified, anonymised pre-clinical and clinical data types to be requested and voluntarily shared. As it is an internationally compliant system protecting privacy rights in clinical data, this has the potential to accelerate trials worldwide.
Given this unprecedented global health challenge, it is critical that the industry works collaboratively to rapidly produce effective and safe therapies for COVID-19.
The next step will be to use this experience more broadly for other therapies, such as cancer. Increasing access and including the investigational product arm can help improve future trial designs.
Finally, the biopharma industry needs to work hand-in-glove with healthcare providers to help innovate clinical care delivery, which might become vital in case of a second COVID-19.
This can range from care delivery at home (e.g. home infusion), to digital remote monitoring that captures patient-reported data to the continuity of care with telemedicine.
What is clear is that COVID-19 may have a significant immediate impact on cancer care. Acting now will not only address the immediate needs of cancer patients, it will also strengthen the system for the future to hopefully improve outcomes for more people.
About the author
Stuart Henderson is a senior managing director leading Accenture’s global Life Sciences business.