Beyond the lessons learned from the COVID-19 pandemic: opportunities to optimize clinical trial implementation in oncology
L Castelo-Branco 1 , A Awada 2 , G Pentheroudakis 3 , J L Perez-Gracia 4 , J Mateo 5 , G Curigliano 6 , S Banerjee 7 , R Giuliani 8 , F Lordick 9 , A Cervantes 10 , J Tabernero 11 , S Peters 12
Since the beginning of 2020, the coronavirus disease 2019 (COVID-19) pandemic has progressively affected millions of people worldwide and has brought many uncertainties for patients, health professionals, and policymakers. According to the World Health Organization (WHO), as of 3 June 2021, there were 171 222 477 confirmed cases of COVID-19, including 3 686 142 deaths.1
Published evidence consistently shows that cancer patients are at a higher risk of death from COVID-19.2, 3, 4 In the first months of the pandemic, all levels of care (screening, diagnosis, treatment, and follow-up) were disrupted.5, 6, 7 Moreover, cancer centers started prioritizing care services, cancelling nonurgent appointments, adapting treatment protocols, and shifting to home-based remote care relying on telemedicine consultations.5,7
The deferral of screening programs and cancer-directed interventions generates concerns for an increase in the number of patients diagnosed with advanced disease stage and poor outcomes.6, 7, 8, 9, 10, 11, 12
In these unprecedented circumstances, health care institutions, researchers, and policymakers adapted quickly with variably coordinated responses worldwide. Along with vaccine development and research for COVID-19 therapies, international collaborative registries such as the ESMO-CoCARE13 or CCC1914 initiatives were set up in record time with the aim to gather evidence from patients with cancer infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
In addition, many societies such as the European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO) published recommendations to provide guidance for cancer institutions, oncologists, and patients.15, 16, 17
However, this crisis also highlighted the need to optimize the delivery of care and the use of resources in clinical research. In this paper, we aim to capitalize on the lessons learnt from the impact of the COVID-19 pandemic on clinical trials and use them as a catalyst to launch a discussion over a framework of broader adaptations needed in the design and implementation of oncology clinical trials.
CITA DEL ARTÍCULO ESMO Open. 2021 Oct;6(5):100237. doi: 10.1016/j.esmoop.2021.100237. Epub 2021 Jul 24.