|In response to the COVID-19 pandemic, in April 2020 the Association for Value-Based Cancer Care (AVBCC) introduced a series of webcasts titled “COVID-19 Impact on the Cancer Care Delivery Ecosystem.” The following article highlights one of the presentations that addressed the impact of the novel coronavirus on healthcare stakeholders during and beyond this pandemic.|
The COVID-19 crisis has far-reaching implications for research in healthcare. A panel of experts explored the detrimental effects of the pandemic on the career development of research students, potential changes in the availability of clinical trials, and the anticipated shortfall of future funding for healthcare research. The session was moderated by Rob Butcher, Chief Executive Officer, Swim Across America, a charity that raises money for cancer research and funds 57 laboratories around the country.
Jedd Wolchok, MD, PhD, FASCO, Chief, Immuno-Oncology, Memorial Sloan Kettering (MSK) Cancer Center, who supervises a National Institutes of Health–funded Swim Across America Laboratory at MSK, opened the discussion with an assessment on how professional life in New York City has been affected by COVID-19.
“For the first time in the 23 years that I have been part of the Swim Across America Lab at Memorial Sloan Kettering Cancer Center, we had to essentially shut down the lab,” said Dr Wolchok. Although the laboratory is very slowly being reopened, the pandemic has had a wide-ranging impact, especially on graduate students, many of whom had to leave New York City for a period. “For our youngest generation of scientists, this has been a very significant event,” he said.
Julie Saba, MD, PhD, Professor of Pediatrics, University of California, San Francisco, agreed, saying that she is concerned about the graduate students in the very earliest stages of their career development who represent the next generation of cancer biologists. “I’m worried about how they are being affected by the disruption of the last couple of months…but also by the kind of conditions under which research is going to be resumed and reestablished,” Dr Saba said.
“Make no mistake about it, the pandemic is having, and will continue to have for the foreseeable future, a significant impact,” said Richard Schilsky, MD, FACP, FSCT, FASCO, Senior Vice President, Chief Medical Officer, American Society of Clinical Oncology. Enrollment in national clinical trials are down, and “many institutions have shut down their entire clinical trial portfolio or large portions of it.” These factors will slow down the completion of many clinical trials and “some may never resume,” he noted.
Dr Schilsky added that these disruptions will add to the complexity of evaluating outcomes, necessitating that researchers do not introduce bias into the interpretation of time to progression in trials.
Maurie Markman, MD, President, Medicine and Science, Cancer Treatment Centers of America, introduced the idea that the pandemic crisis may require systemic changes to current practices that “transform how clinical research is done in the United States.”
Tom Lynch, MD, Chief Executive Officer and President, Fred Hutchinson Cancer Research Center, Seattle, WA, also spoke to the many challenges in conducting long-term research trials and how the virus has added additional pressure. He said that these pressures have “caused us to look differently at how we get things done.”
“Zoom calls and working remotely have been effective for faculty who are writing grants and analyzing data,” Dr Lynch noted, adding that the inability to meet in person and losing the personal connection with coworkers has been difficult.
“We’ve gone from a system of face-to-face healthcare in cancer to one that undermines that, called ‘social distancing,’” said Craig Eagle, MD, Vice President, Medical Affairs Oncology, Genentech. However, he added, the “current system of face-to-face healthcare imposes its own limits.”
With the expansion of telemedicine, the way may be opened to more diverse inclusion in clinical trials of patients who, in Dr Eagle’s words, “truly reflect the disease.”