Smart People: Jeff Elton

How did the pandemic impact oncology trials? What kept them moving during lockdowns?

Oncology care was uniquely, negatively impacted by COVID-19. In the early days of the pandemic, oncology trials that were open either stopped enrolling patients or were substantially slowed, and new study starts were delayed. There were also delayed diagnoses of new patients due to the pandemic. Obviously, fewer patients being diagnosed means fewer prospective patients who may consider clinical trials. It also means that patients’ cancers will progress and that they’ll start treatment at more advanced stages.

That situation persisted from late February 2020 through the middle of the summer of 2020, when precautions had been fully integrated into practice. The standard-of-care was modified to be protective of patients and staff. In certain cancers, surgical interventions were limited in favour of less invasive initial treatment approaches or medical-only treatment. Levels of more invasive diagnostic activities, such as biopsies, were also sometimes reduced versus pre-COVID standard-of-care. This meant that expected outcomes might differ from historical outcomes or that clinical trials based on historical patterns of treatments might find fewer patients available meeting those patterns.

Once protective measures were in place, there was a new focus on restarting stalled studies and initiating new ones.

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