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Innovations in Oncology Q4 2021

Cancer trials are a casualty of COVID-19

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Professor Christina Yap

Professor of Clinical Trials Biostatistics at The Institute of Cancer Research, London

Recruitment onto cancer trials has dropped by nearly 60% during the pandemic. But COVID-19 also offers clues to a recovery that can get new treatments to cancer patients more quickly.

The response to COVID-19 has proven that science can move in leaps and bounds when it’s properly funded and prioritised — transforming patients’ lives with new vaccines and drug treatments. But cancer trials — which provide hope to many patients facing a cancer diagnosis or progression — have become another casualty of the pandemic and recruitment onto trials has plummeted.

The Government must urgently invest in COVID-19 recovery of cancer clinical trials and learn the lessons of the pandemic by streamlining the regulation of clinical research to promote innovation. Failing to do so would see the pipeline of new treatments stall and leave people with cancer — particularly those with advanced disease — without access to potentially life-saving medicines.

The implementation of platform trials – which pre-pandemic was seen mostly in cancer research – has historically been slow.

Learning from COVID-19

The UK’s RECOVERY platform trial — which uncovered many of the treatments now benefiting COVID-19 patients worldwide — is a huge success story and an example of trial innovation. It received ethical and regulatory approval in just nine days and consisted of a flexible framework, allowing ineffective interventions to be dropped early, while permitting new, promising interventions to be swiftly added as new evidence emerged.

The implementation of platform trials – which pre-pandemic was seen mostly in cancer research – has historically been slow. Even before COVID-19, cancer researchers faced many issues with setting up clinical trials – through lack of funding and excessive red tape. It has often taken months, sometimes years to secure funding for a new trial, followed by further delays before patients can be enrolled. Even when trials are funded, insufficient resource within the NHS often hinders their delivery.

Restoring cancer trials

The pandemic has caused additional problems for cancer trials, causing a sharp reduction in patient recruitment. But COVID-19 trials like RECOVERY have also shown us what could be feasible with enough resource and commitment. We now need Government and funding and regulatory bodies to establish the infrastructure needed to make it easier to fund and deliver innovative trials.

We must make up for lost time and test drugs in smarter, faster, more efficient trials to generate the required standard of evidence more quickly. By ensuring the regulation and delivery of trials keeps pace with advances in science, we can accelerate patients’ access to the next game-changing treatments.

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