CFAH VHIO at ESMO 2021: reporting on the impact of COVID-19 on cancer patients and clinical research – VHIO – Vall d'Hebron Institute of Oncology

VHIO at ESMO 2021: reporting on the impact of COVID-19 on cancer patients and clinical research

  • The OnCOVID registry includes over 2700 European cancer patients consecutively diagnosed with COVID-19 in 35 centers from January 2020 – February 2021.
  • Findings from updated analysis, co-authored by VHIO investigators, were presented today during a Mini Oral Session at ESMO’s 2021 virtual Congress. Research compared the clinical outcomes of patients diagnosed with SARS-CoV-2 infection during the first and second major outbreaks in Europe.  
  • Also presented during the SARS-CoV-2 and cancer ESMO Congress Track, results from a study led by clinical researchers at VHIO’s Research Unit for Molecular Therapy of Cancer (UITM) – CaixaResearch, report on the impact of COVID-19 on Phase I studies at the same Unit.

Barcelona, September 21, 2021. The COVID-19 pandemic has undeniably impacted almost every aspect of cancer care and research. As has been widely documented in the literature, throughout 2020 in particular, SARS-CoV-2 posed new risks for cancer patients, disrupted the delivery of cancer treatment and challenged the continuity of cancer research.

Like many other medical oncology departments, the team at the Vall d’Hebron University Hospital (HUVH), headed by Josep Tabernero, had to overcome many challenges during the different waves and variants of the virus including optimizing medical infrastructures overwhelmed by COVID-related illnesses and responding to the inevitable pressures on resources and staffing.

Cancer services swiftly sought to introduce extensive changes to reduce COVID-19 exposure among patients and their healthcare teams. “In addition to some deviations from existing protocols and administration of novel therapies, including immunosuppressive treatment regimens, we had to adopt and rapidly implement technology-based as well as remote interventions and patient care activities to reduce on-site monitoring visits and in-person visits, thereby minimizing the risk of viral infection and disease spread”, noted Josep Tabernero, VHIO’s Director and Past-President of ESMO.

But, how well have such measures faired in reducing the impact of COVID-19 on cancer patients as well as research in oncology?

Throughout this week’s virtual 2021 Annual Congress of the European Society for Medical Oncology (ESMO), 16-21 September, latest data from several studies, presented throughout the dedicated SARS-CoV-2 and cancer Track, addressed this question as well as highlighted continued actions aimed at both closely monitoring and responding to the ongoing challenges of the pandemic. These included two studies that counted on the expertise of medical oncologists clinical investigators at HUVH and VHIO as follows:

1565MO – Time-dependent improvement in the clinical outcomes from COVID-19 in cancer patients: An updated analysis of the OnCovid registry

Updated analysis of the OnCOVID registry, directed by David J. Pinato, Imperial College London (UK), and co-authored by Juan Aguilar-Company, Internal Medicine & Infectious Diseases specialist at HUVH’s Medical Oncology Department, headed by Josep Tabernero, who is also a co-author of this study, evaluated the impact and consequences of COVID-19 in European cancer patients.

Specifically, the investigators assessed OnCOVID registry data from over 2700 European cancer patients consecutively diagnosed with SARS-CoV-2 infection across 35 centers, including VHIO, from January 2020 – February 2021.

Presented today during a Mini Oral Session research compared the clinical outcomes of patients diagnosed with SARS-CoV-2 infection during the first and second major outbreaks in Europe, this study aimed to establish whether mortality from COVID-19 in patients with cancer across Europe has improved over time, and also suggest possible factors behind identified trends.

“Results from this observational study show that mortality from COVID-19 in cancer patients decreased during the second wave of the pandemic compared with the first. During the first, the mortality rate at 14 days reached 25.6%, while during the second, the mortality rate dropped to 16.2%”, explained co-author Juan Aguilar-Company, who also highlighted that during the first wave, patients tended to be over 65 years of age with up to two or more comorbidities.

The investigators suggest that mortality from COVID-19 has improved in Europe as a likely result of expanding testing capacity, improved healthcare resources and dynamic transmission over time, among other factors. “Our data support efforts aimed at continuing to plan resilient oncological care in the context of an unresolved pandemic”, concluded Juan Aguilar-Company.

Another OnCOVID study, also spearhead by investigators at Imperial College London (UK), first-authored by Alessio Cortellini, Medical Oncologist and Clinical Investigator, Faculty of Medicine, Department of Surgery & Cancer, shows that more than one in six cancer patients experience long-term effects of COVID-19.

According to the OnCOVID study, conducted from 27 February 2020 to 14 February 2021 (Abstract 1560O), at a median post-COVID-19 follow-up of 128 days, sequelae were associated with a 76.0% increase in the risk of death (hazard ratio [HR] 1.76; 95% CI 1.16–2.66), after adjustment for sex, age, comorbidities, tumour characteristics, anticancer therapy and COVID-19 severity.

Sequelae included respiratory symptoms (49.6%), fatigue (41.0%) and neuro-cognitive issues (7.3%), with persisting effects significantly more common in males, patients aged over 65 years, those with at least two comorbidities, and those with a history of smoking.

Commenting on the results of this study VHIO’s Director, Josep Tabernero, said,Based on the data from over 1,500 patients with cancer who survived COVID-19, this study shows that sequelae post-COVID-19 compromise long-term survival and outcomes, affecting up to 15% of patients with cancer after recovery. These findings reconfirm the particular vulnerability of cancer patients to SARS-CoV-2 and the importance of COVID-19 vaccination.

1623P – Phase I clinical trials (CT) forge on despite COVID-19.

Also presented during the SARS-CoV-2 and cancer ESMO Congress Track, results from a study led by clinical researchers at VHIO’s Research Unit for Molecular Therapy of Cancer (UITM) – CaixaResearch, report on the impact of COVID-19 on Phase I studies at the same Unit.

Presented as an ePoster by Maria Julia Lostes Bardaji, a phase I Investigator at the UITM, and Silvia Perez-Pujol, Head of VHIO’s Start Up Unit, while data show an initial decrease in new clinical studies during 2020, digitalization and measures in place proved effective in maintaining activity; leading to an increase in the number of new proposals for phase I studies at the end of 2020 at VHIO’s UITM, directed by Elena Garralda. The investigators also observed a more significant increase in proposals from January to July 2021.

We sought to establish the impact of the pandemic, especially during the months of the strictest restrictions and social distancing, on our clinical research activities and the initiation of new studies. Prior to the outbreak of COVID-19, clinical trial processes involved in-person activities with many aspects traditionally performed during face-to-face visits between potential as well as enrolled trial participants and clinical research teams”, noted co-author Silvia Perez-Pujol. She continued, Responding to the many challenges derived from COVID-19, our teams had to quickly readapt and set up new circuits, measures and infrastructures including virtual visits and digital approaches in order to continue with our critical research activities”.

The researchers analyzed statistics relating to the initiation of phase I clinical trials from January 2019 to July 2021, including new study proposals, pre-selection and study initiation visits. Data showed that while there was a 9.6% decrease in new clinical trial proposals in 2020 compared with 2019, dropping from 146 to 132, the number of pre-selection as well as initiation site visits actually increased in 2020.

“Not only have we reached pre-pandemic figures in 2021, we are seeing an increase. In the first half of this year alone, we have 123 Phase I trials as new proposals”, added Silvia Pérez-Pujol.

In conclusion, despite the challenges posed by COVID19 and the subsequent, initial decrease of new studies observed during 2020, results demonstrate that the number of new proposals for Phase I clinical trials is increasing in 2021. This trend supports the efficiency of remote pre-selection site visits as an alternative to on-site visits, and the efficacy of digitalization and measures in place to maintain clinical start up activity at VHIO during the pandemic.

21/09/2021|