How the COVID-19 pandemic is changing the shape of cancer clinical trials


José Baselga, EVP, Oncology R&D

COVID-19 has impacted us all, but for cancer patients the implications are profound. The prospect of a hospital not being able to accommodate a patient for their treatment, or an immunocompromised patient not being able to get to the clinic has become a reality for many cancer patients at some point during the pandemic.

The American Association for Cancer Research organised a COVID-19 and Cancer virtual meeting, bringing together voices from across the healthcare continuum to share learnings from this unprecedented time. I was honoured to serve as a panellist for the Regulatory and Operational Implications of Cancer Clinical Trial Changes During COVID-19 session to discuss the impact of the pandemic on clinical trials for cancer and how we, as an industry, are adapting.

José Baselga, AstraZeneca’s Executive Vice-President, Oncology R&D, participates in a panel discussion as part of the AACR COVID-19 and Cancer virtual meeting.

My fellow panellists provided perspectives from all corners of oncology, and the discussion confirmed what I had suspected: when it comes to helping patients, our drive to innovate and adapt seemingly has no bounds. These are my top five takeaways from the session:

  • This is an opportunity to rethink trial design and implementation. The COVID-19 pandemic has revealed inequalities and inefficiencies across the healthcare continuum, but it also showed what is possible when, out of necessity, we focus on the main challenge in front of us. Within AstraZeneca, we have worked with investigators to flex and adapt for cancer patients: leveraging telehealth, delivering medications directly to patients’ homes and fast-tracking the implementation of digital technologies to closely monitor our oncology trials in real time.
  • The data is out there; we need better ways of getting it. COVID-19 has forced us to take a hard look at and see where we can simplify clinical trials for cancer to ensure we are efficiently answering the question at hand and collecting the most relevant data. How can we re-evaluate our protocols while continuing to collect important data and maintain rigorous safety protocols? Are there ways to obtain information without requiring patients to travel to a hospital every few weeks?  Innovations in big data, AI and machine learning have allowed us to take a new approach in designing our oncology clinical trials with patients at the centre.
  • Trial access is not equitable across all populations. Clinical trials within oncology are not as diverse as they could or should be, and some communities are routinely underrepresented. Physical access to academic medical centres (and transportation options) is just one of the most visible barriers. As we work to “decentralise” care, are we doing everything we can to reduce the burden on patients? The pandemic has forced us to “virtualise” in many ways, and we need to carry this through with telehealth, e-consent options and medication delivery.
  • Collaboration and open communication improve system efficiency. Virtual interactions have enabled collaboration at an unprecedented scale. We’ve witnessed first-hand the impact of this increasingly efficient communication: the US FDA drafted guidance in a matter of weeks on the conduct of clinical trials during the pandemic – this process would usually take months. At AstraZeneca, my team, along with Drs. Louis Staudt and Wyndham Wilson at the National Cancer Institute, collaborated closely to develop and implement a trial protocol to assess the efficacy of an existing medicine against COVID-19 – all in just a matter of days.
  • There are always opportunities for improvement. Nothing is perfect the first time around, and now is the time to look back and ask questions, to understand what worked well and what still needs to be refined.

This is just the beginning. We are, and will continue to be, busy proposing and testing solutions for improving continuity of care for patients with cancer – all to deliver on our bold ambition of one day eliminating cancer as a cause of death.