The Annual Meeting of the American Society of Clinical Oncology (ASCO), now in its 56th year, took place under a new virtual format on 29–31 May 2020. Opening the meeting, ASCO President Howard A. “Skip” Burris III highlighted that although COVID-19 had changed the format of this year’s ASCO 2020, the collective determination to make progress against cancer was as strong as ever.
ASCO President Howard A. “Skip” Burris III
Dr Burris explained that the COVID-19 pandemic has changed the way patients with cancer receive care and has encouraged healthcare professionals in the oncology community and their patients to weigh the risks and benefits of delaying treatment.
Dr Burris highlighted that data on how COVID-19 was impacting patients was being collected through the new ASCO Registry and CancerLinQ database, which this year crossed a milestone of 2.5 million patients.
As ever, this year’s ASCO meeting aimed to enable clinicians to understand how and when to integrate novel research into patient care. Dr Burris noted that the galvanising theme of the ASCO20 Virtual Scientific Program – “Unite and Conquer: Accelerating Progress Together” – would take on even more resonance given the extraordinary times as ASCO’s global audience learnt about new developments in cancer care.
“The world is grappling with a pandemic and we are all readjusting to a new reality, but it cannot stop us. We, the ASCO Community, are absolutely unwilling to let anything stop us in the fight against cancer.”
Howard A. “Skip” Burris III, ASCO President
Cancer Care in the Time of COVID
Assessing Impact and Future Directions
Impact of COVID-19 on cancer care
Norman E. Sharpless, National Cancer Institute at the National Institutes of Health, Bethesda, USA, provided a brief overview on the need to ensure progress in cancer research during the COVID-19 pandemic. Dr Sharpless highlighted that the COVID-19 pandemic had delayed or stopped some cancer research, clinical studies and preventive screenings. Dr Sharpless explained that the National Cancer Institute COVID-19 in Cancer Patients Study (known as NCCAPS) has a ‘natural history’ design wherein researchers will collect blood samples, medical information and medical images from 2000 patients with cancer who also have COVID-19. Each person will be followed for up to 2 years to help physicians understand how cancer affects COVID-19 and COVID-19 affects cancer.
Jeremy Lyle Warner, Vanderbilt-Ingram Cancer Center, Nashville, USA, used 30-day all-cause mortality data from the COVID-19 and Cancer Consortium (CCC19) real-world registry to discuss the clinical impact of COVID-19 on patients with cancer (Abstract LBA110; NCT04354701). This registry contains data from patients who have tested positive for COVID-19, with breast (21%) and prostate (16%) cancers being most prevalent, 43% of patients receiving active anti-cancer treatment, and around 40% of patients in the registry having active cancer. An analysis of 928 patients with cancer and COVID-19 demonstrated cancer progression and treatment with hydroxychloroquine and azithromycin to be independently associated with a 5.2-fold and 2.89-fold greater risk of mortality at 30 days, respectively, compared with patients in remission/no evidence of disease.
Factors not significantly related to 30-day mortality in patients with cancer and COVID-19
Factors not significantly related to 30-day mortality in patients with cancer and COVID-19
“Longer follow-up is needed to better understand the impact of COVID-19 on outcomes in patients with cancer, including the ability to continue specific cancer treatments.”
Jeremy Lyle Warner, Vanderbilt-Ingram Cancer Center, Nashville, USA
Patients with thoracic malignancies are considered at high risk of mortality from COVID-19 infection given their age, pre-existing comorbidities, smoking and pre-existing lung damage in addition to therapies administered to treat their illness. Among patients with lung and other thoracic cancers also diagnosed with COVID-19, prior use of chemotherapy either alone or in combination with other treatments, was associated with increased risk of mortality (64%) compared with those who did not receive chemotherapy, according to an analysis of data from the Thoracic cancERs international coVid 19 cOLlaboraTion (TERAVOLT) registry (LBA111). Leora Horn, Vanderbilt Ingram Cancer Center, Nashville, USA, explained that the majority of patients were either untreated, or on the first-line of treatment, at the time of COVID-19 infection. In addition, while being at least 65-years-old and having comorbidities were both risk factors associated with mortality, corticosteroid and anticoagulant treatment also appeared to pose a risk, although further study is needed.
“With an ongoing global pandemic of COVID-19, data from the TERAVOLT registry suggest that patients with thoracic malignancies are at high risk of hospitalisation.”
Leora Horn, Vanderbilt-Ingram Cancer Center, Nashville, USA
Commenting on the findings from CCC19 and TERAVOLT, Giuseppe Curigliano, European Institute of Oncology IRCCS, Milan, Italy, noted the importance and need for preparedness and facilities planning, not only for the treatment of suspected and confirmed cases of COVID-19, but also for the treatment of patients with cancer.
“We need to determine COVID-19 morbidity and mortality according to treatment, be it chemotherapy, targeted therapy or immune-checkpoint blockade.”
Giuseppe Curigliano, European Institute of Oncology IRCCS, Milan, Italy
Closing Remarks
In response to the COVID-19 pandemic, ASCO completely reimagined and reinvented its 2020 Annual Meeting by delivering a successful virtual meeting. This virtual platform still had the aim of achieving an engaging and educational meeting experience for participants from around the world. Delegates were able to view data, clinical experiences, patient perspectives and best practices that will hopefully stimulate new ways of thinking and ultimately translate into optimal patient care within the oncology field.
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