Study seeks to better understand how COVID-19 and cancer intersect

Researchers at MUSC Hollings Cancer Center have joined a nationwide study to look at the long-term outcomes of cancer patients who have been diagnosed with COVID-19.

The study, which is led by the National Cancer Institute (NCI) and involves the participation of cancer centers across the country, hopes to answer critical questions about how the two diseases intersect, including how often COVID-19 is diagnosed in people with cancer, how COVID-19 impacts cancer treatments and whether the risk of serious illness from COVID-19 is higher in certain cancer subtypes.

While evidence suggests that people who are undergoing cancer treatment are likely at a higher risk of developing a more severe form of COVID-19, little is known about the factors that may make certain patients more prone to COVID-19 infection or how the disease impacts cancer outcomes after a patient has recovered.

According to David Cachia, M.D., a neuro-oncologist at Hollings and the principal investigator for Hollings’ portion of the study, the data being collected will help providers make more informed decisions regarding cancer care for these patients in the future.

“This is a quickly evolving field, and not just when it comes to cancer patients. But specifically, in this population, we have limited data,” said Cachia. “The only way we’ll be able to better manage these patients and determine whether we need to make changes to our current protocols is if we collect this information and understand it better.”

The study, which is known as the NCI COVID-19 in Cancer Patients Study (NCCAPS), is a natural history study, meaning it doesn’t involve any specific treatment procedures and is based on observation. Researchers will simply collect medical records, scans and blood samples and ask participants questions about their symptoms, then follow them for up to two years to study their outcomes over time.

Patients can be enrolled and seen via telemedicine to minimize risks associated with traveling to and from Hollings, and blood will be collected during draws that were already scheduled as a part of their cancer care to reduce their burden.

The study is enrolling patients of all ages, including children, across all cancer subtypes. To be eligible, adult participants must have had a positive COVID-19 test within 14 days of enrollment and must be receiving treatment for their cancer, whether that be chemotherapy, targeted therapy, immunotherapy and/or radiation.

Other questions the study hopes to help answer include:

• Does COVID-19 affect how cancer grows or spreads?
• Does cancer treatment affect a person’s ability to fight off COVID-19?
• Are there genetic or immune-related biomarkers associated with severe symptoms or death from COVID-19?
• Are cancer treatments being delayed when patients are diagnosed with COVID-19, and if so, how do these delays impact outcomes?

The nationwide goal is to enroll 2,000 patients of diverse backgrounds based on age, sex, race, ethnicity, diagnosis and location to be able to better generalize the results to all cancer patients. That’s one of the benefits of collaborating with the NCI and a wide range of health centers, said Cachia.

“We realized many years ago that doing things by yourself is not going to lead to gathering as much information as possible,” said Cachia. “Collaborating and networking with other institutions allows us to gather more information more quickly, enabling us to come to conclusions much faster and more efficiently than if any institution did this by itself.”

Outside of the NCCAPS study, Hollings is also participating in the COVID-19 and Cancer Consortium (CCC19), which is an international project designed to collect and disseminate data about people with cancer who have been diagnosed with COVID-19 as quickly as possible. Initial data released through the consortium’s research on May 28 showed a higher risk of infection among cancer patients when compared with the general population and revealed cancer-specific factors associated with increased mortality.

As researchers gather more information on how best to treat people with both cancer and COVID-19, Cachia recommends that cancer patients who receive a positive COVID-19 test result consult with their oncologist to determine next steps based on their treatment type and the severity of their disease. He also suggests patients reach out to their oncologist once they receive notification that they’re eligible for a COVID-19 vaccine to confirm whether they should proceed with vaccination and to determine the best time to receive it in relation to their oncological treatment.

Because neither of the vaccines (Pfizer and Moderna) that are currently authorized for use in the U.S. were tested in patients undergoing cancer treatment, it’s important to discuss the benefits and risks of vaccination to make an informed decision.

Vaccines aside, Cachia encourages cancer patients to continue following the general safety guidelines set forth for the rest of the population, including social distancing, hand hygiene, wearing a mask and avoiding large gatherings. These precautions are especially important for cancer patients, who are more susceptible to infections in general.

“Avoiding infection with COVID-19 is something that’s on everyone’s mind, especially with the introduction of vaccines that will hopefully help to change the landscape over the coming months as we’re able to vaccinate more people,” said Cachia. “The recommendations are the same for everyone, but cancer patients have to be especially careful about trying to minimize their risk of infection as much as possible.”

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This research is supported by the NCI (grant UG1CA189848).

Founded in 1824 in Charleston, MUSC is the oldest medical school in the South, as well as the state’s only integrated, academic health sciences center with a unique charge to serve the state through education, research and patient care. Each year, MUSC educates and trains more than 3,000 students and nearly 800 residents in six colleges: Dental Medicine, Graduate Studies, Health Professions, Medicine, Nursing and Pharmacy. The state’s leader in obtaining biomedical research funds, in fiscal year 2019, MUSC set a new high, bringing in more than $284 million. For information on academic programs, visit musc.edu.

As the clinical health system of the Medical University of South Carolina, MUSC Health is dedicated to delivering the highest quality patient care available, while training generations of competent, compassionate health care providers to serve the people of South Carolina and beyond. Comprising some 1,600 beds, more than 100 outreach sites, the MUSC College of Medicine, the physicians’ practice plan, and nearly 275 telehealth locations, MUSC Health owns and operates eight hospitals situated in Charleston, Chester, Florence, Lancaster and Marion counties. In 2019, for the fifth consecutive year, U.S. News & World Report named MUSC Health the No. 1 hospital in South Carolina. To learn more about clinical patient services, visit muschealth.org.

MUSC and its affiliates have collective annual budgets of $3.2 billion. The more than 17,000 MUSC team members include world-class faculty, physicians, specialty providers and scientists who deliver groundbreaking education, research, technology and patient care.

MUSC Hollings Cancer Center is a National Cancer Institute-designated cancer center and the largest academic-based cancer research program in South Carolina. The cancer center comprises more than 100 faculty cancer scientists and 20 academic departments. It has an annual research funding portfolio of more than $44 million and a dedication to reducing the cancer burden in South Carolina. Hollings offers state-of-the-art diagnostic capabilities, therapies and surgical techniques within multidisciplinary clinics that include surgeons, medical oncologists, radiation therapists, radiologists, pathologists, psychologists and other specialists equipped for the full range of cancer care, including more than 200 clinical trials. For more information, visit hollingscancercenter.musc.edu.