NCI pivots some research activities to COVID-19 amid ‘unprecedented disruption’
NCI staff have identified opportunities to contribute to the fight against COVID-19 while striving to make sure cancer research continues, one of the agency’s deputy directors said during a presentation at the virtual American Association for Cancer Research Annual Meeting.
“The pandemic has caused an unprecedented disruption across the cancer research community,” Dinah S. Singer, MD, PhD, deputy director for scientific strategy and development at NCI, said during a presentation. “As scientists and human beings, we have an obligation to respond to the crisis to the extent we are able. Despite the pandemic, we continue to make progress in cancer research and patient care, which are still our top priorities.”
NCI has unique research capabilities and capacities that can be brought to bear during the pandemic, Singer said.
“We have responded by pivoting some of our cancer research activities to COVID-19,” she said. “These include clinical trials, epidemiological studies and basic research."
NCI initiated a compassionate use protocol to distribute the immunosuppressant tocilizumab (Actemra, Genentech) to patients with cancer aged 2 years or older who have severe respiratory compromise from presumed or proven COVID-19 infection.
“Based on the reports of cytokine storms associated with COVID-19, the ability of the anti-interleukin-6 antibody to reduce time on ventilators and in the ICU will be studied,” Singer said.
In May, NCI will launch a longitudinal cohort of patients with cancer infected with COVID-19. The study is expected to enroll more than 2,000 patients regardless of age.
Some patients will be followed for more than a year to assess the effect of COVID-19 on survivorship and quality of life. Blood samples will be collected to estimate antibody response and genetic susceptibility, as well as to help develop biomarkers.
“We hope to be able to generate a comprehensive data set of treatments, medications, behaviors and outcomes that will inform our understanding of risks and disease course,” Singer said.
Many NCI-funded centers also are developing novel therapeutic trials for patients with cancer and COVID-19, as well as working to develop antibodies and vaccines against the virus.
Singer praised Vanderbilt Comprehensive Cancer Center “for galvanizing a grassroots effort” to collect clinical data on patients with cancer and COVID-19 infection.
This effort, called the COVID-19 Cancer Consortium, opened March 30. All data collected will be open access.
Singer highlighted the Cellular Immunotherapy Data Resource program, which collects patient metadata associated with cellular therapies. It now is collecting data on COVID-19 infections and COVID-19-related deaths among cellular therapy recipients.
NCI and NCI-funded investigators also have started novel basic and translational studies.
An analysis of patients with COVID-19 is underway to determine if there are genetic predispositions to infection susceptibility or disease severity.
“NCI, in collaboration with the FDA and hospitals in New York City, are collecting serum from patients to test and validate assays for the virus, and for antibodies that are going to be so critical for us going forward,” Singer said.
NCI is undertaking high-throughput screening for small-molecule inhibitors of SARS-CoV-2 proteins, and tissues from patients with COVID-19 are being analyzed using the cyclic immunofluorescence platform funded in part by the National Cancer Moonshot’s Human Tumor Atlas Network.
Despite the response to the COVID-19 pandemic, NCI’s primary mission remains cancer research. Those efforts — basic, translational and clinical — are continuing to the greatest extent possible, Singer said.
“We have seen progress, even since the pandemic started,” Singer said.
Accrual across NCI clinical trials has declined 40%, but some sites are managing to accrue and treat patients who need curative therapy, and NCI has adapted its approaches to providing care.
Local health care providers can provide study activities to ensure continuity of care, with oversight from responsible study investigators. NCI can ship oral investigational new drugs directly to patients, alternative procedures that do not compromise the safety or integrity of the study will be considered minor deviations, and onsite auditing visits are either being rescheduled or performed remotely, Singer said.
“I would urge you to continue your research efforts to the extent possible,” Singer said. “If you are working remotely, as so many of us are, you can analyze data, work on manuscripts, read the literature or take the time to just think — the time we don’t normally have because we’re so busy in the lab.” – by Mark Leiser
Singer DS. NCI activities: COVID-19 and cancer research. Presented at: AACR Annual Meeting; April 27-28, 2020 (virtual meeting).
Disclosure: Singer reports no relevant financial disclosures.