Last month at COTA, we announced a three-year extension of our Research Collaboration Agreement with the FDA, with an immediate focus on using real-world data (RWD) to examine the pandemic’s impact on cancer treatment. This ongoing partnership could not be more timely and urgent.
The pandemic has stalled and derailed our progress against cancer to a devastating degree. I read of one oncologist whose patient had first found a lump in her breast back in March at the start of the pandemic. By the time she ventured in to see him in July, the cancer had progressed to her lymph nodes. Tragically, such heartbreaking stories of delayed screenings and missed treatment windows are echoing through the halls of cancer centers across the world.
The decreased volume of screening tests will have a significant impact on cancer care. For example, breast cancer screenings were down by as much as 89% this year. Because of this, we’re not seeing as much early stage disease detection. More and more patients are either not getting screened or putting it off to a later date, which will result in more patients with advanced cancer when they finally see an oncologist.
The gold standard of cancer care is in using data-backed evidence to determine the best treatment pathways and adhere to them, monitoring for and continuously correcting unwarranted variation. But the pandemic upended that overnight, with valid concerns about higher virus exposure risks for cancer patients throwing time-tested protocols out the window. In the absence of clear data and guidance, many doctors were left to exercise judgment in weighing the risk from delayed treatment against the risk of exposure to the virus.
Thankfully, there are many examples of the healthcare community coming together to combat this crisis, including the Covid-19 Evidence Accelerator, an initiative my company is a part of that was launched by the Reagan-Udall Foundation for the FDA, in collaboration with Friends of Cancer Research. It brings together the country’s leading experts in health data aggregation and analytics to share insights and results and quickly answer questions about Covid-19 treatment and response. During this time, when there is no playbook to rely on, this collaboration allows various stakeholders to establish standards that include input from the FDA and provide the scientific research that will be used to inform regulatory decisions related to Covid-19.
Another notable healthcare advancement resulting from the pandemic is the speed at which new technologies are being adopted. These include contactless check-ins that utilize facial recognition software and thermal technologies that can take the temperature of every person entering the clinic.
Additionally, some providers are integrating telemedicine directly into the EHR. The physician can press a button, and it takes them right to the patient information and telemedicine visit structure where they can enter notes and documentation.
In a recent study conducted by the Covid-19 Healthcare Coalition, nearly 60% of clinicians said they could not access telehealth technology through their EHRs, citing inefficient workflow as a barrier to greater adoption of telemedicine. Nothing can replace an in-person visit, but telemedicine has helped physicians and hospitals in the short term and will continue to play an important role in care delivery after the pandemic.
We can do better — new technologies and real-world data are key to getting us back on track. They can help us better understand the complex interplay of Covid-19 and various forms and stages of cancer. By a retrospective study of pandemic-related treatment variation, we can gain new insights about adherence to or deviation from standard pathways and their impact on patient outcomes. As we learn more about this shape-shifting virus and its impact on cancer treatment, speedy analysis of RWD can help us keep pace and adjust course where needed.
As I write this, the U.S. is nearing 200,000 new coronavirus cases. Hospitalizations have topped 100,000, and we have recorded the highest daily death toll since the pandemic began. Hospital capacity is feeling the strain, with some pausing or pulling back on elective procedures again. The virus is showing no signs of abating, and CDC director Robert Redfield has warned that the winter will be “the most difficult time in the public health history of this nation.” We need to learn how to fight it and fight cancer together.