The COVID-19 crisis has far-reaching implications for investigators and other individuals working in clinical research settings. This was the focus of an important discussion by a panel of experts who explored the detrimental effect of the pandemic on the career development of research students, potential changes in the availability and accessibility of clinical trials, and the anticipated shortfall of funding for research in the future. The session was moderated by Rob Butcher, CEO, Swim Across America, a charity that raises money for cancer research and funds 57 laboratories around the country.
Jedd Wolchok, MD, PhD, FASCO, Chief, Immuno-Oncology, Memorial Sloan Kettering Cancer Center, who supervises an National Institutes of Health–funded Swim Across America Lab at MSK opened the discussion with an assessment on how professional life in New York City has been affected by COVID-19.
“For the first time in the 23 years that I have been part of the Swim Across America Lab at Memorial Sloan Kettering Cancer Center, we actually had to essentially shut down the lab,” said Dr Wolchok. Although the lab is very slowly being reopened, the pandemic has had a wide-ranging impact, especially on graduate students, many of whom had to leave New York City for a period. “For our youngest generation of scientists, this has been a very significant event,” he said.
Julie Saba, MD, PhD, Professor of Pediatrics, UCSF, agreed, saying that she is concerned about the graduate students in the very earliest stages of their career development who represent the next generation of cancer biologists. “I’m worried about how they are being affected by the disruption of the last couple of months…but also by the kind of conditions under which research is going to be resumed and reestablished,” she said.
“Make no mistake about it, the pandemic is having, and will continue to have for the foreseeable future, a significant impact,” said Richard Schilsky, MD, FACP, FSCT, FASCO, Senior Vice President, Chief Medical Officer, American Society of Clinical Oncology. Enrollment in national clinical trials are down, and “many institutions have shut down their entire clinical trial portfolio or large portions of it.” These factors will slow down the completion of many clinical trials and “some may never resume.”
Dr Schilsky added that the disruptions will add to the complexity of evaluating outcomes, necessitating that researchers do not introduce bias into the interpretation of time to progression in trials.
Maurie Markman, MD, President, Medicine & Science, Cancer Treatment Centers of America, introduced the idea that the pandemic crisis may require systemic changes to current practices that “transform how clinical research is done in the United States.”
Tom Lynch, MD, CEO & President, Fred Hutchinson Cancer Research Center, also spoke to the many challenges in conducting long-term research trials and how the virus has added additional pressure. He said that these pressures have “caused us to look differently at how we get things done.”
“Zoom calls and working remotely have been effective for faculty who are writing grants and analyzing data,” he said, adding that the inability to meet in person and losing the personal connection with co-workers has been difficult.
“We’ve gone from a system of face-to-face healthcare in cancer to one that undermines that, called ‘social distancing,’” said Craig Eagle, MD, VP, Medical Affairs Oncology, Genentech. However, he added, the “current system of face-to-face healthcare imposes its own limits.”
With the expansion of telemedicine, the way may be opened to more diverse inclusion in clinical trials of patients who, in Dr Eagle’s words, “truly reflect the disease.”