The Impact of COVID-19 on Oncology Clinical Trials
Since the beginning of the COVID-19 pandemic in early 2020, the diagnosis, treatment and surveillance of cancer has been transformed globally. The heavy demand for resources, exacerbated by limited excess health system capacity, means that health care systems have become quickly overwhelmed and hospitals have become sources for virus transmission.
Furthermore, a severe COVID-19 phenotype is seen more commonly in men and older, more comorbid patients.
1 Indeed, this is the same comorbidity profile common for many patients with genitourinary malignancies. The need for repeated in-person interactions has hampered the ongoing accrual and conduct of prospective research during the COVID-19 pandemic. In many regions, accrual to prospective studies has entirely stopped as a result of the pandemic. In jurisdictions which are particularly hard hit, many research personnel and research-related resources have been re-directed and re-deploy
SUO 2020: New Paradigms in NMIBC: The Evolving Role of Checkpoint Inhibition
(UroToday.com) The Society of Urologic Oncology (SUO) 2020 virtual meeting featured a session examining the new and emerging agents in bladder cancer chaired by Dr. Neal Shore, which included a presentation by Dr. Ashish Kamat discussing the evolving role of checkpoint inhibition in nonmuscle-invasive bladder cancer (NMIBC).
Dr. Kamat notes that Bacillus Calmette Guerin (BCG) is the original cancer immunotherapy with urologists administering approximately 1.2 million doses of BCG for bladder cancer. However, there are BCG failures, with ~30% failing at 1 year, and ~40% failing at 2-3 years after induction therapy. Classification of BCG failure is as follows:
GSRGT 2020: The Global Voice of Penile Cancer Research: The International Registry
(UroToday.com) The Global Society of Rare Genitourinary Tumors (GSRGT) 2020 Virtual Summit included an update on the international registry for penile cancer provided by Dr. Marco Bandini from San Raffaele Hospital in Milan, Italy. According to Dr. Bandini, there are several important questions under consideration, including:
Is penile cancer research moving along with the incidence of the disease?
Are there countries with remarkable numbers of patients with penile cancer adequately involved in multi-institutional studies?
Are there open randomized clinical trials in areas where the incidence of the disease is maximal?
GSRGT 2020: Evolution of Systemic Therapies and the Landscape of Clinical Trials Enrolling Patients
(UroToday.com) To discuss the evolution of systemic therapies and the landscape of clinical trials among patients with penile cancer, Dr. Philippe Spiess, the co-Course Director of the Global Society of Rare Genitourinary Tumors (GSRGT) 2020 Virtual Summit, invited Dr. Jad Chahoud, his colleague from the Moffitt Cancer Center.
Dr. Chahoud started by highlighting that penile cancer is a rare disease in the US, representing 0.7% of all cancer, with high-risk HPV responsible for ~50% of all penile squamous cell carcinoma. The majority of these patients will present with localized or locally advanced disease whereby platinum-based combination chemotherapy remains the front-line therapy. The InPACT trial is actively enrolling patients to determine the frontline therapy for locally advanced penile cancer, given there have been limited treatment advancements in the last decade. Survival
GSRGT 2020: The Need for Perioperative Management Strategies: Role of Clinical Oncologists - Chemotherapy
(UroToday.com) The penile cancer session at the Global Society of Rare Genitourinary Tumors (GSRGT) 2020 Virtual Summit included a discussion for the role of chemotherapy in the perioperative management of patients with penile cancer by Dr. Guru Sonpavde from the Dana-Farber Cancer Institute. Dr. Sonpavde notes that surgery alone for patients with locally advanced disease is associated with high-risk of recurrence, both locoregionally and distant, with 5-year overall survival (OS) rates of 0-42%. Particularly bad predictors include bulky inguinal adenopathy of ≥ 4cm, bilateral nodes, pelvic lymphadenopathy (N3 disease), an unresectable primary tumor (T4), and extranodal extension.