Cancer in a time of COVID 鈥� keeping vital research and treatment on track

4 February 2021

To mark World Cancer Day, we asked our scientists about how 果冻影院 has been able to continue vital cancer research throughout the pandemic. Cancer Institute Director, Tariq Enver, and clinician scientists, Adele Fielding and Gert Attard, share their thoughts

"We mustn鈥檛 give up on cancer 鈥� it certainly hasn鈥檛 given up on us," says Tariq Enver, Professor of Stem Cell Biology and Director of the 果冻影院听Cancer Institute.

Facing unprecedented disruption to funding streams, material resources and clinical capability, simply keeping the Paul O鈥橤orman Building 鈥� main site of the Institute 鈥� operational throughout the Covid-19 pandemic was far from easy. But doing so demonstrates 果冻影院鈥檚 commitment to patients, and the world-leading and unique cancer research capacity that will impact so many of their lives.

In partnership with Cancer Research UK, the Institute is home to one of the largest cancer trials centres in the UK. Its critical role in tackling such a profound health issue makes it unthinkable that its work should stop for a year or longer.

Supporting cancer patients

鈥淭hrough 果冻影院 Partners, we support around eight million patients, in a mixed area of London with immense under-privilege. We had to keep going so that patients could continue to receive the best and most advanced care, and so that we wouldn鈥檛 be starting from zero after the pandemic recedes. Cancer itself remains an ongoing pandemic 鈥� we cannot afford to slow down,鈥澨齈rofessor Enver adds.

Professor Enver鈥檚 words are borne out of projections 鈥� released by 果冻影院 at the outset of the first lockdown 鈥� which suggest that there could be an additional 18,000 cancer deaths in England attributable to the effects of coronavirus.

In response to such a stark outlook, researchers quickly adapted long-established ways of working so tasks such as computational research could be achieved from their homes. However, lab-based work had to take place at the Institute. With low occupancy strictly enforced in order to ensure social distancing, those on-site were able to maintain remarkable levels of productivity.

Continuing clinical trials

Urological cancer specialist Professor Gert Attard leads one of the teams that has kept its vital work going under national restrictions. His research into prostate cancer has identified a 鈥榝ingerprint鈥� in the blood that provides an early signal that the disease is active and spreading, meaning doctors can assess how advanced a person鈥檚 cancer is and determine the best course of action.

Knowing how important the work is to clinical trial participants, he and his team were determined to continue processing the donated samples which would otherwise have been disposed of.

鈥淪amples come to us from across the country,鈥� Professor Attard says. 鈥淭he flexibility and support of 果冻影院 made it safe and feasible for lab work to be done, and we kept going thanks to the extreme dedication of staff, who recognised patients鈥� wishes to be on the trial and didn鈥檛 want to waste their samples.What we managed was small compared to what we normally do, but it was important nonetheless.鈥�

Professor Adele Fielding, one of the leads for the UK鈥檚 clinical trials programme for acute lymphoblastic leukaemia, agrees that finding a way to continue was the right course of action.

Her lab receives specimens from across the UK for patient-specific tests to detect minimal residual disease 鈥� small numbers of leukaemia cells that remain in a person during or after treatment. Each test is unique to an individual鈥檚 tumour, and closing the lab would mean adult patients whose sample had been lodged with 果冻影院 would not get access to testing.

鈥淲e were driven by the realisation that, if our work stopped, there was no chance that these patients could be helped,鈥� she says.

Working through a series of lockdowns is complex. The team needs to manage access to buildings when the majority of the campus is closed and ensure the safety of its personnel in the lab 鈥� but also to access reagents amidst a huge surge in global demand owing to COVID-19 testing programmes. As a result, one member of the lab was re-assigned to purchasing supplies on a full-time basis.

鈥淚t didn鈥檛 reduce the level of specimen testing we are able to do, but it was much more work to do it,鈥� Professor Fielding says. 鈥淒espite the challenges, it is an absolute pleasure and gives the team an additional sense of purpose during a terrible time. I鈥檓 very proud of the lab for pulling together so effectively.鈥�

Tackling听Covid-19 through research innovation

As well as keeping its research up and running, the Cancer Institute has also found new ways to support 果冻影院鈥檚 rapid contribution to the broader national effort against COVID-19 through testing and research; for example, tackling the issue of blood clotting that some coronavirus patients experience.

鈥淲e鈥檙e good at looking at blood,鈥� says Professor Enver. 鈥淪o we were able to apply our blood cancer expertise to one of the main effects of serious infection that made so many patients go on ventilation. Thanks to a state-of-the-art cell sorter 鈥� acquired through a philanthropic donation 鈥� we were able to work out why the immune system is causing these big problems.鈥�

The Institute also diverted its antibody engineering expertise to COVID-19 research, drawing on two decades of innovation in developing antibodies to fight cancer. By creating a unique 鈥榗ocktail鈥� of recombinant antibodies, this treatment could block the virus from entering cells and remove it from circulation 鈥� vitally important for cancer patients, who are often more vulnerable to COVID-19.

But whilst utilising its considerable knowledge to tackle the virus, 果冻影院 scientists have听been proactive in raising awareness of how cancer research and treatment has been affected by lockdowns and the focus on COVID-19. 果冻影院 published its first analysis in April showing that the UK could see at least 20% more deaths over the following 12 months in people newly diagnosed 鈥� finding a 76% decrease in urgent referrals and a 60% decrease in chemotherapy appointments.

鈥淥f course it is right to tackle COVID but cancer remains a major issue and the impact on patients will become evident over the next year,鈥� says Professor Attard. 鈥淲e鈥檙e in the process of rebuilding to get back to where we were and get momentum going again, but the reality is that research has been put back by months and patients have been hit badly by not being able to access their normal treatment.鈥�

In addition, diminished funding for cancer research听is a particular and urgent source of concern. Clinical trials are funded for a particular period, Professor Attard explains. 鈥淪o when something stops for five months, where do you get that time back? Funders don鈥檛 have five months of extra funding to add on.鈥�

鈥淚t鈥檚 a desperate situation,鈥� says Professor Adele Fielding. 鈥淐harities are a huge mainstay of cancer research funding and the continuation of basic research relies on them. The impact will be felt everywhere, from research and clinical trials to training. 鈥淭here could be long-term implications for this country鈥檚 life-saving research and translation capacity.鈥�

Professor Enver shares his colleagues鈥� deep concern. However, he is determined not to lose the extraordinary momentum the Institute and the wider 果冻影院 community has听built up prior to the pandemic.

鈥淣ow more than ever we need to keep this amazing show on the road,鈥� he says. 鈥淲e can move quickly for as long as we have the funding to do so. We are not giving up on cancer patients and we won鈥檛 let them be forgotten. Our vision and commitment hasn鈥檛 lessened; we are still researching, still treating, still striving.鈥�

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