COMMENTARY

New Study Supports Treating Cancer Now

David J. Kerr, CBE, MD, DSc, FRCP, FMedSci

Disclosures

July 01, 2020

Find the latest COVID-19 news and guidance in Medscape's  Coronavirus Resource Center .

This transcript has been edited for clarity.

Hello. I am David Kerr, professor of cancer medicine at University of Oxford, England, and intrepid reporter from the frontline of my kitchen table.

Still in lockdown, we're conducting our clinics in this peculiar time from home, but it works rather well. Patients like it, as it saves them a long trip to the hospital, taking hours out of their own lives to be seen by me for 15-20 minutes. So far, so good. A huge credit goes to our wonderful chemotherapy nurses and junior doctors who continue to deliver care from the hospital. For us relative oldies, we're also managing to control, deliver, and provide a very decent cancer service. As I mentioned before, we modified our approach in terms of the intensity of chemotherapy, waiting times, and so on. And so far, so good for this, too. (I'm touching wood as I say that.)

I would like to talk about a recently published prospective cohort study in The Lancet from some of my colleagues in Oxford and Birmingham, England, that looked at cancer patients with symptomatic COVID-19. Investigators analyzed data from around 800 patients across multiple hospitals in the United Kingdom. The death rate was 28%, I'm sorry to say. But when they conducted their various multivariate analyses, they found that the factors that were important determinants in terms of mortality were age (older people), gender (with men still faring much worse), and underpinning comorbidities.

Most important of all, the data echo data that have been published elsewhere, concerning the general picture of COVID-19. In terms of our cancer patients, though, the analysis found no association at all between the risk for death and receiving chemotherapy or immunotherapy.

When COVID-19 first started, this was one of the big unknowns, understanding whether by giving chemotherapy to our patients we would be having a major negative impact on mortality. That seems not to be the case. I believe this strengthens the approach that we took with our guidelines; that is to say, we're not going to stop treatment, but we're going to modify and continue it. We're going to keep calm and carry on.

It will be interesting to see whether there are any disease-associated differences. My guess is that when we compare patients with solid tumors and patients with hematologic cancers, those with hematologic cancers will have worse outcomes. They haven't yet analyzed that data, so this is just a prediction because we hit patients with hematologic cancers harder in terms of bone marrow reserve and in terms of using alkylating agents, agents that are known to deplete lymphocytes in particular.

Please leave any comments you'd like to make about this study. Will it give you more confidence to deliver cancer care in the time of COVID-19? I hope it will. Thanks for listening.

David J. Kerr, MD, is a professor of cancer medicine at the University of Oxford. He is recognized internationally for his work in the research and treatment of colorectal cancer, and has founded three university spin-out companies: COBRA Therapeutics, Celleron Therapeutics, and Oxford Cancer Biomarkers. In 2002, he was appointed Commander of the British Empire by Queen Elizabeth.

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