Cancer doesn’t stop. From Chicago the answers for the post Covid


The curtain closes on the first virtual edition of the most important oncology congress in the world, that of the American Society of Clinical Oncology (Asco). The Covid-19 emergency has transformed the convention center which hosts tens of thousands of doctors and health professionals every year into a hospital, but it has not stopped the research and determination of the international community of oncologists who meet every year at the McCormick Center in discuss the future of the fight against cancer, as pointed out Howard A. “Skip” Burris III, outgoing president of the Company. “When I chose the theme for the conference months ago -” Unite and Conquer: Accelerating Progress Together “- I never thought the meaning could be so different today,” said the president during the Opening Lecture on Saturday. “Today the need to be united and accelerate progress together is even more urgent and evident. “Our interview starts right here.President Burris, can the pandemic be a setback for clinical research?
“We are very concerned about the impact that the epidemic has had on cancer research: we conducted a survey that revealed that 60% of research programs had to stop screening or enrolling in some clinical trials and that patients involved in the studies are less likely or more difficult to contact the staff for help. Obviously our first concern is to preserve the safety and health of patients; a difficult task given the limited evidence that we still have on the impact that Covid-19 has on cancer patients, limited notions that do not allow us to give specific guidelines on treatment and management of patients “.

However, Asco has published recommendations in recent months, what is it?
“When the new coronavirus was proclaimed a pandemic, we publicly acknowledged the absence of the data needed to make decisions based on the evidence. As a result, we asked our Ethics Committee to develop new recommendations, published in the Journal of Clinical Oncology, on the basis of which we can make difficult decisions about the allocation of resources during the pandemic. “The pandemic is still running its course and we are likely to witness a new wave in the fall. How can we protect cancer patients?
“For cancer patients, the impact of Covid-19 has been particularly severe, regardless of whether they have come into contact with the virus. They are typically elderly, often with other diseases, and their immune systems are weakened by the disease or several treatments they undergo. The best protective measure for these people is not to meet the virus: staying at home, avoiding unnecessary travel, washing your hands often and not having contact with those who are infected are the prevention measures. Unfortunately the pandemic has many oncologists have been forced to delay or modify treatment plans to reduce the risk of patient infection and we do not know what impact these changes will have on patients. We are also very concerned about the delays in screening and diagnosis that we have recorded in recent months that could increase the risks of diagnosing the disease already at an advanced stage or of recurrence “.

Uncertainties that research can help solve. A very active research, as demonstrated by the more than 2200 presentations recorded at the congress despite the online mode. What were the main news on the clinical practice front?
“The mission of ASCO is more important today than ever, which is why we have not stopped and we have decided to communicate the main innovations in cancer research worldwide oncology community in a virtual format. The main innovations on the treatment front concern immunotherapy and target therapy in lung, colorectal, ovarian and bladder cancers. We then brought important data on access to care and the impact of Covid-19 on cancer patients. too early to change treatments on the basis of these data, the studies presented give us fundamental indications on the risk factors for our patients and indicate the need to continue with the research. A study then showed that video conferences between patients and caregivers, especially in a period like the one we are experiencing, are a useful tool for alleviating anxiety and stress.
As regards lung cancer, on the one hand it has been shown that in patients who have a specific mutation and suffer from non-small cell tumor, the targeted therapy used after surgery increases disease-free time; on the other, a new study has shown that quitting smoking always gives an advantage even when you decide to do it a few months before receiving a lung cancer diagnosis. ”

Immunotherapy and target therapy are the great promises – in part already a reality – of the oncology of the future. Should alternative approaches be considered or can they be combined?
“Immunotherapy and target therapies can already be combined today in specific settings and for some types of cancer, for example in kidney cancer. However, research and clinical studies are still needed to understand if it is better to combine rather than to administer these two sequentially drug classes, as well as understanding which doses and modalities are most effective. ”

What prospects does the agnostic approach open? For which tumors can we think of finding therapies in this way?
“The agnostic approach will soon become the standard in oncology. The identification of some mutations – among others NTrk, Ros, Ret, Alk, Kras – will increasingly guide the therapeutic choice. Starting from metastatic, recurrent or recurrent cancers for which is increasingly possible to have the molecular profile “.

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