The pausing of almost all clinical research trials in Scotland in response to COVID-19 has removed treatment options for many people living with cancer, a report to MSPs and charities has found.
A report to the Scottish Parliament’s Cross Party Group on Cancer, which meets online today, has also highlighted a 95% drop* in new patients entering clinical trials, which has left people with cancer with fewer options for treatment. Coronavirus has also delayed research into drugs that could potentially be effective in the future.
Cancer Research UK is now urging Scotland’s health service providers and the Scottish Government to move swiftly to get existing clinical trials for cancer restarted as quickly as possible.
To ensure patients can participate in clinical trials safely, the charity says Scottish Government must ramp up COVID-19 testing so people with cancer can be treated in safe spaces where the risk of exposure to the virus is minimised.
Marion O’Neill, Cancer Research UK’s head of external affairs in Scotland, said: “Cancer hasn’t stopped because of the pandemic and it’s essential that clinical trials are restarted urgently.
“The Scottish Government has acknowledged that restarting cancer care is a priority. This urgency must now be extended to clinical trials and research.
“For those living with a cancer diagnosis now, the pause to trials has had a catastrophic and heart-breaking impact by removing access to final treatment options. For those diagnosed with cancer in the future, clinical trials are key to helping us understand more about this devastating disease and improving the range of treatments available.
“The Scottish Government and health boards, together with NHS Research Scotland, needs to move fast to get existing cancer clinical trials that provide a lifeline to patients and their families restarted.
“The guidance that’s been developed by NHS Research Scotland on the restart of trials is welcome. But, as hospitals look to resume trials, we’re concerned that cancer trials may not be given high enough priority.”**
The Cross Party Group on Cancer will discuss the findings of the report which also scrutinises the impact of the pandemic on cancer diagnosis, treatment and care.
At the meeting, CPG co convenors Anas Sarwar MSP and Miles Briggs MSP will be joined by Health Secretary Jeanne Freeman, along with representatives from charities and other interested parties.
As well as the pause to existing trials, Cancer Research UK has voiced concerns about the impact of COVID-19 on the future of cancer research. The charity announced last week it could be forced to cut £150m a year from its research funding as the pandemic decimates its income.
Cancer Research UK working alongside the Association of Medical Research Charities, which represents over 150 medical research charities, is urgently asking the UK Government to work with them to develop a solution that will bridge the funding gap. The sector funds hundreds of clinical trials testing new treatments for people diagnosed with cancer. Cancer Research UK is concerned that funding cuts means fewer new trials will start.
The charity is now preparing for a 30% fall in income in the 2020/21 financial year, with further losses the following year, following temporary closures of its shops and major fundraising events being cancelled during the COVID-19 crisis. Coupled with an uncertain economic environment, this means even more difficult decisions about where further cuts to its life saving research will need to be made.
The UK Government has provided £750 million in support for charities in response to the COVID-19 pandemic. However, Cancer Research UK, like other medical research charities, is not eligible for this funding.***
Marion O’Neill added: “Cancer research and clinical trials offer a life-line to patients.
“Cancer Research UK’s work benefits patients everywhere. We also support thousands of scientists and world-leading research initiatives in all parts of the UK, all with the aim to improve the lives of people with cancer.
“We’re doing everything in our power to continue our mission to find better cancer treatments and beat the disease. But without further support, our life-saving cancer research will be set back for years to come.”
Around 32,200 people are diagnosed with cancer every year in Scotland****.
Professor Charlie Gourley is Clinical Director at the Cancer Research UK Edinburgh Centre. He leads a portfolio of clinical trials testing new treatments for ovarian cancer. All but one of these trials were paused due to the coronavirus pandemic. As restrictions have started to lift, he and his team have been able to restart a second clinical trial and plans are underway to restart a third soon.
Professor Gourley said: “Clinical trials are such an important part of our armoury. For some of our patients with ovarian cancer, it’s the last option for them. So many trials are successful now that the pause has taken away hope for some patients when they know that they would be offered a trial under normal circumstances but, because of coronavirus, trials have been closed to new patients. This has been incredibly hard for patients.
“We are getting clinical trials back up and running now, which is great. It gives another option for some people with cancer who are desperate and gives them hope. But the restart is only being ramped up slowly so we’re still way below our usual research activity.”
He continued: “We’re all very concerned about the impact that coronavirus is going to have on funding for trials going forward. A lot of our clinical trials are funded by Cancer Research UK and the charity’s income has been heavily impacted by the pandemic. We’re very concerned about what the impact will be on funding for the infrastructure we need to support new clinical trials.”
*Medidata’s international comparison data showed 95% fewer new patients were entering UK clinical trials in April 2020 compared to April 2019.
**On May 27th, Chief Scientist Office (CSO) published its statement on the framework for restarting research paused due to the COVID-19 pandemic. The CSO has also established a NHS Research Scotland Operational Restart Group whose objective is to share best practice and support development of operational processes and guidance to support the resumption of non-COVID research activity. Cancer Research UK welcomed this development.
*** While Cancer Research UK has tried to mitigate the fall in income by furloughing 60% of staff through the Government’s Job Retention Scheme. Staff who are not accessing this support have been moved to 80% hours and pay from May. However, this has not been enough to offset the drop in fundraising income.
In April 2020, Cancer Research UK had to make a difficult decision to cut £44 million funding across its research portfolio because of the pandemic. The re-evaluation of the charity’s financial position now raises the potential impact to £150 million of funding cuts per year while the charity recovers.
**** Based on the average annual number of new cases of cancer (ICD10 C00-C97 excluding non-melanoma skin cancer) diagnosed in Scotland between 2014-2016.
The Cross Party Group on Cancer involves 76 member organisations and individuals from across cancer research, treatment, care and prevention, as well as a number of cancer patient representatives. The group aims to look at key issues in cancer care in Scotland by bringing together the cancer community.