COVID-19 and Lung Cancer: What We Know and Don’t Know

Impact of COVID-19 on Lung Cancer Screening

Another key topic covered in Dr Hirsch’s review is the reduction in lung cancer screening related to the pandemic.⁵ Most centers in the United States have experienced at least some disruption to regular screening, but the knock-on effects of this disruption are unknown. 

“COVID-19 has had an impact on lung cancer screening,” Dr Hirsch said. “But we don’t yet know what that means for the future. Are patients going to be diagnosed with more advanced disease?” 

A UK study suggested there will be a 4.8% to 5.3% increase in lung cancer deaths in the next 5 years, largely due to reduced access to regular screening causing later diagnoses.⁷

Anecdotal reports of late diagnoses have been seen already, but it will take time to assess quite how widespread this problem is. 

Dr Sands described seeing a case of delayed diagnosis recently. The patient underwent yearly lung screening before the pandemic but was not screened in 2020. Now, the patient has stage 4 lung cancer. 

“It is likely that that would have been diagnosed earlier, and we would be discussing curative intent with his treatment,” Dr Sands said. “Instead, we were discussing how to control the disease for as long as possible.” 

Impact of COVID-19 on Clinical Trials

Dr Hirsch’s review cited several sources showing that clinical trial accrual declined as a result of the pandemic.⁵ One study suggested that trial enrollment in May 2020 was 74% of what it was the year before. 

Other data showed that, between March and May 2020, the number of patients enrolled in Alliance for Clinical Trials in Oncology studies decreased more than 50%. Enrollment did return to baseline levels in fall 2020, however.

Global enrollment in lung cancer trials declined 43% from 2019 to 2020, according to data presented at the IASLC 2021 World Conference on Lung Cancer.²

Dr Sands noted that Dana-Farber did not see a slow-down in trial enrollment due to COVID-19, “but most centers don’t have the infrastructure that we do, so this really impacted the majority of centers throughout the country.” 

Disclosures: Dr Hirsch disclosed affiliations with Amgen, AstraZeneca, Bristol-Myers Squibb, Daiichi-Sankyo, Genentech/Roche, Merck, Novartis, OncoCyte, Pfizer, Regeneron, Sanofi, and GLG. Dr Sands disclosed affiliations with AstraZeneca, Daiichi-Sankyo, Boehringer Ingelheim, Medtronic, Takeda, Jazz Pharmaceuticals, Blueprint Medicines, and Lilly.

References

1. Rodriguez T. Impact of COVID-19 on new cancer diagnoses. Cancer Therapy Advisor. Published December 15, 2021. Accessed January 6, 2022.

2. Goodman J. Global impact of COVID-19 on enrollment in lung cancer trials. Cancer Therapy Advisor. Published September 28, 2021. Accessed January 6, 2022.

3. Goodman J. Lung cancer patients have lower antibody response to COVID-19 vaccination. Cancer Therapy Advisor. Published September 14, 2021. Accessed January 6, 2022.

4. Stong C. COVID-19 vaccine boosters appear effective in patients with thoracic cancer. Cancer Therapy Advisor. Published November 30, 2021. Accessed January 6, 2022.

5. Rolfo C, Meshulami N, Russo A, et al. Lung cancer and severe acute respiratory syndrome coronavirus 2 infection: Identifying important knowledge gaps for investigation. J Thorac Oncol. Published online November 10, 2021. doi:10.1016/j.jtho.2021.11.001

6. Researchers study COVID-19 antibody response in lung cancer. Patient Power. Published November 23, 2020. Accessed January 6, 2022. 

7. Maringe C, Spicer J, Morris M, et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: A national, population-based, modelling study. Lancet Oncol. 2020;21(8):1023-1034. doi:10.1016/S1470-2045(20)30388-0

This article originally appeared on Cancer Therapy Advisor