The Covid-19 pandemic has severely impacted healthcare in the U.S., and for people living with cancer, it poses a unique set of challenges. Among the most urgent has been diminished access to critical biomarker tests that can inform and guide treatment decisions for patients.
Despite extraordinary advancements in precision medicine that have helped reduce cancer mortality over the past 25 years,i the pandemic has deferred early detection, workup, treatment, and biomarker testing efforts and disrupted initiatives aimed at expanding access to targeted therapies that can improve patient outcomes.
Today community care has an elevated role to play in directly supporting both patients and practitioners working to navigate interrupted access pathways to care, which are critical to testing and treatment.
The pandemic’s impact on precision medicine has been profound
Covid-19 may stall the progress made in reducing cancer deaths, with experts growing deeply concerned about access to potentially lifesaving biomarker tests and innovative, targeted therapies.
“We know cancer patients and oncologists alike are facing immense challenges from the coronavirus pandemic, and it’s regrettable that many patients will likely experience worsened outcomes as a result,” said Debra Patt, M.D., Executive Vice President of Public Policy and Strategic Initiatives at Texas Oncology and a nationally renowned leader and educator in oncology.
Patients have understandably been reluctant or simply unable to seek out routine primary and specialty care that often includes vital preventative cancer screenings like mammograms and colonoscopies — extending the time patients are evaluated and potentially diagnosed and treated for cancer. The natural consequence from the absence of screening and symptom neglect is that patients with more advanced cancers often require more invasive therapies, and are at greater risk of death from their disease.
Further, patients diagnosed with cancer and receiving certain cancer treatments have a higher risk for infections that can be more serious. In today’s environment, patients often have to be tested for Covid-19 before they can visit a hospital or treatment center. This safety measure may have downstream effects including potentially delaying existing pathways to biomarker testing to inform treatment decisions.
“People with cancer are vulnerable to more serious complications from the coronavirus because of their tumors and treatments, which for them, means severity of infections can escalate, very quickly,” said Dr. Patt. “And since patient data helps informs how we treat cancer, ensuring safe access to biomarker testing is critically important so oncologists can treat their patients using the latest targeted therapies and offer them the most personalized cancer care.”
Seth Feldman, Head of U.S. Oncology Precision Medicine & Nurse Education at AstraZeneca, agrees. “This unprecedented situation has led to an alarming reduction in health care providers’ ability to gather vital patient data from biomarker testing, which is often a prerequisite for determining the right course of therapy for patients with many of the most commonly occurring cancers.”
Given the above impediments to quality care, improving access to biomarker testing, especially among patients with hereditary risks and those from underserved rural and urban communities, becomes vital.
“Depending on the tumor type and the etiology of the disease, cancer may look very different from patient to patient,” added Feldman. “That’s why biomarker-driven therapies are so valuable – to help ensure that treatments selected are consistent with the genetic basis for each patient’s disease, which we know can lead to better outcomes and survival.”
How the cancer community has an important role to play
To overcome these challenges, patients, providers, caregivers and the entire cancer care community have a vital role to play.
“Continuing to educate professionals and patients alike that optimal intervention means finding ways to deliver more biomarker testing upfront, and in ways that consider safety and distancing, can help solve these challenges. That means ensuring pathology capabilities are available and appropriately resourced to respond to multiple public health crises at once,” said Dr. Patt.
A diverse set of stakeholders, including diagnostic manufacturers, academic institutions, and biopharmaceutical companies, all play an important role in ensuring that such biomarker testing technologies are delivered to the market, that health care providers are aware of their application and utility, and that patients ultimately have access to the corresponding care.
“Precision medicine is central to our vision of eliminating cancer as a cause of death. Ninety percent of our oncology pipeline is oriented toward a precision medicine approach to treatment, and to date we have launched more than 30 companion diagnostic tests that are linked to 6 different targeted therapies in Oncology. We believe that this approach will improve patient care, and are working closely with community partners to realize its potential through provider education and support with testing process improvement, because it gives patients the best chance at improved survival,” Feldman said.
One element of AstraZeneca’s community outreach has been through its YOUR Cancer program, which has helped to increase awareness and appreciation of precision medicine by involving community leaders in national educational summits and a series of policy roundtables. Last year, Dr. Patt facilitated a roundtable at the Texas State Capitol to help educate legislators and identify meaningful policy solutions that help expand access to precision medicines for underserved patients across the state.
The program also celebrates the meaningful work already being done in the cancer community through the annual Cancer Community (C2) Awards, which will be taking place later this fall. These awards recognize unsung heroes across four categories celebrating individuals and grassroots organizations working to strengthen the care continuum for patients across the U.S.
“We’re helping to amplify the great work community organizations are doing for patients, so that what’s working well for them can potentially help inspire others to create meaningful change,” said Feldman. “This is particularly critical now as patients are relying on these organizations to collaborate locally to help ensure biomarker testing continues to be accessed despite the numerous pressures on the health care system during the Covid-19 pandemic.”
Our goal is for every patient who needs targeted therapy to have access to the latest diagnostic science so they and their care teams can make treatment decisions that meaningfully benefit each patient, which is vitally important throughout this pandemic and beyond, as we work together with the community to one day eliminate cancer as a cause of death.”
Learn more by visiting YourCancer.org.
iFDA, 2019, Understanding Precision Medicine. https://www.fda.gov/media/138005/download