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Advancing Cancer Clinical Trials in the “New Normal”

ACCCAs cancer programs and practices across the country transition into the chronic-phase landscape of the COVID-19 pandemic, the Association of Community Cancer Centers (ACCC) continues to respond to the needs of its multidisciplinary membership. 

Over the coming weeks and months, as health systems, hospitals, and cancer programs and practices navigate this “new normal,” ACCC will be providing weekly COVID-19 next-phase webcasts and podcasts focused on practical, “how-to” strategies and resources for the cancer care community. Discussion topics include effective COVID-19 testing strategies, staffing models, best practices for infection control, approaches to risk stratification, lessons learned, and more. Just as the lived experience of the COVID-19 pandemic varies widely among cancer programs, practices, and their communities, there is no single solution for how best to ramp up cancer services or a one-size-fits-all planning strategy for the months ahead. 

Research to understand the real-world impact of the COVID-19 pandemic on cancer patients and survivors is essential as the United States transitions to a “new normal” health care delivery environment. As part of Dr Randall Oyer’s 2020-2021 ACCC President’s Theme, “Community Oncology Can Close the Gap in Cancer Research,” ACCC is exploring the impact of COVID-19 on all facets of cancer care, including the administration of—and patient access to—clinical trials. COVID-19 poses a particularly significant challenge for oncology clinical trials, as investigational approaches are often considered standard of care for many disease types. According to results from the 2019 ACCC Trending Now in Cancer Care survey, the top hurdles to offering clinical trials include staff resources and training challenges (53%), program infrastructure (50%), and lack of patient understanding of the clinical trial process (46%)—all factors likely to be exacerbated by the COVID-19 health emergency. In live polling during the ACCC National Oncology Conference in Fall 2019, 52% of respondents reported that among quality metrics collected and reported is involvement in clinical trials.

Quality cancer care is evidence-based and data-driven. A critical step in moving forward with cancer care in the wake of the COVID-19 experience is the ability to use data to develop a better understanding of the impact of the pandemic on patients with cancer. ACCC strongly encourages cancer care providers to contribute to the American Society of Clinical Oncology Survey on COVID-19 in Oncology Registry (ASCO Registry). Development of a large data set is vital for researchers who are studying the important questions to which cancer care providers and their patients need confirmed answers. The ASCO Registry is collecting information about patterns of symptoms and severity of COVID-19 infection, how COVID-19 influences the delivery of cancer care, and how patients’ cancer and COVID-19 outcomes are affected.

Once sufficient patient data have been received and analyzed, ASCO will deliver periodic reports on key insights, including characteristics of patients with cancer most impacted by COVID-19, estimates of disease severity, treatment modifications or delays, implementation of telemedicine in the cancer treatment setting, and clinical outcomes among patients related to both COVID-19 and cancer.

The registry is open to all oncology programs, including physician-owned, academic, and hospital/health system-owned practices, and hospitals in the United States. The Centers for Medicare & Medicaid Services recognizes the ASCO Survey on COVID-19 in Oncology Registry as an acceptable clinical trial registry for the MIPS COVID-19 Clinical Trials Improvement Activity.

ACCC was founded nearly 50 years ago by a small group of physicians who advocated for clinical trials in the community setting. Oncology clinical trials continue to drive advancements in diagnosis and treatment of the many diseases that comprise cancer. And yet today there remains a lack of concordance between where the majority of patients with cancer receive care—in the community, close to home—and where clinical trials are most often located—at academic medical centers. 

Dr Oyer’s President’s Theme centers on redressing this imbalance: community oncology can close the gap in cancer research. The COVID-19 pandemic has made clear the critical importance of access to care close to home. Stay tuned for updates from ACCC, as we put Dr Oyer’s theme into action in the “new normal” health care environment.

Access the knowledge, experience, and information from leading organizations in oncology on the ACCC COVID-19 Resources page.