Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, opened the American Association for Cancer Research’s COVID-19 and Cancer Conference by reinforcing that the novel Coronavirus is “more than just the common cold.”
In a virtual keynote address, Fauci also highlighted the potential effects of the ongoing COVID-19 pandemic on individuals with cancer, as well as high-risk individuals and cancer survivors.
In particular, he reported the interruption of preventative medical care since the pandemic began may have downstream ramifications for years to come.
“With regard to cancer, COVID-19 related reductions to cancer screening, because of the total country lockdown that we and other nations have experienced, could actually result in 10,000 or more excess deaths from breast and colorectal cancer [over the next decade] because of the reductions in routine screening,” Fauci said.
The impact of the novel Coronavirus on the oncology research landscape is already being observed, according to Fauci.
“Beyond clinical care, the COVID-19 pandemic has caused an unprecedented disruption throughout the cancer research community, shuttering many labs and slowing down cancer clinical trial operations,” Fauci noted.
The most pronounced effects of the virus have been seen among older adults and individuals of any age with underlying health conditions, including cancer, according to Fauci. Because patients with cancer and cancer survivors often take medications that can result in immunosuppression, he urged these individuals and their medical providers to take “common-sense approaches” to slow the disease’s spread.
These measures included regular hand-washing, maintaining a physical distance of six feet or greater whenever possible, and wearing a face mask or cloth covering in public settings when social distancing is not possible. Fauci also underlined the ongoing importance of large-scale public health measures in protecting all citizens, especially those with underlying health concerns.
“The bottom-line common denominator is physical distancing,” Fauci said. “This can be accomplished by stay-at-home orders, closing or modifying school schedules, bans on public gatherings, travel restrictions, followed by aggressive case identification and contact tracing.”
Fauci further discussed emerging potential treatments for COVID-19, including a study published in The New England Journal of Medicine which showed patients treated with the antiviral medication remdesivir recovered from COVID-19 in a significantly faster time period than patients treated with placebo (median recovery time, 11 days vs. 15 days; P < .001). Remdesivir treatment was further associated with a reduction in 14-day mortality compared with placebo.
“Another randomized, placebo controlled trial in the U.K. looked at patients in the hospital, on ventilators or requiring oxygen, compared with patients with early disease,” Fauci said. “It was very clear that dexamethasone, given at 6 mg per day for up to 10 days, had a significant impact on decreasing mortality in the patients on ventilators and those requiring oxygen. However, it did not have a positive effect — and maybe had a negative effect — in people with early disease.”
The topic of a COVID-19 vaccine looms large in discussions of the pandemic. Fauci offered background information on potential vaccine development.
“We at NIH are taking a strategic approach,” Fauci said. “We are supporting, directly or indirectly, a number of candidates, using different platforms. We have tried to harmonize the approach, so that even when you have multiple candidates with multiple platforms, you have a common protocol that is quite similar in many respects.”
According to Fauci, the three major platforms being pursued are nucleic acids, viral vectors and protein subunits. He noted that a phase 3 trial for a potential virus candidate will commence in late July.
“A phase 1 trial published online just a few days ago showed some very promising data,” Fauci said. “It showed in 45 individuals that even the moderate dose of this mRNA platform induced very robust neutralizing antibodies that were at the level or greater of what you would see with convalescent serum. That is very good news, since one of the tenets of vaccinology is that you want a vaccine that induces a response comparable to what’s induced by natural infection.”
In addition to Fauci’s commentary, Antoni Ribas, MD, PhD, professor of medicine, surgery and molecular/medical pharmacology at University of California Los Angeles and president of AACR, praised the collaborative efforts of oncology providers to maintain continuity of cancer care during the pandemic.
“This pandemic has resulted, in a remarkably short period of time, in dramatic changes in how we deliver care for patients with cancer,” Ribas said. “We are seeing an unprecedented collaborative environment between investigators from industry, academia, foundations and government. We know we are all in this together, and it is exciting to see how previously competing enterprises are now working toward the common goal of beating COVID-19 in the shortest possible time.”
Fauci concluded his keynote by urging medical professionals and the public alike to remain positive but prepared.
“We have always had emerging infectious diseases,” Fauci said. “We have them now, and we will continue to have them in the future. Just as emerging infections provide a perpetual challenge, we need to be perpetually prepared.”
