Before delving into the content of this issue, we first want to address the obvious: News From ECOG-ACRIN has made the leap – from humble PDF to modern blog. This new format offers a number of benefits, but the one we most look forward to is the ability to have bi-directional, interactive discussions. Readers can now comment directly on articles, share them to social media, and email them to colleagues. The blog also accommodates rich media, such as videos and podcasts, which we may post periodically. Once you have had time to explore the blog let us know your thoughts. We would like this space to be as useful to our membership as possible, and to serve as a source of connection during this time of physical isolation and distance.
As the pandemic continues to unfold, with widely varying levels of control across the country, we seem to be transitioning in a way familiar to all of us: from responding to an acute emergency to managing a continuing threat. The perceived risk is perhaps in a more realistic range, conditioned as it is by known risk factors and managed accordingly. As our hospitals develop approaches to the successful care of SARS-CoV-2-infected patients that require admission, mortality rates are improving. At Penn, inpatient activities are almost back to normal, and outpatient clinics are increasingly busy.
Compliance with safety measures is remarkable – there is clearly a sense of shared responsibility, and there has been no reduction in the rigor of the preventive measures. Indeed, some are increasing. Whereas a temperature check coming in the door was the standard since March, this has been found to be an unreliable predictor of viral infection, and has been replaced by a short phone questionnaire that is used to create a pass valid for 24 hours. I’m sure that similar evolution of safety measures is taking place in different ways at different institutions, all of which is contributing to a new comfort level for patients and staff, diminishing anxiety and tension while vigilance remains at a high level.
This progress is reflected in a return toward normal in accrual to our trials: in August (often a slow month) therapeutic trial accrual was back to 66% that of February/early March, and screening trial accrual back to 64%. In both domains, our studies are successful if they represent the best of medical care, whatever the clinical scenario, so we celebrate this resurgence, and hope that the momentum can be maintained in all of our member institutions. And, as the setting for routine care evolves, so must our considerations of how to manage our patients who contract COVID-19 while on trials. Our recommendations, developed in March on the basis of limited data, are now being re-examined. Together with CTEP, we will amend as appropriate. Look for updates to the guidelines in the next month or so.
As we have discussed in these pages before, our research is a shared endeavor, and particularly involves patients and advocates in optimizing trial design. They represent the patient perspective in our therapeutic committees, and through their advocacy represent our collective struggle against cancer in the public space. This effort is led by Mary Lou Smith, chair of the Cancer Research Advocates Committee. This committee recently added five new members: Mitch Achee (Sarcoma), Sam Guild (Melanoma), Steven Merlin (GI), Anne Patterson (Cancer Control and Survivorship), and Glenn Sykes (GU). We welcome their participation, and are grateful for the perspectives and guidance that they will bring to ECOG-ACRIN.
Read the August/September 2020 issue here.