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Oncology Research Rebounds from Pandemic Low, but Shows Cancer Patients Need Special Attention After COVID-19 Recovery [ESMO Congress 2021 Press Release]

  • Practice-changing data presented at ESMO Congress 2021 proves oncology has recovered from pandemic-related setbacks
  • Research shows cancer patients must continue to be prioritised as incidence and mortality expected to rise further
  • ESMO launches International Cancer Foundation to make the best cancer care accessible to patients worldwide
10 Sep 2021

LUGANO, Switzerland – At the opening press conference of the ESMO Congress 2021, President Solange Peters announced that ESMO, the leading professional society for medical oncology, is launching the International Cancer Foundation, ICF by its acronym, which has taken upon itself a mission to support activities that enhance cancer prevention, diagnosis, treatment and follow-up in every country where they are needed, with the ultimate goal of saving lives by ensuring that the best treatment is available to every cancer patient worldwide.

“Immunotherapy is being shown to work across many diseases and new drugs are on the horizon in the precision oncology field, but as an international organisation, we at ESMO have to be realistic about how accessible these breakthroughs are from a global perspective. Even if we constantly offered education to our members to be at the forefront of cancer research and treatment, we would still be leaving some patients at the side of the road,” said Peters, detailing that the new foundation will provide practical support for the training of oncologists as well as offer financial backing for fellowships, country-specific research projects, patient resources, prevention campaigns and public education about cancer in under-resourced regions across Africa, Asia and Latin America.

The announcement comes in the context of the ESMO Congress which, one week before its official opening, is already counting more than 19,000 participants from all around the world. “Connecting and engaging those who care about cancer” is the fitting tagline for this second consecutive virtual edition of the highly anticipated annual event, an appointment not to be missed for the entire oncology community – and the second to be held against the backdrop of the COVID-19 pandemic.

With a wealth of landmark studies in Breast, Cervical, Melanoma, Prostate, Colorectal, Oesophagus, Endocrine and Lung cancer, the ESMO Congress 2021 is a clear demonstration that oncology research has once again gathered momentum after being temporarily stopped in its tracks by the outbreak of the virus. “The pandemic generated remarkable consequences on people and healthcare systems, but also on cancer research,” said ESMO Press Officer Dr. Antonio Passaro. “This year, however, we have seen a resurrection of oncology research reflected by an increase in the number of abstracts and practice-changing data submitted, and ultimately translating to more than 2,000 studies, with nearly 70 late-breaking abstracts being presented at this ESMO Congress.”

“In addition to research, the pandemic has also disrupted the treatment strategies in place for our patients,” Passaro continued. “In this area, too, new data shows that the oncology community has worked and continues to work in the right direction to protect cancer patients during the health crisis.”

A study (1) to be presented at the upcoming Congress explored the prevalence of  long-term side-effects from COVID-19 among cancer patients having survived an infection with the virus, as well as the impact on pathways to resuming treatment following recovery. Based on data collected about 2,795 patients at 35 European institutions between February 2020 and February 2021 through the OnCOVID registry, 1,557 patients who underwent a clinical reassessment after recovering from COVID-19 were included in the analysis. The results show that at least 15% of cancer patients who survived an infection with SarS-CoV-2 went on to experience symptomatic sequelae from the disease, the most common being respiratory symptoms (50%), such as shortness of breath or a chronic cough, as well as chronic fatigue (41%). Men were significantly more likely than women to be burdened by sequelae, as were individuals aged over 65 years, those with two comorbidities or more and those with a history of smoking.

“The fact that the cancer patients who most frequently suffered sequelae were those who survived severe forms of the disease leads us to imagine the beneficial effects that COVID-19 vaccination campaigns will have on these aspects,” said study author Dr. Alessio Cortellini, Hammersmith Hospital and Imperial College London, UK.

Cortellini added that prevention, early recognition and treatment of COVID-19 sequelae would be an important step to prevent disruptions in the continuity of patients’ cancer care in the future.

“This data confirms the need to continue to prioritise cancer patients, which is one of the top goals that ESMO has set since the start of the outbreak,” Passaro emphasised. “Amid the efforts invested by healthcare systems in the fight against the pandemic, it is of the utmost importance that we do not neglect to study and understand the curves of cancer incidence and mortality in order to plan appropriate health policies for the future.”

These are described in a second study (2), which used the latest estimates of the cancer burden in EU and EFTA countries (3) along with the most recent projected population figures released by Eurostat for the coming decades to predict long-term cancer incidence and mortality across Europe by age, sex, country and cancer site. The results show that by 2040, the number of new cancer cases could increase by more than a fifth (21%) to 3.4 million, with deaths from cancer reaching 1.7 million the same year, up from 1.3 million in 2020.

“We evaluated how demographic variations in terms of fertility, mortality and migration levels would impact the population age pyramid over time and how that, in turn, would affect the number of future cancer cases in 2040,” said study author Dr. Manola Bettio from the European Commission, Join Research Centre, Italy. “The results we obtained allow international comparisons, highlighting differences and identifying possible actions to mitigate inequalities between and within countries. The first and easiest way to reduce the future cancer burden across Europe is prevention, because the good news is that almost 40% of cancers can be prevented by reducing people’s exposure to environmental and lifestyle risks, which are also linked to social and economic development.”

For those who do have to face a diagnosis of cancer, today or in the future, ESMO2021 Scientific Co-Chair Prof. Pasi Jänne saw hope in the results to be unveiled over the five days of the ESMO Congress, which are evidence that cancer research works. “Many of the studies presented this year will change or influence our current clinical practice,” he said, highlighting great strides made in precision medicine: “Giving the right treatment at the right time, to the right patient, is an important strategy that we as an oncology community are implementing worldwide to continue making progress in cancer therapies and thus improve outcomes for patients,” Jänne said.

Notes to Editors

Registration to the ESMO Congress 2021 is still possible for medical professionals and media representatives. To apply for media accreditation, please fill out the online media registration form.

Please make sure to use the official name of the meeting in your reports: ESMO Congress 2021

Official Congress Hashtag:  #ESMO21

Disclaimer

This press release contains information provided by the authors of the highlighted abstracts and reflects the content of these abstracts. It does not necessarily reflect the views or opinions of ESMO who cannot be held responsible for the accuracy of the data. Contributors quoted in the press release are required to comply with the ESMO Declaration of Interests policy and the ESMO Code of Conduct.

References

  1. Abstract 1560O_PR ‘Prevalence and impact of COVID-19 sequelae on treatment pathways and survival of cancer patients who recovered from SARS-COV-2 infection’ will be presented by Alessio Cortellini during the Proffered Paper Session ‘SARS-CoV-2 and cancer’ on Tuesday 21 September 2021, 13:30 to 14:50 (CEST) on Channel 5. Annals of Oncology, Volume 32, 2021 Supplement 5
  2. Abstract 1501O_PR ‘Long-term estimates of cancer incidence and mortality for the EU and EFTA countries according to different demographic scenarios’ will be presented by Tadeusz Dyba during the Proffered Paper Session ‘Public policy’ on Monday 20 September 2021, 13:30 to 14:50 (CEST) on Channel 5. Annals of Oncology, Volume 32, 2021 Supplement 5
  3. European Free Trade Association (EFTA) member states: Iceland, Liechtenstein, Norway and Switzerland

A. Cortellini1, E. Roldán2, M.C. Carmona Garcia3, R. Berardi4, A. Sánchez5, C. Martinez6, A. Parisi7, E. Jones8, R.M. Bertulli9, G. Rizzo10, A. Guida11, C. Chung12, M.D. Bower13, M. Betti14, B. Vincenzi15, O. Mirallas16, F. Biello17, P. Queirolo18, A. Gennari19, D.J. Pinato20 

1Medical Oncology Dept., Ospedale Civile San Salvatore - ASL 1- Avezzano Sulmona L'Aquila, L'Aquila, Italy, 2Hematology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain, 3Medical Oncology Dept., Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain, 4Oncology Clinic, Ospedali Riuniti Di Ancona, Ancona, Italy, 5Medical Oncology, Hospital Universitario de Getafe, Madrid, Spain, 6Medical Oncology, Fundació Althaia Manresa, Manresa, Spain, 7Department Of Life, Health And Environmental Sciences, University of L'Aquila, L'Aquila, Italy, 8Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom, 9Medical Oncology, Istituto Nazionale dei Tumori di Milano - Fondazione IRCCS, Milan, Italy, 10Oncology Dept., Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, 11Medical Oncology, Azienda Ospedaliera Santa Maria, Terni, Italy, 12Surgery And Cancer, Imperial College London, London, United Kingdom, 13Medical Oncology, Chelsea and Westminster Hospital - NHS Trust, London, United Kingdom, 1414. infrastruttura Ricerca Formazione Innovazione, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy, 15Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Italy, 16Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain, 17Department Of Translational Medicine, University Of Eastern Piedmont, Azienda Ospedaliera Universitaria Maggiore della Carità, Novara, Italy, 18Melanoma And Sarcoma Medical Treatment Unit, IEO - Istituto Europeo di Oncologia, Milan, Italy, 19Medical Oncology Department, Università Degli Studi Del Piemonte Orientale - Scuola di Medicina, Novara, Italy, 20Surgery And Cancer, Imperial College London - Hammersmith Hospital, London, United Kingdom 

Background: The long-term impact of COVID-19 in cancer patients (pts) is undefined.

Methods: Among 2795 consecutive pts with COVID-19 and cancer registered to OnCovid between 01/2020 and 02/2021, we examined clinical outcomes of pts reassessed post COVID-19 recovery.

Results: Among 1557 COVID-19 survivors, 234 (15%) reported sequelae including respiratory symptoms (49.6%), fatigue (41%) and cognitive/psychological dysfunction (4.3%). Persisting COVID-19 sequelae were more likely found in males (p=0.0407) aged ≥65 years (p=0.0489) with ≥2 comorbidities (p=0.0006) and positive smoking history (p=0.0004). Sequelae were associated with history of prior hospitalisation (p<0.0001), complicated disease (p<0.0001) and COVID-19 therapy (p=0.0002). With a median post-COVID-19 follow up of 128 days (95%CI 113-148), multivariable analysis of survival revealed COVID-19 sequelae to be associated with an increased risk of death (HR 1.76, 95%CI 1.16-2.66) after adjusting for sex, age, comorbidities, tumour characteristics, anticancer therapy and COVID-19 severity. Out of 473 patients who were on systemic anticancer therapy (SACT) at COVID-19 diagnosis; 62 (13.1%) permanently discontinued therapy and 75 (15.8%) received SACT adjustments, respectively. Discontinuations were due to worsening performance status (45.1%), disease progression (16.1%) and residual organ disfunction (6.3%). SACT adjustments were pursued to avoid hospital attendance (40%), prevent immunosuppression (57.3%) or adverse events (20.3%). Multivariable analyses showed permanent discontinuation to be associated with an increased risk of death (HR 4.2, 95%CI: 1.62-10.7), whereas SACT adjustments did not adversely affect survival.

Conclusions: Sequelae post-COVID-19 affect up to 15% of patients with cancer and adversely influence survival and oncological outcomes after recovery. SACT adjustments can be safely pursued to preserve oncological outcomes in patients who remain eligible to treatment. Clinical trial identification: NCT04393974

Legal entity responsible for the study: Imperial College London 

Funding: Has not received any funding

Disclosure: 

A. Cortellini: Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: BMS; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Invited Speaker: Novartis; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Invited Speaker: Astellas; Financial Interests, Personal, Advisory Board: Sun Pharma. 
D.J. Pinato: Financial Interests, Personal, Advisory Board: ViiV Healthcare; Financial Interests, Personal, Invited Speaker: Bayer; Financial Interests, Personal, Advisory Board: EISAI; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Invited Speaker: AstraZeneca. 

All other authors have declared no conflicts of interest.

T.A. Dyba, G. Randi, C. Martos, F. Giusti, R. Calvalho, L. Neamtiu, N. Nicholson, M. Flego, N. Dimitrova, M. Bettio 

Health In Society Unit, European Commission – Joint Research Centre, Ispra, Italy

Background: Long-term projections of cancer burden are an important input to health-policy planning. Major cancer risk factors – such as genetics, lifestyle, environmental exposure to carcinogens, in combination with the associated population structures – impact on observed number of cancer incidence and mortality cases. The latest estimates on cancer burden in the EU and EFTA countries for the year 2020 predicted 2.8 million new cancer cases and 1.3 million cancer deaths. This study investigates how these numbers would change up to the year 2040 under different population structures, assuming the estimated 2020 cancer incidence and mortality crude rates remain the same. 

Methods: Using the estimated 2020 cancer incidence and mortality crude rates and the projected populations for years 2025, 2030, 2035 and 2040, as released by Eurostat, cancer incidence and mortality was projected by age, sex, country, and cancer site. Alternative projections were computed using different population structures, also released by Eurostat, modelled on the following demographic scenarios: 20% lower fertility rate, lower mortality rate, 33% lower migration rate, no-migration and 33% higher migration rate as compared to the 2020 baseline.

Results: The number of new cancer cases in the EU and EFTA countries is estimated to increase to 3.4 million by 2040, with an increment of 21.4%. The increment is estimated to be highest in the scenario with lower mortality (23.3%), while it is lowest for the no-migration scenario (19.7%). Large variability is estimated among the different cancer sites, varying from a decrease of 5.2% for testicular cancer up to an increase of 35.2% for the mesothelioma in males. The variability is highest for the no-migration and lower mortality scenarios. The number of cancer deaths in the EU and EFTA countries is estimated to grow to 1.7 million by 2040, with an increment of 32.2%, increasing up to 35.4% for the lower mortality scenario.

Conclusions: The results obtained are of big value in planning health policies for cancer in the EU and EFTA region.

Legal entity responsible for the study: N/A 

Funding: Has not received any funding 

Disclosure: All authors have declared no conflicts of interest.

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