Researchers at The Royal Marsden NHS Foundation Trust and Francis Crick Institute, and funded by The Royal Marsden Cancer Charity, are launching a five-year study with over 1200 cancer patients, analysing the impact of COVID-19 and how cancer treatment interacts with the virus. The study will also be supported by the NIHR Biomedical Research Centre at The Royal Marsden and Institute of Cancer Research, London. During the COVID-19 pandemic, clinicians have had to explore new approaches to treatment, balancing the need for life-saving care with the risk COVID-19 presents to cancer patients, a particularly vulnerable group who often may have a weakened immune system. With the virus likely to impact cancer patients for several years, clinical and research teams at The Royal Marsden and The Francis Crick Institute are setting out plans to shed light on interactions between a patient’s immunity, COVID-19, the cancer, and cancer treatment. They will also investigate the impact of the virus in healthcare workers, especially those facing the most vulnerable patients such as those receiving bone marrow transplant and those involved in the Cancer Hub activity. Approximately 1200 cancer patients across all tumour types will be followed up for five years. In addition to online questionnaires where they disclose the physical and psychological impact of cancer and treatment, clinical teams will collect data relating to cancer and anti-cancer interventions, and also fluid samples, e.g. blood for different analysis of the immune system. Researchers will compare cancer outcomes and safety of treatment in those with and without the virus. Over 1000 healthcare staff will also be monitored for 12 months with healthcare outcomes and blood samples to monitor their immune response. Whilst the study is long-term, researchers will aim to provide interim data six months after the study has commenced to help inform immediate clinical decision-making, with an overall aim of minimising risk of severe infection and maximising cancer control. Chief Investigator Dr Samra Turajlic, Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust, and Group Leader at The Francis Crick Institute, said: “Our oncology community is really dealing with two pandemics – cancer and COVID-19. Currently there is little evidence that helps to understand the impact of the virus on our patients, whether they are exhibiting symptoms or not. Critically we have to carefully consider which cancer treatments are safe to administer in the pandemic and beyond. It’s very important that we start informing the wider cancer community by studying large groups of patients. “There is also a lack of solid evidence about the risk to healthcare workers generally, but specifically those caring for the most vulnerable patients, and the nature of immunity they develop after repeated exposure to the virus. Throughout this study we hope to inform policies on healthcare worker management especially in the cancer patient environment.” Outside of The Royal Marsden, Dr Turajlic aims to involve other cancer centres across the UK and will collaborate internationally to maximise the insights across all the studies that being performed. “This is a substantial but necessary effort” she adds. “What is clear is that we face challenging decisions for some time, but with collaborative studies such as this we hope we can better protect cancer patients and staff, and optimise the clinical decisions being made well into the future.” The Royal Marsden and ICR have launched several critical research studies such as this at unprecedented speed, with The Royal Marsden Cancer Charity now needing to raise over £500,000 over the coming weeks to ensure support for the research studies can continue. Professor David Cunningham, Consultant Medical Oncologist at The Royal Marsden and Director of the NIHR Biomedical Research Centre at The Royal Marsden and Institute of Cancer Research said: “We are uniquely placed to look at COVID-19 in a cancer setting, investigating the pandemic’s impact across a wide range of patients. These trials call upon our multidisciplinary expertise in areas such as systemic therapies, radiotherapy, circulating tumour DNA which is detectable in blood tests, surgery and holistic care.” “Teams have been working at pace to establish studies that adhere to our usual rigorous protocol; each will have varying durations, with a focus on immediate impact through to longer term understanding of this novel virus. Importantly, with commercial, NHS and academic partners across the country, and thanks to fundraising from The Royal Marsden Cancer Charity and support from The NIHR Biomedical Research Centre we hope this research will have a national and international impact.” Find out more about other COVID-19 research here.