Some say COVID-19 is an equal-opportunity disease, bringing suffering to all corners of the globe. But the virus does not play fair – it disproportionately preys on the vulnerable, including those with cancer. Liquid biopsies help even the odds.
Time can be a matter of life and death for cancer patients. Early detection and treatment are essential to improve outcomes, and consistent care is crucial. But the pandemic puts cancer patients at increased risk in three ways:
- A trip to the nearest hospital can be more than a day of arduous travel for patients in rural regions, even in normal times. In the early months of the pandemic, access to healthcare changed for nearly everyone, and infrastructures – from transit to healthcare – broke down.
- Lockdowns and overburdened hospitals prevent patients from seeking testing or treatment. Some are simply too scared to go, even if they could.
- For cancer patients – who are immunocompromised – the risk of infection from COVID-19 and other diseases is particularly high, especially in overcrowded spaces.
Since the pandemic, government and academic institutions report massive declines in cancer care globally. One study shows that nearly 61% of oncology centres across 18 countries reported reduced clinical activity during the first peak of the pandemic, and nearly two-thirds cited under-treatment as a major concern.
Data presented at the ESMO Virtual Congress 2020, in that same study, shows that treatments most likely to be cancelled or delayed at cancer centres were surgery at 44%, chemotherapy at nearly 26% and radiotherapy at nearly 14%. Palliative (quality of life) care ended earlier in 32% of centres.
Regular screenings plummeted, too, reducing the odds of early detection, which translates to decreased survival odds for those diagnosed at a later stage.
Other studies suggest a roughly 80% drop in March and April 2020 in the U.S. alone, in routine screening appointments that could catch new cancers. Another paper estimated that screening for breast, colon and cervical cancer in the U.S. dropped by about 60% from mid-March to mid-June 2020.
Finding solutions for those in need
Roche affiliates around the world recognised early that cancer patients were among those being left behind in the race to combat the pandemic. And they were determined to find new and innovative ways to help.
“The situation in Italy was difficult; it was one of the most hard-hit countries,” says Luca Lattanzi, Brand Manager of Precision Medicine at Roche.
In some ways, it was the perfect storm for the pandemic: The risk of cancer increases with age, and almost a quarter (23.1%) of Italy’s population is estimated to be 65 years and older – the largest percentage of elderly in Europe in 2019. Research shows that coronavirus is more of a threat to older people, who, if they get the disease, are more likely to have a severe case.
“We learned from our own field force and physicians that cancer patients in Italy were not always able to go to hospitals to undergo testing or treatments,” Luca says. “The first lockdown was the spark that pushed us to think outside the box and come up with a way to help.”
One of the solutions? A liquid biopsy in the form of a simple blood draw, performed directly in the patient’s home by a traveling nurse. The nurse arrives at a specified time, draws two vials of blood and packages them for courier pickup within four hours. The vials are sent to a special lab, which can test a tumour for genomic alterations, giving the doctor and patient greater insight to target treatment options.