Research COVID-19 Esophageal Cancer
The COVID-19 pandemic had dramatic effects on all types of cancer screenings, from mammograms to colonoscopies. In the early days of the health crisis in spring 2020, screening numbers dropped dramatically as health care providers shifted their attention to caring for the seriously ill and fears of contracting the virus kept the general public away from hospitals, clinics, and other facilities.
Research Community COVID-19 Cancer
Among the many lessons collectively learned during the initial months of the worldwide COVID-19 pandemic was this: The experience was uncharted psychological and emotional terrain. It wasn’t uncommon for people across the globe to express uncertainty about how to navigate new stresses and new emotions.
Despite the growing threat of the Delta variant, many Americans who have been vaccinated against COVID-19 are living life much as they did pre-pandemic — traveling, shopping, going out to eat, and forgoing masks in many situations.
Research COVID-19 Clinical Trials
The early days of the COVID-19 pandemic were an adjustment period for medical professionals across the board, but they brought up particular challenges for the Cancer Clinical Trial Office (CCTO) at the University of Colorado Cancer Center. A number of procedures that used to take place in person or in the office — collecting signatures from patients and doctors, delivering medications, submitting data to trial sponsors — suddenly had to be done in a whole new way.
Long before RNA and mRNA became important parts of the COVID-19 vaccine conversation, researchers at the University of Colorado School of Medicine were studying how RNA biology can improve diagnostics and therapeutics for a range of diseases.
Patient Care COVID-19 Colorectal Cancer
There’s never a good time for a cancer diagnosis, but it’s especially difficult in the middle of a pandemic, when concerns about safety compound the worry and anxiety that come along with hearing, “you have cancer.”
In mid-March, the University of Colorado Cancer Center Cell Technologies Shared Resource shut down along with almost all the other labs and technologies on the Anschutz Medical Campus. Then shared resource director, Steve Anderson, PhD, got an email from a colleague asking if the facility could make COVID-19 proteins. They could: The shared resource has been making proteins for over 15 years.
One of the few labs on the Anschutz Medical Campus to remain mostly open during the COVID-19 shutdown is the University of Colorado Cancer Center Animal Imaging Shared Resource (AISR).
During the COVID-19 pandemic patients with cancer may be experiencing mental health challenges such as increased anxiety or depression. The psycho-oncology team at the CU Cancer Center is providing tips that can help during these difficult times.
One of the major complications of severe COVID-19 is blood clots in the lungs – a pulmonary embolism that can block lung function leading to death. In fact, these blockages are similar to those from chronic heart disease, stroke, and even traumatic injuries like a car crash or gunshot wound. In these non-COVID-19 conditions, doctors use drugs to break up and dissolve the clotted blood. Now a team led by Colorado trauma surgeon Gene Moore, MD, is testing a similar approach against the dangerous blood clots associated with COVID-19.
March 5th: The first confirmed case of COVID-19 in Colorado is reported in a young man who had been on vacation to Italy before continuing his vacation amid the skiing and snowboarding crowds up in Vail.
March 10th: While I am in my lung cancer clinic, I get an email from Harry Ren, a doctor from the Shanghai Pulmonary Hospital who had worked with us previously. He had heard COVID-19 was in Colorado. Harry warns me to wear protective equipment, to keep myself and the team safe. Over 3,000 Chinese doctors and nurses have gotten sick from COVID-19.
March 11th: The World Health Organization officially labels COVID-19 a pandemic.
March 12th: We admit our first lung cancer patient with COVID-19 symptoms – a potential “patient zero” for us. Bert, short for Roberta, is a wonderful 77-year old retired publisher, who appeared to be responding to her treatment but then developed increasingly difficult breathing and low-grade fevers over a week.1 On her CT scan there are new infiltrates in both lungs. She had received immunotherapy together with her last chemotherapy which can cause inflammation in the lungs. We send blood tests for different infections, including COVID-19.
Bert is stabilized and kept under isolation conditions. Steroids, which can be used to treat inflammation in the lungs, but which could worsen some infections, are kept in reserve while the test results are awaited.
March 16th: All my work meetings have become virtual. From our respective rooms and offices, the clinical and research teams discuss ongoing clinical trial accruals; then new and difficult cases in our weekly Tumor Board.
March 17th: My clinic has changed dramatically. I see a fraction of the patients I would normally see in person; the rest are through telehealth appointments. Our scheduler jokes that tech support for older patients has now become an everyday part of her job.
March 19th: There is little traffic and I get rock star parking at the clinic. We still do not have the COVID-19 results back on Bert. It has been 7 days since she was admitted. Her other infectious tests are all negative.
I do my usual phone call with the thoracic oncology consortium that I direct – 14 University Hospitals and Cancer Centers across the USA and Canada. Patient accruals to clinical trials are down. Everything is becoming bottlenecked. Patients are scared. Staff are scared. However, the feeling on the call is that, as doctors, this is what we went to medical school for.
Because medical situations are the explosions we run toward rather than away from. In medicine, we are used to chaos. We are used to finding and protecting the possible, under a barrage of the uncontrollable, the impossible.
On the call among my colleagues, we all feel as if we are the shepherds of our own flocks. Patients with lung cancer are, in theory, no more susceptible to catch COVID-19 than anyone else, but if they do catch it, they will have a higher risk of dealing with the worst of the symptoms COVID-19 has to offer.
I finish off the day with a Remote Second Opinion from Israel.2 In Haifa, the patient and her children are now faced with not just the stress of her lung cancer growing, but a new kind of stressor. To determine the next best treatment would require a biopsy but going into the hospital to get this done could increase her risks of COVID-19 infection. To not get the biopsy would mean hunkering down with a progressing cancer or switching straight to chemotherapy in the absence of rational alternatives. The risks they are most worried about all relate to catching COVID-19. The risks from her progressing cancer appear clearer.
There are internet adverts for virus killing light-wands. Hydroxy-chloroquine, an anti-malarial and anti-inflammatory agent, is being thrown around as a possible ‘treatment’ for COVID-19 without any debate about the source or extent of the data available to support these claims. I revisit how patients with cancer can fall prey to promises of miraculous results from unproven treatments simply because they so desperately want the good news to be true.
March 21st: I get Bert’s COVID-19 test result back. She is negative. She finally starts steroids and her treatment can move on. It took 9 days to get her results back and we can only test people who are in-patients in the hospital. Any attempt to halt the spread of the virus by isolating known positive people using these tools is doomed to failure.3 Instead we have only one solution for the entire population: Keep distant, keep clean.
March 26th: Colorado as a state is ordered to stay at home. In the Cancer Center, we set in place jeopardy and double, triple and quadruple jeopardy plans. Who covers whose patients in the event one of our lung cancer doctors gets quarantined or sick. We even establish back-ups across other tumor-types in case whole teams are incapacitated.
March 31st: My thoughts on the similarities between how we are all dealing with COVID-19 worldwide and what patients with cancer have already been through from the moment they were diagnosed crystalize after a particular conversation in the clinic. The patient said to me, “Now you know what it’s like:”
This is what not knowing whether you will be well next month or on the verge of death feels like.
This is what not knowing if you will be financially ok or ruined because of matters beyond your control feels like.
This is what worrying that every minor symptom is the start of something far more deadly feels like.
This is what consuming every piece of news, hoping for a breakthrough, knowing that most of the breakthroughs you find are not real, but you still consume them because anything is better than nothing, feels like.
This is what watching others die and wondering if you will be next feels like.
But now we have to worry about COVID-19 as well.
That same day I see Bert again. She looks great and feels great. Her treatment, without the immunotherapy, is set to continue. Life goes on.
COVID-19 Melanoma Climate Science
During COVID19, getting outside for socially distanced activities is one of the few forms of available recreation. But more people getting out also means more sun exposure, and so during Skin Cancer Awareness Month, University of Colorado Cancer Center reached out to one of our members, Neil Box, PhD, president of the Colorado Melanoma Foundation, to learn about the risks and how to stay safe.
The Colorado Cancer Screening Program (CCSP) for Patient Navigation is working with the safety net clinics throughout Colorado to help respond to the coronavirus and COVID-19.
“We are responding to the urgent request from our clinics, community partners and state agencies, indicating navigators need support to best serve clients in the front line and to help support patients with acute chronic conditions” says Andrea (Andi) Dwyer, Director of CCSP.
Within the CCSP program, feedback from the clinics note that their navigators have had to turn their efforts to working with COVID-19 as the priority.
“The cancer prevention aspect is not lost as the navigators and clinics, as we work on sharing the importance of rescheduling colonoscopies and if patients have signs and symptoms, they still need to be seen urgently, but we need to support the dire needs of our partners and their patients,” says Dwyer.
Working with Dr. Patricia Valverde, the Primary Investigator (PI) of the Patient Navigator Training Collaborative (PNTC) and the statewide Alliance for Community Health Workers and Patient Navigators, Dwyer and the teams are helping inform the development of supports such as telephone scripts, workflow and assessment tools, technical support and education modules and sessions to better support navigators who are now adapting their positions to work in remote settings, on the front lines and in a much different context.
“Having the expertise and input from clinicians, programs partners, bio-ethic professionals and policy experts is helping us create the best support for our Colorado navigators,” says Valverde.
Benjamin Brewer, PsyD, is a University of Colorado Cancer Center investigator and health psychologist at the UCHealth University of Colorado Hospital Bone Marrow Transplant Program, providing mental health and counseling services for highly immunocompromised patients who are often in the hospital four weeks or more. For these patients, catching COVID-19 could be deadly and the climate of uncertainty adds another layer of stress to an already challenging experience. Here we talk with Dr. Brewer about his patients’ new worries and about how our health system is adapting to meet the mental health needs of cancer patients during COVID-19.
French and Australian studies suggest the anti-malarial drug chloroquine could be effective against COVID-19. Promising early results now lead the U.S. Food and Drug Administration to fast-track its own tests, and have spurred the drug’s maker, Bayer, to offer the drug free for treatment. Earlier today, President Trump (among others) touted chloroquine as a ready-to-use treatment for the disease.
We should all be doing our best to keep from catching COVID-19, if not for ourselves and our loved ones, then to avoid passing the disease to people in high-risk populations – like cancer patients taking chemotherapy, which can lower white blood cell counts and undercut the effectiveness of remaining white blood cells, leaving these patients immunocompromised and less able to fight infections like COVID-19.
With the first cases of COVID-19 reported in Colorado, CU Cancer Center reached out to Thomas Campbell, MD, Professor in the CU School of Medicine Division of Infectious Diseases to ask what cancer patients should do to keep themselves safe.
Cure Today
July 12, 2024
University of Colorado Cancer Center member Dr. Steven Thorpe emphasizes the collaborative nature of treating soft tissue and bone sarcomas, highlighting the multidisciplinary efforts at CU School of Medicine's Department of Orthopedics and Children’s Hospital Colorado. He underscores the goal of not only curing the disease but also preserving function through advanced surgical techniques and modern therapies, ensuring patients maintain quality of life post-treatment. Thorpe stresses the importance of long-term outcomes, tailoring treatments to support patients’ aspirations beyond their cancer journey, especially for pediatric cases.
OncLive
July 08, 2024
CU Cancer Center member S. Lindsey Davis, MD, highlighted that the combination therapy of sapanisertib and alisertib showed marginal clinical benefit for patients with advanced solid tumors, correlative analyses suggested that apoptotic response and tumor immune cell infiltrate might influence clinical outcomes. The phase 1b study's expansion cohort indicated some positive outlying responses among patients and underscore the need for further research to tailor treatments for standout patients and explore rational combinations to enhance efficacy.
News Medical
June 19, 2024
A new study led by University of Colorado Cancer Center member Marco Del Chiaro, MD, PhD, reveals that nearly 5% of pancreatic adenocarcinoma patients achieved a pathological complete response (pCR) after pre-surgical chemotherapy or chemoradiotherapy. This significant finding indicates that patients with pCR have a 63% five-year survival rate, compared to 30% for those without pCR, suggesting the potential for tailored treatments to improve outcomes.
Cancer Network
June 14, 2024
In a conversation at the 2024 European Hematology Association Congress, CU Cancer Center member Manali Kamdar, MD, discussed potential future research on lisocabtagene maraleucel (liso-cel; Breyanzi) for mantle cell lymphoma (MCL) and other lymphoma subgroups. She highlighted findings from the phase 1 TRANSCEND NHL 001 trial, noting improved efficacy and safety in patients with fewer prior therapies and non-refractory disease, suggesting liso-cel's utility in earlier treatment lines and specific lymphoma subgroups.
Greg Glasgow
