Cancer Research in the Era of COVID-19
, by Dr. Dinah S. Singer
NCI Deputy Director Dr. Dinah S. Singer emphasizes critical aspects of her recent presentation at the virtual 2020 AACR annual meeting. She discusses the impact that the COVID-19 crisis has had on NCI and the extramural community. Dr. Singer also provides an overview of NCI’s efforts to address the pandemic by pivoting some cancer research activities to focus on COVID-19.
On April 28, using the virtual techniques and technology we’ve all grown accustomed to, I addressed the 2020 annual meeting of the American Association for Cancer Research (AACR). I began by acknowledging the heroic efforts of so many in the biomedical community, praising health care providers and biomedical researchers working tirelessly to contain the pandemic and care for patients suffering the consequences of COVID-19. They are on the front lines of this raging battle. But the pandemic touches all of us, many of us profoundly.
This Bottom Line post provides some of the key points from my address. Those interested in my complete remarks can view my AACR presentation.
NCI Contributions During the COVID-19 Crisis
COVID-19 is a global public health crisis, the equivalent of a 100-year storm, or worse. Although we remain focused on cancer, NCI has pivoted some cancer research activities to respond to the crisis. For example:
- Tocilizumab: NCI has initiated a compassionate-use protocol for tocilizumab (Actemra), which blocks the inflammatory protein IL-6. Based on the widespread reports of cytokine storm in people with COVID-19, NCI is conducting this trial with about 200 cancer patients experiencing severe respiratory symptoms to evaluate whether tocilizumab will reduce time in intensive care units, on ventilators, and in hospitals.
- Longitudinal Cohort: This month, NCI will launch a longitudinal cohort study of cancer patients with COVID-19. Our target is to enroll at least 2,000 patients. The goal is to generate a comprehensive dataset of treatments, medications, behaviors, and outcomes to understand the risks and course of the disease in cancer patients.
Examples of Extramural Activity
Many NCI-funded centers are developing novel therapeutic trials for cancer patients with COVID-19. Others are gathering clinical data to analyze the consequences of COVID-19 for patients with cancer.
One example is the COVID-19 and Cancer Consortium led by Vanderbilt University. A second is the Cancer MoonshotSM-funded Cellular Immunotherapy Data Resource program, which expanded its focus to collect data on COVID-19 infections and deaths among patients receiving cellular therapies. These are just two of the many examples of the extramural community applying their talent and insights to respond to the COVID-19 crisis.
Three NCI Notices for COVID-19 Related-Research
NCI understands that many cancer researchers want to use their expertise and creativity to contribute to understanding COVID-19. In response, NCI has published two Notices of Special Interest (NOSIs) for Urgent Competitive Revisions and Administrative Supplements (NOT-CA-20-042) and for SBIR/STTR Urgent Competitive Revisions and Administrative Supplements (NOT-CA-20-043).
A third notice, Redirecting Grant Resources to COVID-19-Related Research (NOT-CA-20-054), invites investigators—under certain conditions—to use some existing NCI grant funds on COVID-19-related and cancer-relevant research that they can immediately commence. Those interested in pursuing any of these opportunities should contact the NCI program official assigned to their awards.
Progress in Cancer Research and Care
Yes, NCI is responding to the COVID-19 crisis. But, like all of you, we are also maintaining a clear focus on advancing our cancer research mission. We understand that, due to the COVID-19 crisis, institutions have had to introduce extraordinary measures. Some, for example, have stopped accruing patients for clinical trials. We respect the need for such actions.
For others, work continues, or continues with constraints. During this pandemic, NCI encourages every member of the cancer science community to continue their work, wherever and however possible. Those working remotely can focus on priorities such as analyzing data, preparing manuscripts, reviewing the literature—and embracing the opportunity to just think.
In the era of COVID-19, NCI is also adapting how we conduct trials and deliver care. Ways of adapting include:
- Allowing local health care providers to participate in study activities under the guidance of the responsible investigator
- Shipping most oral investigational new drug agents directly to patients, although injectable agents must be administered at a registered site
- Adopting alternative procedures that don’t compromise safety or the integrity of the study, while reporting major deviations to the Central Institutional Review Board
- Obtaining informed consent remotely, based on guidance from the Central Institutional Review Board
NCI Helps Researchers Adapt to COVID-19 Disruptions
We are clearly seeing progress in cancer research and cancer-related COVID-19 research. At the same time, there is considerable stress and anxiety throughout the community about the consequences of COVID-19 on research grants and careers.
Let me highlight steps that NCI and NIH have taken to address some of these concerns.
More information on COVID-19 related research resources is available on:
In a development that occurred since my AACR address, NCI recently created a webpage for the extramural community with answers to questions related to the impact of COVID-19 on NCI grants. This page addresses questions such as:
- Which NOSI is appropriate to use based on your individual circumstances?
- How do I request NCI prior approval to repurpose funds in an award to conduct COVID-19 research?
- What is the time-frame for NCI decisions on requests you submit?
If you have additional questions, you can always contact NCI program officials directly. We continue to process, review, and fund grants.
We recognize that the pandemic has disrupted research and undermined the ability of many to prepare grant applications. We’ve heard the many concerns you have voiced. And while we are committed to advancing cancer research, NIH and NCI developed COVID-19-related policies with the safety and flexibility of researchers foremost in mind. These flexible policies include:
- Extending deadlines for applications
- Allowing institutions to use NCI grant funds to maintain salaries and stipends
- Flexibly extending project timelines and reporting requirements
- Extending eligibility periods for early-stage investigators and trainees
One of our greatest concerns is that some institutions may consider furloughing research staff. NCI urges institutions not to further disrupt the progress of research by taking such actions. Given the flexibility we allow on using NCI grant funds to maintain salaries and stipends, we are hopeful that research staff can continue to receive pay. This flexibility will help sustain progress in cancer research and also permit normal activities to resume promptly, when possible.
In closing, I encourage you to review answers to questions related to the impact of COVID-19 on NCI grants, and other material on the COVID-19 pandemic available from NCI and NIH.
Once again, many thanks for your deep commitment to cancer patients and cancer science during this crisis. From all of us at NCI, please stay safe and stay healthy.