ACCC Report: Immunotherapy Research Grew in 2020 Despite COVID-19 Pandemic

Sigrun Hallmeyer, MD

The COVID-19 pandemic had a relatively limited effect on immuno-oncology (IO) research, according to results from the Association of Community Cancer Centers (ACCC) fourth annual analysis of the IO landscape.¹ As of August 2020, there were 4720 IO agents and 504 targets under investigation in more than 6200 active clinical trials as of August 2020, a 22% increase in the number of IO agents being actively investigated compared with 2019.²

As part of the report, ACCC collected completed questionnaires from 39 of its member practices. Respondents treat an average of 21 to 50 patients with IO therapies per week.

“While this year’s report is different because of the impact of COVID-19 on all areas of cancer care, what we found to be encouraging about immuno-oncology is how the pandemic actually revealed strategies that will forever change care,” Sigrun Hallmeyer, MD, chair of the ACCC Immuno-Oncology Institute Executive Committee, said in a news release. “For example, the rapid utilization of telemedicine revealed the potential for effectively monitoring patients under IO treatment. An incredibly tragic pandemic did not slow down the speed of development, approval, or adoption of immunotherapy.”

Respondents reported that maintaining day-to-day operations for IO clinical trials and using telehealth or other technologies to triage or manage immune-related adverse events ­­was extremely (43%) or very (40%) challenging” issues during the COVID-19 pandemic. That said, COVID-19 did not appear to be a stumbling block in all cases. Just 10% of respondents found decision-making about permitting patient clinic visits and adjusting treatment regimens “slightly” challenging and 3% found it “not at all” challenging.

The pandemic was not the only stumbling block community practitioners reported. Financial toxicity and managing communications with subspecialists remain the top IO-related struggles for community cancer programs. Eighty-seven percent of respondents reported that communications with subspecialists was moderate, very, or extremely challenging. Eighty percent felt the same about financial toxicity.

Respondents said that, in the specific context of survivorship, knowing when to stop treatment and communicating with subspecialists, again, were among their most pressing concerns. Eighty-one percent rated those issues as very challenging and 77% said they were extremely challenging.

Community cancer programs are also looking for more clinical and operational support regarding the use of IO agents. Seventy-eight percent want to learn more about associated molecular testing, 63% are looking to learn about easing patient and program financial

strain and 45% are seeking more knowledge about coordinating care across subspecialties.

In general, respondents felt that their knowledge of novel IO therapies was lacking. Approximately half felt that they are very or extremely unfamiliar with emerging therapies such as bispecific antibodies and CAR T-cell therapies. Furthermore, 92% want to learn more about biomarkers and molecular testing and 85% are looking to learn about clinical applications and optimization (TABLE).

The type of education desired varied by provider. Most medical oncologists (67%) prioritized having IO-specific treatment information available whereas 71% of nurse managers ranked the ability to work with payers directly to explain the unique components of immunotherapy as most important. A plurality of pharmacists (40%) emphasized the importance of being able to consult with experts on clinical issues.

TABLE: Greatest areas of educational need

References

1. American Association of Community Cancer Centers. Immuno-Oncology in 2021: committed to the cutting edge of care. July 29, 2021. Accessed August 6, 2021. https://bit.ly/37tJVvu
2. Upadhaya S, Hubbard-Lucey VM, Yu JX. Immuno-oncology drug development forges on despite COVID-19. Nat Rev Drug Discov. 2020;19(11):751-752. doi:10.1038/d41573-020-00166-1
3. Association of Community Cancer Centers releases annual report on current state of immuno-oncology. News release. Association of Community Cancer Centers. July 30, 2021. Accessed August 6, 2021. https://bit.ly/3AhyEuL