CCP-Cancer UK [COVID-19] [UPH]
Research type
Research Study
Full title
CCP-Cancer UK: Clinical Characterisation Protocol for Severe Emerging Infections in the UK (CCP-UK) – a prospective companion study for patients with Cancer and COVID-19.
IRAS ID
285044
Contact name
Carlo Palmieri
Contact email
Sponsor organisation
Clatterbridge Cancer Centre NHS Foundation Trust
ISRCTN Number
ISRCTN15019599
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Research Summary:
Currently, there is extremely limited information regarding the risks posed by SARS-CoV-2 virus responsible for COVID19 to patients with cancer. This study aims to understand the presentation, management and outcomes of cancer patients with COVID19. The influence of cancer type and treatment will be explored as well as comparing cancer patients with non-cancer patients. \nThis study will provide valuable information that would educate as well as help inform practice for future possible outbreaks. The information may also inform the development of guidelines with regard to the care and management of cancer patients with viruses such as COVID19 and similar infectious diseases.\nCancer is immunosuppressive, the nature of the immunosuppression seems to be influenced by the microbiota, in addition pulmonary infections are also influenced by the host microbiota, therefore it is important to understand this impact in cancer patients. Analysis of samples from cancer patients with COVID19 offer the opportunity to learn more of these interactions \nThe purpose of CCP-CANCER UK study is to obtain additional data from patients with cancer who were/are recruited into the Principal CCP-UK study which is the key national protocol for characterising COVID19 in the UK population. This study is designed to supplement, not replace, the Principal CCP-UK protocol.\nThis study will be open to research sites who are currently participating in the Principal CCP-UK study.\nThe CCP-Cancer UK study will run for two years. An additional specific cancer data set will be collected from participant’s existing medical records. This cancer specific information when combined with the rich data set related to the COVID-19 episode (derived from CCP-UK) will enable a full understanding of COVID-19 in patients with cancer as well as enable a comparison with non-cancer patients.
Summary of results:
: At the start of this study, we already knew that people with cancer were more likely to die from COVID-19 than people without cancer. Using data from the very large Clinical Characterisation Protocol UK study of COVID-19, plus extra data collected from a group of cancer patients, we looked at which groups were most at risk.
We found that the gap in death rates between cancer and non-cancer patients did not close over two years, even though deaths fell for everyone. At some points the gap actually widened, for example in spring 2021 when the Delta variant emerged. Our most striking finding was that cancer patients under 50 who were having active cancer treatment had by far the highest relative risk of death (five times higher than people of the same age without cancer), even though their actual chance of dying was lower than older patients'. Pandemic planning should treat younger patients on active cancer treatment as a priority risk group.
We also found that patients with lung cancer or brain tumours were at greatest risk, as were those who had been treated for cancer recently. We identified some groups that had not been flagged as high-risk early in 2020 but turned out to have a much higher risk of death than similar people of the same age without cancer. This included younger patients (under 50) who had recently been diagnosed with cancer but had not yet started treatment.
Further work using routine NHS data from Wales showed that, during the peak pandemic years, cancer patients who caught COVID-19 remained at higher risk of death for six months afterwards, compared with cancer patients who did not catch COVID-19.
Some of these findings have already been published; others will follow. We have fed the findings back to policymakers through SAGE, and through publications and presentations at scientific meetings. Our findings show why younger cancer patients need to know they face a significantly higher risk than people their age without cancer.
https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2Fwww.thelancet.com%252Fjournals%252Flanonc%252Farticle%252FPIIS1470-2045&data=05%7C02%7Cleicestercentral.rec%40hra.nhs.uk%7C1221ca464fb24e21382a08deee97979d%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C639210532020248007%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=%2F81fFL%2BMxzOBScVjwvxji1AxjM2ZWyhkOHBJ3mNBWsg%3D&reserved=0(24)00107-4%2Ffulltext/NBTI/xw3HAQ/AQ/cad669f2-105b-4a34-b4ca-21943d1cdfd8/3/CxAGDXecwz
Paper number 2 pending publication.
Study results have been presented at two conferences:
1) European Society For Medical Oncology Congress 2022
2) Fred Hutchinson symposium on infectious diseases in the immune compromised host 2023Study data has also been used by one of the co-investigators to form the basis for training with consultants across the North West of England, as well as training with registrars, oncologists and the cardiovascular society. Results of the wider study have also been used to help revise information and policies regarding SARS-COV-2.
REC name
East Midlands - Leicester Central Research Ethics Committee
REC reference
20/EM/0205
Date of REC Opinion
11 Aug 2020
REC opinion
Favourable Opinion