Resources for tackling COVID-19 in Oncology

30 April 2020

A table of COVID-19 oncology resources previously published may be found HERE. This table will be regularly updated.

 

Latest News and Resources

 

1. Macmillan Cancer Support – Information for patients

Since the COVID-19 pandemic there has been a clear reduction in the number of patients being referred into hospitals for urgent investigation for potential cancers. Macmillan are seeking to encourage the public to present to their GPs with symptoms of cancer and reassure them that cancer tests can be carried out safely.   Your GP is still here for you link to you tube https://www.youtube.com/watch?v=O7JDiuEG15c&feature=youtu.be

2. Government Guidance

Coronavirus (COVID-19): latest guidance for medicines safety – This lists key MHRA advice and guidance issued so far on medicines safety and pharmacovigilance, including on reporting to the Yellow Card Scheme.

Available at: https://www.gov.uk/drug-safety-update/coronavirus-covid-19-latest-guidance-for-medicines-safety

NHS England Clinical guide for the management of palliative care in hospital during the coronavirus pandemic (last updated 22.4.20) available at:  https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/04/C0081-AMENDED-Speciality-guide-Palliative-care-and-coronavirus-v2-2020-04-22.pdf

COVID-19: guidance for stepdown of infection control precautions within hospitals and discharging COVID-19 patients from hospital to home settings - Advice on appropriate infection prevention and control (IPC) precautions for stepdown in hospital or discharge to home or residential settings. (23.4.2020) Available at: https://www.gov.uk/government/publications/covid-19-guidance-for-stepdown-of-infection-control-precautions-within-hospitals-and-discharging-covid-19-patients-from-hospital-to-home-settings

New guarantee on death in service benefits for frontline health and care staff during pandemic (27.4.20) - The families of health and care workers on the frontline in England will benefit from a new life assurance scheme during the coronavirus (COVID-19) pandemic. Available at: https://www.gov.uk/government/news/new-guarantee-on-death-in-service-benefits-for-frontline-health-and-care-staff-during-pandemic?utm_source=79e7d581-5fa0-4c0b-8073-27bc6b7deef4&utm_medium=email&utm_campaign=govuk-notifications&utm_content=daily

 Covid-19: What do we know so far about a vaccine?

The World Health Organization has announced that 83 potential covid-19 candidate vaccines are being assessed (as at 23 April), including seven that have now been approved for human testing through clinical trials. The MHRA has approved a COVID-19 vaccine trial to start in Oxford. Available at: https://www.gov.uk/government/news/mhra-approves-covid-19-vaccine-trial-in-7-working-days

Management of patients with multiple myeloma during the COVID-19 pandemic

Review summarises some recommendations to help with management of these patients. Authors’ state data regarding patients with haematological malignancies are scarce. Nevertheless, the SARS-CoV-2 infection pattern is expected to be similar to that of patients with solid cancers. https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(20)30124-1/fulltext  

 

An evidence summary of paediatric literature around COVID. This post is a rapid literature review of pertinent paediatric literature regarding COVID-19 disease. We are proud to have joined forces with the UK Royal College of Paediatrics and Child Health to provide systematic search, and selected reviews of all the COVID-19 literature relevant to children and young people. https://dontforgetthebubbles.com/evidence-summary-paediatric-covid-19-literature/

Mobile coronavirus testing units to target frontline workers Mobile testing units, operated by the Armed Forces, will travel around the UK to increase access to coronavirus testing. Available at: https://www.gov.uk/government/news/mobile-coronavirus-testing-units-to-target-frontline-workers?utm_source=5e624210-bb20-4a50-8c5f-5ab3c1ee664b&utm_medium=email&utm_campaign=govuk-notifications&utm_content=daily

Weekly COVID-19 surveillance report published PHE will be publishing a new weekly COVID-19 epidemiology surveillance summary. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/880925/COVID19_Epidemiological_Summary_w17.pdf

Latest from eCancer.org on CoVid19 this is a link to the latest available evidence from eCancer. available at: https://ecancer.org/en/news/17527-covid-19-resources       

3. NICE Guidance

COVID-19 rapid guideline: critical care in adults (updated 24.4.20) - They clarified the role of specialists in their recommendation on frailty assessment. Available at: https://www.nice.org.uk/guidance/ng159

COVID-19 rapid guideline: managing symptoms (including at the end of life) in the community Last updated: 22 April 2020 updated guidance on the use of ibuprofen as an antipyretic. Available at: https://www.nice.org.uk/guidance/ng163/chapter/Update-information 

4. Research articles

28/04/2020 update

• Nekhlyudov, L., Duijts, S., Hudson, S.V. et al. Addressing the needs of cancer survivors during the COVID-19 pandemic. J Cancer Surviv (2020). https://doi.org/10.1007/s11764-020-00884-w 
• He, W., Chen, L., Chen, L., Yuan, G., Fang, Y., Chen, W., & Li, L. (2020). COVID-19 in persons with haematological cancers. Leukemia, epub, https://doi.org/10.1038/s41375-020-0836-7 
• Sud, A., Jones, M. E., Broggio, J., Loveday, C., Torr, B., Garrett, A., & Handy, J. M. (2020). Collateral damage: the impact on cancer outcomes of the COVID-19 pandemic. PREPRINT medRxiv. https://www.medrxiv.org/content/10.1101/2020.04.21.20073833v1
• Saini, K. S., de las Heras, B., de Castro, J., Venkitaraman, R., Poelman, M., Srinivasan, G., ... & Curigliano, G. (2020). Effect of the COVID-19 pandemic on cancer treatment and research. The Lancet Haematology. https://doi.org/10.1016/S2352-3026(20)30123-X 
• Barbieri, L., Talavera Urquijo, E., Parise, P., Nilsson, M., Reynolds, J. V., & Rosati, R. (2020). Esophageal oncologic surgery in SARS-CoV-2 (COVID-19) emergency. Diseases of the Esophagus. https://doi.org/10.1093/dote/doaa028 
• Ardura, M. I., Hartley, D. M., Dandoy, C., Lehmann, L., Jaglowski, S., & Auletta, J. J. (2020). Addressing the impact of the Coronavirus Disease (COVID-19) pandemic on hematopoietic cell transplantation: Learning networks as means for sharing best practices. Biology of Blood and Marrow Transplantation. https://www.bbmt.org/article/S1083-8791(20)30229-9/pdf 
• Dietz JR, Moran MS, Isakoff SJ, et al. Recommendations for prioritization, treatment, and triage of breast cancer patients during the COVID-19 pandemic. the COVID-19 pandemic breast cancer consortium [2020 Apr 24]. Breast Cancer Res Treat. http://doi.org/10.1007/s10549-020-05644-z 

• UK Coronavirus Cancer Monitoring Project team. The UK Coronavirus Cancer Monitoring Project: protecting patients with cancer in the era of COVID-19 [2020 Apr 15]. Lancet Oncol. http://doi.org/10.1016/S1470-2045(20)30230-8 
• Zic JA, Ai W, Akilov OE, et al. United States Cutaneous Lymphoma Consortium Recommendations for Treatment of Cutaneous Lymphomas During the COVID-19 Pandemic [2020 Apr 16]. J Am Acad Dermatol. http://doi.org/10.1016/j.jaad.2020.04.049 
• Hrusak O, Kalina T, Wolf J, et al. Flash survey on severe acute respiratory syndrome coronavirus-2 infections in paediatric patients on anticancer treatment [2020 Apr 7]. Eur J Cancer. http://doi.org/10.1016/j.ejca.2020.03.02 
• Tan J, Yang C. Prevention and control strategies for the diagnosis and treatment of cancer patients during the COVID-19 pandemic [2020 Apr 20]. Br J Cancer. http://doi.org/10.1038/s41416-020-0854-2 
• Balduzzi A, Brivio E, Rovelli A, et al. Lessons after the early management of the COVID-19 outbreak in a pediatric transplant and hemato-oncology center embedded within a COVID-19 dedicated hospital in Lombardia, Italy. Estote parati [2020 Apr 20]. Bone Marrow Transplant. http://doi.org/10.1038/s41409-020-0895-4 
• Gillessen S, Powles T. Advice Regarding Systemic Therapy in Patients with Urological Cancers During the COVID-19 Pandemic [2020 Apr 17]. Eur Urol.http://doi.org/10.1016/j.eururo.2020.03.026 
• Campi R, Amparore D, Capitanio U, et al. Assessing the Burden of Nondeferrable Major Uro-oncologic Surgery to Guide Prioritisation Strategies During the COVID-19 Pandemic: Insights from Three Italian High-volume Referral Centres [2020 Apr 11]. Eur Urol. http://doi.org/10.1016/j.eururo.2020.03.054 
• Gandhi, R, Lynch, J and del Rio, C (2020) Mild or Moderate Covid-19, New England Journal of Medicine https://www.nejm.org/doi/full/10.1056/NEJMcp2009249?query=featured_coronavirus
• The Health Data Research Hub for Cancer in the UK Deaths in people with cancer could rise by at least 20% https://www.ucl.ac.uk/news/2020/apr/deaths-people-cancer-could-rise-least-20

5. Times Higher Education (THE) Some types of patient data, crucial for understanding who might be worst hit by the virus, are often inaccessible for researchers. A new portal hopes to change that by centralising the European data. https://www.timeshighereducation.com/news/europe-seeks-centralise-fractured-coronavirus-data?utm_source=THE+Website+Users&utm_campaign=a9f9eb90f5-EMAIL_CAMPAIGN_2020_04_24_02_50&utm_medium=email&utm_term=0_daa7e51487-a9f9eb90f5-74749477

6. The Royal Society of Medicine RSM Live brings together leading experts and decision makers to share, discuss and debate the latest developments on a range of healthcare topics and specialties. There are a range of webinars available for free on this website around CoVid19. Available at: https://www.rsm.ac.uk/rsmlive

7. NHSE Guidance on reuse of medicines in care homes and hospices during COVID-19 https://www.gov.uk/government/publications/coronavirus-covid-19-reuse-of-medicines-in-a-care-home-or-hospice

8. Updated resources on Macmillan learnzone On the Learnzone the palliative, end of life care and prehabilitation resources have updates https://learnzone.org.uk/coronavirus/. On the Coronavirus hub The End of Life page is now updated with all of the information about funerals: https://www.macmillan.org.uk/coronavirus/end-of-life-care-and-coronavirus. The treatment videos have been added to the treatment page. They are really  helpful, reassuring, and have real human content, with thanks to everyone who made these happen! https://www.macmillan.org.uk/coronavirus/cancer-treatment-and-coronavirus

9. Blood cancer UK survey of 3000 people on COVID-19 experience

Blood Cancer UK surveyed more than 3,000 people affected by blood cancer to find out their concerns about coronavirus. The results and proposed actions are published here  https://bloodcancer.org.uk/news/findings-our-survey-covid-19/

10. Prescribing Advice in COVID-19 Disease

a) MHRA Drug Safety Update- Coronavirus (COVID-19): latest guidance for medicines safety

Key MHRA advice and guidance issued so far on medicines safety and pharmacovigilance, including on reporting to the Yellow Card Scheme is available here https://www.gov.uk/drug-safety-update/coronavirus-covid-19-latest-guidance-for-medicines-safety

b) Offer of free access to online training for prescribing

CHAIN is a successful online mutual support network of people working in health and social care. The Network originated 20 years ago in the NHS Research & Development programme in England. They have produced a training resource for prescribers, which has just been made freely available due to the current COVID-19 pandemic. It is available here https://www.safemedicate.com/sm_site/promo/nhsoffer.php

 

11. SafeFit: Virtual clinics to deliver universal interventions to maintain and improve mental and physical health in people with cancer who are following social distancing guidance: A COVID-19 targeted trial

A recent statement by Professor Chris Whitty, Chief Medical Officer, NHS England, emphasised the significant benefits of exercise for all people. He said -:
 “this may be challenging for people self-isolating and even more so for those highly vulnerable people that are having to shield against the virus within their own home”. 

COVID-19 updates 28 May 2020

   

• Safety, tolerability, and immunogenicity of a recombinant adenovirus type-5 vectored COVID-19 vaccine: a dose-escalation, open-label, non-randomised, first-in-human trial, The Lancet May 22 2020, DOI: https://doi.org/10.1016/S0140-6736(20)31208-3
• Coronavirus: Children and older adults to take part in vaccine trial Children and older adults are to be included in the second phase of vaccine trials to protect against coronavirus. https://www.bbc.co.uk/news/health-52760871
• Covid-19 and thrombosis: what do we know about the risks and treatment? BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2058 (Published 21 May 2020)
• Covid-19: Two antibody tests are “highly specific” but vary in sensitivity, evaluations find BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2066(Published 21 May 2020)
• Government to offer antibody tests to health and social care staff and patients in England https://www.gov.uk/government/news/government-to-offer-antibody-tests-to-health-and-social-care-staff-and-patients-in-england
• British Society of Blood and Marrow Transplantation and Cellular Therapy, latest recommendation regarding transplants during COVID  http://www.bsbmtct.org/bsbmtct-recommendations-for-covid-adult-bmt-18th-may-2020/
• Cancer Research UK have updated their patient information pages to include information around Covid-19. Visit the pages here:https://www.cancerresearchuk.org/about-cancer/cancer-in-general/coronavirus
• Some easy to read stats re coronavirus to date https://www.laingbuisson.com/coronavirus-latest-stats-figures-numbers-and-charts/
• The UK Coronavirus Cancer Monitoring Project: Report (25/05/2020). Report available online at: www.ukcoronaviruscancermonitoring.com(people can sign up for weekly bulletins if information is helpful)
• The Palliative Care Institute in Liverpool is currently setting up an online survey regarding end-of-life care during the Covid-19 crisis, for which they have received University of Liverpool ethics approval. The impact of Covid-19 will have affected the experience of death and dying for patients, relatives, friends and healthcare professionals. This is an open online survey through which respondents will be asked questions about their experiences of end-of-life care provided to a recently deceased relative or patient. At the end of the questionnaire, they will be invited to participate in a follow-up questionnaire 3 months later and potentially an in-depth interview. The target audience is bereaved relatives/friends and healthcare professionals/trained volunteers (all specialties and disciplines) who have experienced the death of a relative/friend/patient during the Covid-19 crisis. The deceased may or may not have had Covid-19 themselves. Interested parties will be openly invited to participate via social media, public websites and personal contacts. The survey will launch on Monday next week.
• HDR UK researchers analysed recent weekly data from major cancer centres in the UK and found a 76% average decrease in urgent referrals from GPs for people with suspected cancers and a 60% average decrease in chemotherapy appointments for cancer patients compared to pre-COVID-19 levels. The study estimates that as a result of the COVID-19 emergency, there could be at least 6,270 additional deaths in newly diagnosed cancer patients alone. https://www.hdruk.ac.uk/case-studies/delineating-the-adverse-impacts-of-the-covid-19-pandemic-on-patients-with-cancer-and-cancer-services/

 

SafeFit has been designed, in response to the COVID-19 crisis, to support people living with cancer to maintain and improve their physical and mental health and well-being, whilst following government guidelines. 

The service is for people living with cancer aged 18 years and over who will access the service via a dedicated page on the Macmillan website. The service will be delivered by CanRehab specialist exercise instructors, who will undertake a robust screening and holistic needs assessment.   

People will be supported remotely in their own homes with advice about exercise, nutrition and emotional support - the ‘universal interventions’ described in the Principles and Guidance for Prehabilitation in the support and management of people with cancer (https://www.macmillan.org.uk/about-us/health-professionals/resources/practical-tools-forprofessionals/prehabilitation.html), the NHS England Personalised Care model and aligns to the development and inclusion of prehabilitation in national cancer strategies in Northern Ireland, Scotland and Wales.

An integral part of this service will be a COVID-19 interventional evaluation trial led by the University Hospitals Southampton NHS Trust WesFit research team. This will provide the evidence required by commissioners and include both primary and secondary outcomes.

The service interventions will be delivered by one of more of the following methods: 
• individual telephone consultations 
• one to one video exercise sessions 
• group exercise sessions. 

People living with cancer are likely to need different numbers of interventions and this will be accommodated as part of this developing service offer.
The instructors will have information required to enable them to signpost people to both Macmillan and other local information and service offers based on their identified needs including ‘Move More’ services in Northern Ireland and Scotland.

The service, due to go live imminently, has been set up initially for a six -month period during which there will be close monitoring of the demand, capacity and funding options for the service going forward. 

The ambition is that SafeFit will become a business as usual service, providing on-going support for people affected by cancer, especially during the extremely challenging recovery period of this pandemic. This model is highly translatable and transferable to all people with chronic diseases, particularly those recovering from critical illness

SafeFit has been developed in partnership with:  University Hospitals Southampton NHS Trust,  Wessex Cancer Alliance, Macmillan Cancer Support, CanRehab Trust

 

• Covid-19 treatments could be fast tracked through new national clinical trial initiative

This will accelerate the development of new drugs for patients hospitalised with COVID-19, reducing the time taken to set up clinical studies for new therapies from months to weeks. Click here to access: https://www.gov.uk/government/news/covid-19-treatments-could-be-fast-tracked-through-new-national-clinical-trial-initiative?utm_source=cfe12fba-ccf3-4b34-a54b-858f4733d771&utm_medium=email&utm_campaign=govuk-notifications&utm_content=daily

• Current awareness service for health 

Links and Resources to provide easy access to the key sources of information about the pandemic. Click here to access: http://cash.libraryservices.nhs.uk/subject-a-z/i/infection-prevention-and-control/covid-19/

• COVID-19 rapid guideline: antibiotics for pneumonia in adults in hospital

NICE guidance available here: https://www.nice.org.uk/guidance/ng173

• COVID-19: guidance on shielding and protecting people defined on medical grounds as extremely vulnerable, Government updated 5.5.20- https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19 

Updates from Macmillan 12 June 2020

·       Easier access to Macmillan resources for professionals on our website hub - www.macmillan.org.uk/coronavirus which you can access without the need to log onto Learnzone

·       Macmillan are reviewing and up-dating their acute oncology e-learning.  If anyone has experience of developing acute oncology e-learning and would like to help Macmillan with this work, please contact Jo Fairhurst - JFairhurst@macmillan.org.uk

·       Will there be a second wave of COVID-19? data and views from COVID symptom study https://www.youtube.com/watch?v=oAmVPaxMQ1c

·       cancercovidsurg study – global study of cancer surgery https://globalsurg.org/covidsurg-dissemination-and-outputs/ first publication in Lancet https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31182-X/fulltext

·       International Long Term Care policy Network Resources to support community and care homes by country for comparison and sharing https://ltccovid.org/

·       Telephone buddies for patients, How a Telephone Buddy helps. Going through cancer can be an isolating experience at any time, and especially when social distancing. Macmillan provides a free Telephone Buddy service to support patients at home. They match patients with each other who understand what a patient is going through, and they give the patient a weekly call. The volunteer buddy will be a listening ear, ready to talk about how they are feeling and provide support during this difficult time. The buddy can also talk about Macmillan services, and all the ways Macmillan can help, to ensure they don't face cancer alone.  https://www.macmillan.org.uk/get-involved/campaigns/telephone-buddies

• Ethnicity and Outcomes of COVID-19 patients in England

Increased COVID-19 risk for ethnic minorities, according to academic study supported by NHS digital

Click to access: https://vanderschaar-lab.com/papers/Ethnicity_COVID19_Cambridge_NHS.pdf

Current awareness service for health Links and Resources to provide easy access to the key sources of information about the pandemic. Click here to access: http://cash.libraryservices.nhs.uk/subject-a-z/i/infection-prevention-and-control/covid-19/

NICE guidance updates

‘Special considerations in the management of adult patients with acute leukaemias and myeloid neoplasms in the COVID-19 era: recommendations from a panel of international experts’ 

These expert consensus recommendations cover key changes related to service allocation, clinical and supportive care, clinical trial participation, and ethical considerations regarding the use of lifesaving measures in haematology patients. 

https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(20)30205-2/fulltext

Scottish partnership for palliative care 

This highlights new Scottish key guidance and resources relevant to palliative care. We also look at other useful resources (UK and beyond) and highlight research sources. There are also some self-care ideas and a couple of things intended to lift spirits. Click here for access: https://www.palliativecarescotland.org.uk/viewmail.php?i=5527&l=member-1&m=1588335963&c=3b82e0f072da27a1e62a20ed82e55c0c

COVID-19 rapid guideline: haematopoietic stem cell transplantation, NICE guideline [NG164] Published date: Last updated: 29 July 2020 amended recommendations on advice and testing for COVID-19 for patients and donors, and removed recommendations on deferring treatment for some patients to reflect changes in the risk of infection and the capacity in services. https://www.nice.org.uk/guidance/ng164