Can lessons learnt from COVID-19, aid Childhood Cancer Research? 

by Kidscan’s Scientific Director Dr Dave Pye

Never before has the worlds media focused so much on the development of new medical treatments and the dissection of the regulatory process required to approve their use on humans. COVID 19 has been an eye opener in many ways but the speed by which new vaccines have been developed and the pace they have gone from the lab, to the point of release to the general population, is astounding. Especially in comparison to recently developed therapeutics for other conditions and diseases, where timelines are measured in years and decades, rather than months. 

This obviously begs a few questions, such as why this isn’t the case for other killer medical conditions such as cancer, which killed an estimated 9.6 million worldwide in 2018 according to the WHO and around 165,000 people in the UK each year? Clearly COVID is a disease caused by a single virus, whereas as cancer’s are caused in 100’s of different ways and so is easier to target than cancer. Yet the approval process for the use of new COVID therapies follows the same pathways as for other treatments. So why has the average time for the approval of new innovative cancer drugs moved from 13-years in the period 2000-2008 to 14-years during 2009-2016, and can we learn lessons from the COVID pandemic and speed up the approval process for new cancer treatments? 

Unfortunately, the situation is even worse for childhood cancer. A recent study showed that during the period 2000–2016, there were 177 new drug authorisations for adult cancers by the European Medicines Agency (EMA), with only 6 for children’s leukaemia and just 2 for any other childhood cancers. Most worryingly there were no new drug treatments for lymphomas and brain tumours, these are the second and third most common childhood cancers. Also, the first use of drugs in children takes 6.5 years longer than their first use in adults, so slowing up access for families to the latest treatments that have already benefited adults. 

So are there lessons to be learned from the COVID-19 pandemic and the speed by which clinicians and researchers have moved in identifying and developing new therapeutics? Can the lessons be applied to speed up the development of new childhood cancer treatments? Well first let’s analyse some potential problems. Over 1000 clinical trials into new COVID treatments were registered between January and June 2020 out of these only about a third used the gold standard of a randomised controlled clinical trials. There is also evidence that some clinical trials have been driven by hype rather than a solid knowledge base, for example about 18% of all COVID trials used antimalarial treatments, after the early unsubstantiated media coverage surrounding the drug hydroxychloroquine, which has now been shown to be of no benefit to COVID patients. These and other limitations surrounding COVID clinical trials shouldn’t, however, take anything away from the success and speed of development of the recent Pfizer vaccine and the others that will follow in the coming months. 

Yes, valuable lessons can undoubtably be learned from the rapid success of COVID vaccine development, however many other obstacles stand in the way of the discovery and timely approval of Childhood cancer treatments than just the speed by which the clinical trials process progresses. We need to ensure that more is done to speed up the availability of innovative treatments for childhood cancer by offering greater incentives to pharmaceutical companies to develop these new drugs, and regulations need to be changed to ensure that adult and children’s cancer clinical trials run in parallel when they work in the same way on children as adults. A number of initiatives have been implemented in the last few years that may increase the availability of new childhood cancer treatments, such as the UK’s Early Access to Medicines Scheme, the Accelerated Access Pathway for innovative treatments and the EUs Priority Medicines scheme. However, the impact of these schemes has yet to be researched. 

COVID-19 has allowed scientific and clinical research to shine like never before, with huge media interest worldwide. Yet it’s important that some of this light begins to shine on other areas of medical research, including the field of childhood cancer drug discovery as we move into the post pandemic era.