Topic: To understand the specific needs of lung cancer patients during the COVID-19 pandemic, panelists will discuss a recent survey created by GO2 Foundation and other patient advocacy groups.
- Danielle Hicks, Chief Patient Officer at GO2 Foundation
- Amy Moore, PhD, Director of Science and Research at GO2 Foundation
When: July 30, 2020. 3PM - 4PM EDT
Where: Newswise Live Zoom Room
This live event will also be recorded and transcribed for use by media and communicators after it is concluded.
Julia Spiess Lewis
Thom: Welcome to this Newswise live event. Today we have representatives from the Go2 foundation for lung cancer to discuss the needs and concerns of the lung cancer community during the Covid pandemic, and especially to discuss the results of a survey that they participated in, along with other cancer advocacy groups. We have with us on our panel today - Danielle Hicks. She's the chief patient officer for the GO2 foundation. And we also have Dr. Amy Moore, who is the director of science and research for the GO2 foundation.
Thank you very much for joining us. And I want to ask to start off with here, Dr. Moore - tell us about the results of this survey that you collaborated on and what insights that's provided about the concerns and needs identified in the lung cancer community during this pandemic.
Dr. Moore: Sure, thanks for the question. And before I do that, I want to give you a little bit of the context for what led to the survey in the first place, and that was basically the recognition early on in the face of this pandemic, that SARS -COV2 and COVID-19, the disease caused by it presented a unique threat to the lung cancer community. And then my role with GO2 foundation. I work closely with a number of the patient driven groups, advocacy groups and my colleagues across other Lung advocacy organizations. And so, we really came together and mobilized rapidly to try to provide scientifically vetted information to our community and we wanted to assess both the impact of that joint effort and these weekly statements that we've been providing to our community. But then we also conducted a rapid needs assessment survey early June to dig deeper into the concerns of patients within the lung cancer community.
So again, this was a survey that we disseminated in early June it was open for five days, we had 83 respondents, most of whom had stage three, stage four lung cancer, over half of the respondents were over age 60. And we delved into several areas, if you will - first patients, want to know general information about COVID-19. And so, we asked them questions about symptoms, how to reduce their risk, how to find reliable sources of information. We looked at their concerns about what happens if they get the disease so they want information about the latest treatments, what are the efforts that are underway to develop a vaccine? They want to understand what immunity looks like, what does it mean in the context of COVID-19? Do we know yet what immunity means? And they also want to know more about testing, what do the different types of tests mean? Additionally, they also had concerns about what the impacts of the pandemic were on lung cancer research specifically, what were the impacts on clinical trials? Would they have access to appropriate treatment? We were hearing in the early days the pandemic, especially in Europe and Italy, where it was so severe and where hospitals were overwhelmed that some patients were being triaged of treatment.
So, we delved into each of these concerns, and what we found was that, according to age patients did have different concerns - those under age 60, were especially concerned about, what it would mean for them if they're located in a COVID hotspot. They were also particularly concerned about, clinical trials shutting down or laboratory research stopping, that we would lose momentum in our efforts to address lung cancer. For those over age 60 - they were primarily concerned about having
access to their health care providers. So, it's clear that lung cancer patients are anxious. They are fearful because what our data has shown is that lung cancer patients are uniquely vulnerable to this disease and they have higher rates of severe disease and increased mortality. And so, we wanted to be as proactive as we could - partner with our colleagues across the lung cancer advocacy community to address these needs and to educate and empower patients to make the most informed decisions possible.
Thom: I'd like to ask Danielle how the GO2 foundation is responding to these needs identified from this survey, and ensuring to deliver useful and accurate info about the Covid 19 pandemic to these lung cancer patients.
Let's make sure your audio is live.
Danielle: Thanks, Thom.
Yeah, we have several different programs within GO2 foundation that are trying to help not only to Amy's point with the survey and the study that we did, not only to identify what some of these concerns in our patient population might be, but to help us better be set up to help them based on those concerns. So, some of the resources that we provided go to Amy from our team, as well as some scientists from some of the other lung cancer groups out there, we put out a joint statement. Early on in the pandemic, it was once a week, we've recently switched to bi weekly. They report on general COVID-19 information as well as COVID-19 and its impact on lung cancer patients.
We have a helpline at the foundation where patients can call us and they really see us as this trusted third party for reliable information. So, we can, grab them and in real time, what some of their concerns might be, and then triage them into the appropriate space based on their needs.
A lot of things we're hearing from the helpline are, patients feeling socially isolated, where can they, how can they kind of come out of their mental health sort of funk that they've found themselves in based on this. And we have some peer to peer mentoring programs where we provide that direct one on one support from patients who have offered to volunteer and be part of our mentorship program. And we also have our online communities – Help Unlocked and Belong, which are really designed for that peer to peer support online. It's moderated by staff from GO2 foundation. We have a rapid response living room that we rolled out through at the beginning of the pandemic - through June, which really was a weekly sort of visual response to what Amy and her colleagues were working on in the rapid response joint statements that they were putting together. Some of the work that we've done is community advocacy to federal and state leaders during the time of the pandemic, to identify and communicate the needs of our community around issues such as expanding telehealth, testing medical supplies, fairness, and access to treatments and medications. So, on and so forth. I think those are just a few of the things that we are doing at GO2 foundation to help address the needs of this community.
Thom: Dr. Moore, what are the biggest concerns about someone already in the course of lung cancer treatment to continue to get their care that they need during the pandemic in a way that allows them to stay safe, but keep on track with their with their therapy?
Dr. Moore: Yeah, I alluded to some of the concerns that emerged as a result of the survey and I think first and foremost, the early reports that were coming out, really spoke to the increased risk to the lung cancer community. And when we first started these joint statements, it really was about communicating how patients can protect themselves, kind of reaffirming those public health protective measures that we've all been practicing religiously for the last four and a half months, social distancing, washing hands, wearing the mask, doing all that. It then was also a concern of, would they, especially patients with later stage disease, more advanced disease, be triaged out of the system completely and not even receive access to care? And so we tried to provide and wade through the information - I think that was the other thing is, it was a highly, it's a very scary time for everyone and the amount of information that has been coming out is difficult even for those of us who are scientists to process and make sense of and the news seems to change almost daily, in some cases. So, for patients that was particularly hard to navigate. And so, we wanted to kind of take that burden off of their shoulders and provide that scientifically vetted up to date, most current information that we had at our fingertips to help them make decisions. I think, as I said, depending on your age, different concerns, were kind of top of mind for older patients who are used to having that face to face interaction with their doctor, that was particularly scary for them. And so, they want to know, will I continue to have access to my healthcare provider, maybe I'm not as computer savvy and I'm not used to this new concept of tele-health. For younger patients, many of them are a little more technology savvy. And so, they are keeping up with the news. And they see what's out there and they're concerned about – what if I'm in a COVID hotspot? Should I go into my appointments? Should I keep up with my treatment? But they also wanted to know - does it mean that now we're deploying all of our efforts against COVID at the expense of lung cancer research – is my next lifesaving drug out of reach, because now we've halted everything that has to do with lung cancer. And I think, the takeaway that we've tried to reinforce is that this isn't an either-or conversation. It's not either-or time in the research community - it is all hands-on deck, but we continue to make rapid progress and continue to chip away at lung cancer.
So, there are multiple concerns and we're doing our best just to reiterate to the patient community that we are here in every way to support and guide them through these challenging times.
Thom: Danielle, tell us a little bit more about the resources and support type of activities that the foundation is doing. You mentioned peer to peer and various kinds of other newsletter and meetings. What's going on in these discussions? And what kind of feedback are you hearing and seeing about how patients and caregivers are coming together and, and providing support to each other?
Danielle: So, I think pointing back to what Amy said in some of the what we're hearing and seeing directly with her patient population is very similar to what the study that she mentioned earlier showed. One of the things I think outside the concerns around their direct health care are concerned just around any increased risk and when can they go back to living in the real world, a lot of patients are still following more strict guidelines even as things start opening up and now looks like are closing back down again. But things like family visits, even going to the grocery store, for some of them even taking a walk. I mean, those are great concerns for them - contracting the virus.
In our communities, we're seeing a lot of really interesting relationships happening. I mentioned social isolation a little bit earlier and I think, in particular, when it comes to our lung cancer living room, which is a patient education and support series, that has really been a live and virtual event for the last decade or so. So, we have obviously gone completely virtual but patients have a chance to not only have access to the speakers and the key opinion leaders that come in and speak at these meetings, but they have access to one another through the online chat. So, they're making great connections there. And in our online communities, it's really interesting to hear that patients - I can tell a patient all I want and so can Amy - all she wants, about, what is happening in the real world, and this is what data is telling us and so on and so forth. But we aren't lung cancer patients. So, these communities really generate an environment where they can learn from people who are walking the walk, and there's been a ton of positive feedback about patients being allowed that opportunity and, and appreciative of it.
Thom: Yeah, it's really remarkable how the right message also needs the right messenger sometimes in those cases, right. Dr. Moore as we continue to monitor the progress of the pandemic and it shows no sign of slowing down at the moment, there's clearly a lot of concern among people with all kinds of respiratory diseases and disorders about exposure to the coronavirus. What's particularly, so risky for lung cancer patients if they were to contract COVID and therefore, more important than ever, maybe to protect them from that exposure and give them good, accurate information about what they can do.
Dr. Moore: There have been a number of studies that have emerged since the start of the pandemic, looking at the increased risk of patients with various comorbidities - not limited to cancer. We've heard talk about diabetes or hypertension. So, what we do know is that cancer puts patients at added risk for worse outcome and lung cancer in particular, of the various malignancies seems to be
one of the worst scenarios because again, this is a respiratory virus that infects the lungs and lungs of lung cancer patients are already compromised to some extent. So, it was important for us to try to understand the reasons for that and why this increased mortality was occurring. There have been reports that range anywhere from 20% mortality to as high as 50% mortality, depending on the study and there are different caveats and considerations with each of those studies and where they were conducted and the size of them and so forth. But what is clear from a number of registry studies that have developed internationally is that lung cancer patients have elevated risk. So, what does that mean for us and how we message that to the community?
It means we keep reinforcing the need to take appropriate precautions. So, there are lots of efforts underway to develop effective therapeutics, to develop vaccines - until we have those and till, we know we have something that works, we do have effective measures to limit your risk. Again, there's public health precautions that we've discussed and so, to Danielle's point, it's a huge - I think concern induces a lot of anxiety for patients to think about kind of sheltering in place almost indefinitely, it seems at times and so what we want to do is to empower people with the facts that they can take to be as cautious as possible. So, I’d like to remind them that it's, think about if you are, considering taking a trip over the summer, think about the context, where are you going, what's the burden of COVID-19 in the location you're thinking about traveling to? Are you going to be primarily indoors or outdoors because we know that carries additional risk, if you're going to be indoor. How long will you be participating in said activity and you can begin to kind of assess the risk of various activities that you might be undertaking. And that helps you minimize your risk to the largest extent possible. We don't want to take people's kind of empowerment and control away. What we want to do is educate them so they can be as safe as possible. And that's a balancing act that we try to achieve because it's difficult times and people - they need to have that balance I think as the pandemic kind of drags on.
Thom: We have a question in the chat from Neil Auster Weil, who writes for chest physician, and he's asking how do you get clinicians to buy into these efforts? Dr. Moore, what's the success rate of getting the caregivers to participate in these projects?
Dr. Moore: I mean, that's a great question and I think, it's something that has been challenging, admittedly, in various places, depending in the country, in the early days to, our cities were hard hit, and now we see the pandemic kind of marching across the country and moving into smaller communities and how do you get, not just the patients taking appropriate precautions, but those in their circle, their caregivers and their family, the health care providers. I mean, thankfully, what we've heard through our networks of screening centres of excellence and care continuum centres of excellence is - at least in a health care community, good uptake of appropriate precautions, and even me personally, I'm trying to check off my own self-care, doctor's visits and dental appointments during this time and I've been encouraged by the lengths that the health care system is taking to ensure patient safety when they do go in for those appointments. As far as how do we educate your immediate circle of family and friends to take the same level of precautions that the patients are taking? Hopefully, it's a matter of protecting the people you love and doing the right thing. That's I think a struggle that we find ourselves engaged in nationally - is that broader dialogue of doing the right thing and looking out for your fellow man and for cancer patients in particular, they're near and dear to us. So, we encourage everyone to just adopt those behaviours as well because you're really taking care of your fellow man.
Thom: Danielle, is there anything you'd like to add on the question of getting physicians to participate in these efforts?
Danielle: I mean, I think I agree with what Amy said, I think education is key. And we say all the time. For us, it's not always just about educating the patients on best practices and how to stay safe during this time, but providers as well, right. So, we have a provider page on our website where physicians, nurses, nurse navigators, anybody want a clinical team, or administrative team for that matter can go and find out what the current recommendations are. We have staff on board to help answer questions to get folks back up and running, particularly in the screening area, which Amy pointed on a little bit where there has been a very significant decrease in patients participating in lung cancer screening, thereby directly affecting - an extremely significant decrease in lung cancers diagnosed since the pandemic started.
Thom: What can you tell us about measures that are being taken by cancer centres and clinics and other physicians treating cancer patients to protect those patients so that they continue their treatment without delays and what could really reassure these patients and their families that it is indeed safe to go into these places these healthcare settings in spite of the pandemic?
Danielle: Sure. So, there's a couple of things both inside and outside of a medical facility that can be done - telehealth of course, plays a big role for patients who don't necessarily need to come in to the physician, but they need to connect with their physician or someone for their care team for one reason or another. The other is, we talk all the time internally about how hospitals and doctor's office and your dentist office and your restaurants for that matter, are cleaner now than they've ever been right. And it's equally as important to your health care team, that you're safe when you're there as it is to you that you're safe when you're there. So quite often you will see pre-screening, general wellness questions, temperature checks once you get to the facility, rather than waiting and waiting rooms quite often they will ask patients to wait in there in their vehicles until it's time for their - for them to come in for their appointment. Obviously, we've all heard about how patients are asked to come in alone, which can be a challenge quite often, for patients who are often frightened about whatever that that appointment may or may not be about. Not only are the patients doing these wellness checks, but the clinical teams and the hospital workers are also doing these wellness checks as they're signing in for work that day, maybe they're getting their general questions and temperature checks happening. Another thing that's, been an interesting sort of shift and is done where applicable is changes in dosing regimens. So, the amount of time in between maybe a physician's visit can be extended - immunotherapy in a good example of where they're changing the length of time that you're required to have your treatment.
Thom: That's interesting. So, optimizing the way that the drugs might be administered so that the patient needs to come actually into the clinic less often.
Dr. Moore, what can you tell us about the different types of tests for COVID? And how understanding that can impact the safety of treating lung cancer patients as they come in for visits with their doctor, as well as they themselves or family members, get screened for the coronavirus infection so that they can minimize the risk of transmitting it to the patient. What's important for them to understand about those different kinds of tests, right?
Dr. Moore: Well, there are really two key types of tests. One is to determine if you have an active infection and that's where, we think about going in and getting the gold standard nasal swab tests which can detect the genetic material of the virus. So again, these viruses have RNA as their genetic material, and we're looking for that signal on the, on the nasal swab. So that's to look for active infection. There's also something called a rapid antigen test that, again, is to try to, detect the presence of active virus more quickly. I've heard the analogy of maybe when you go in for a strep test, you have the rapid strep test versus they always send a swab off to the lab to see if there's bacteria present, but there's a rapid antigen test and then there's the antibody test. So that is to determine if you have had a previous exposure to the virus at some point. Now, there's been a lot of controversy and swirl and challenges around testing all the way from, our inability to test enough people in a timely kind of way, but also to deliver those test results in a way that kind of minimizes potential exposure to other people. And then in the context of antibody test, again to determine if you've had this previous exposure, that brings in this whole discussion around immunity, that was kind of the early conversation, people wanting to get these antibody tags so they could get some kind of, seal of approval and say, oh, I've been infected – I’m immune.
Well, what we understand to be true right now is that we don't know how long the immunity lasts, there seems to be some variability in how long antibodies generated to the virus may linger in your system. So, it's a complicated landscape, but what I tell people is if you have symptoms, if you're presenting with a fever, cough, shortness of breath, loss of taste or smell or any of those kind of growing list of symptoms, you should go out and get either the nasal swab or rapid antigen test. Maybe you were sick at some point in the past and you want to confirm whether or not you may have had coronavirus. That's where you consider the antibody test. So again, lots of challenges. I know it's a confusing kind of landscape for people. But that's really kind of the differentiator there's distinguishing active infection in previous infection.
Thom: You mentioned potential delays and getting results to the PCR type of tests, for example, how much does that complicate things for someone who's undergoing treatment for lung cancer for them and their family's safety? is there any possibility or option for expediting or prioritizing tests for people who are in a particular risk group like this?
Dr. Moore: I think certainly in the case where patients are going in for, surgery, biopsies - those tests are often performed in house and yeah, there is I think some - seems to be some encouraging news that maybe, some of the tests have been developed in house at different facilities, they can turn those over a little bit more quickly, to have a little more control than if it's done by, an outside laboratory that's kind of doing these tests in mass and trying to process them.
But I mean, that back to Danielle's point about kind of the added security, I mean, I think that's another piece that hospitals and doctors’ offices are trying to layer in is, if a patient is coming in for , surgery – be it lung cancer or something else - they want to upfront kind of do that testing. There have been anecdotes, we've all heard of them. One medical oncologist we worked with who early on had a patient who had all the symptoms that were consistent with COVID yet the person kept testing negative on repeated tests, but they treated the patient is if they had COVID. And, eventually they did the antibody test on them and confirmed it. Indeed, they had had the virus at some point. So, we're still, as a scientific community, I think pressing harder to try to improve the reliability of the test to scale up our manufacturer in testing capacity to improve our ability to relay those results in a timely manner. Because again, the concept of contact tracing, being able to know if someone is positive in a timely way so that we can protect as many people around them and try and limit the spread because again, this virus has the potential for exponential spread and we think about the number of people you could infect - being two - we're between two and three people.
So, all those things are important and, it's imperative that we make improvements there but critically important for lung cancer patients for sure.
Thom: Danielle, when we talk about the likelihood of infecting two to three or more people when someone has the coronavirus infection, and they don't know it, or haven't gotten a test back yet, because they weren't symptomatic until a certain stage and what we know is that the transmissibility is highest right before symptoms, what's going out to patients as part of your education efforts to explain about those risks, that the transmissibility can happen before symptoms, or even with cases that are completely asymptomatic - That seems very important to really convey effectively and convincingly to people in this community and it's been something that's been a bit of a controversy or debate in the public. So, I wonder how you're helping to make sure that that kind of education is happening in a way that really sinks in for these folks who are at risk?
Danielle: Yeah, I mean, I think all of the aforementioned programs, and support and education services that we provide are updated on the regular. One of the biggest, challenges or concerns, I think, in working directly with patients is their fear of the unknown, right, and how quickly things are changing. We're sort of building the plane while we're flying it in a sense, right? Because there are so many unknowns about this virus. The joint statement that goes out, like I said, I will reiterate that. We've pushed that out through all of our communication channels, as well as the living rooms when we have our rapid response living room. With our experts coming in talking about this, we've pushed that out through all of our communications and marketing channels. So, I think us like most folks out there who are trying to educate the general population, are using the tools that we have in place. And were fortunate enough, like I said that a lot of our programs were virtual prior to this. So, we had a lot of folks already knowing to tune in when the pandemic hit.
Dr. Moore: If I could just piggyback onto that briefly, as part of this joint statement, the beauty of kind of the collaboration that has come together is, my background is - my PhD is in virology, which is obviously of added value right now. My colleague, Dr. Upal Basu Roy, who is at LUNGevity Foundation has a master's in public health. And then we co-write these updates with Janet Freeman Daily, who herself is a lung cancer patient and research advocate, and brings that lens of the patient to everything that we do.
So, through these joint updates we had one week where it was effectively a primer in epidemiology. And what we call the ‘R nought’ the reproduction number of the virus, trying to educate people on what that means, how many people you're infecting, the steps you can take to minimize the risk not only to yourself, but to others around you. We really feel that’s our moral obligation, if you will, to provide that scientific information in a way that our community can understand, in a way that empowers them, in a way that is still hopeful, so that, in the face of so much uncertainty and so much fear, I want people to still know that there's hope. And so, we are really committed to distilling down the essential pieces of what they need to know, how they can protect themselves, what it means, so, I think that's an important service that we're providing to the community.
Thom: One of the major issues as hospitals and health care facilities shut down earlier this year, and then beginning to reopen while the pandemic spreads is a drop in cases of newly diagnosed cancer. And I wonder - as this is potentially somewhat of a looming crisis, that many more people eventually may be diagnosed, but could have missed out on early detection and earlier treatment interventions. The impact on their long-term outcomes certainly will be affected. Dr. Moore, what are your concerns with that? And what would you want patients to know in order to get them talking to their doctors, doing that telehealth visit or coming in for a screening if necessary?
Dr. Moore: Absolutely. I mean, it's very disheartening, disturbing to us who do so much to try to educate and empower people to begin with, a big piece of what GO2 foundation does is around screening, because we know fundamentally that early detection saves lives. And if that's not happening - to your point, with the drop in new diagnoses, we don't want to lose ground. As I said, at the beginning of this year, we were celebrating the single, single year biggest drop in cancer mortality, largely attributed to advances in lung cancer in particular, new targeted therapies or immunotherapy. So, we are working with our partners to figure out what we can do to best address these gaps. And, I personally, take it upon myself to model those best behaviours, I'm going out and doing their own screening tests, doing my own cancer prevention. So, I want to model that and convince our community that it's still safe to go and do these things and it's critical that you do these things. But we'll be delving deeper into how can we convince patients that it's safe, they should keep up with their visits, they should do the screenings. And that gets back to some of the educational pieces that Danielle and her team, really spearhead working with our colleagues that work closely with those screening centres of excellence and with our care continuum centres of excellence, which focus on best practices around lung cancer care in community hospitals. So, it's definitely top of mind for us. And we're going to be kind of re-upping our efforts to help people get the care they need. Because again, early detection is paramount.
Thom: Media who were on the call, please feel free to chat your questions, you can chat them to me, and we'll offer if you'd like to ask the question yourself or if not, I'll relay the question to our panellists for you. Danielle, what would you if anything add to that question about people not coming in for screenings, maybe someone who had a case of cancer that was treated effectively and successfully but maybe they were reluctant to come back in for a follow up or something and could be having cases re-emerge or new cases that are getting missed. What else should we be doing about this?
Danielle: Yeah, so I think one of the things I'd like to kind of point out is that, screening for lung cancer is a fairly new, it's been around for a few years now. But the folks that are eligible in this country alone for lung cancer screening - the numbers are anywhere between 9 and 10 million people that currently qualify for lung cancer screening. Pre pandemic, we were at roughly 4% of that population actually getting screened. So, it was a challenge even before the pandemic, right, so we're looking at not only those that qualify for screening, but there's another subset of patients that we're looking at where their nodules are found incidentally. So, they had gone to the doctor for one thing, and, it turns out everything was fine from whatever that one thing was, but they did find a pulmonary nodule, right. So, because screening centres early pandemic had to close, folks are afraid – there are a multitude of factors and variables that we've talked about, since the beginning of this that caused people not to be able to go to the doctor directly affect the screening rate, but it also directly affects those who's nodules may have been found incidentally. I think I mentioned earlier that the new lung cancer diagnosis, not just screening and early detection, those early stage patients but across the board, recent data showing down 50 to 60% - That's huge. That's a huge number and it's not only a huge number of people who are missing - it's a huge number of that 4% I guess if you're looking at the early stage patients, but it's an even bigger number, if you look at the those that qualify if that, if that makes sense. So, I think all we can do, Amy touched on it earlier, we have both our screening and our care continuum centre of excellence that make up our Centre of Excellence Program. We have a little over 700 screening centres across the country, a lot of which had to shut down early pandemic, and we've been working very closely. Our team has been working very closely with them to help them get back up and running, using some of the tools and recommendations that I mentioned before.
Dr. Moore: For example, there's a webinar that's upcoming right, Danielle, that we've convened a panel of experts to discuss safe resumption of screening for lung cancer. So, that's been part of the resources and offerings that we've provided throughout the pandemic is - really having these expert panels talk about, telemedicine, or, as we said, the impacts on lung cancer screening how we can get those numbers back up. Because to your point, we don't want to lose patients to the pandemic, we've made too much progress to go backwards, we need to figure out how we can keep moving forward.
Thom: One of the things that will quite clearly make it easier for patients to come in and get screened or have their cancer detected maybe anecdotally, is an effective treatment and cure for Covid. So, I'm curious what your organization is doing to keep people up to date about the latest information about progress with treatments, and development of vaccine.
Dr. Moore: That's really my space and part of what we have been communicating through these weekly joint statements, since I, again have this virology background, that's something that I'm particularly interested in and, what I can tell our community is that the news is very encouraging right - there at least 200 vaccine efforts underway. This week, we all heard the news that Moderna one of the kind of front runners initiated its phase three study, there's hope among leaders in the vaccine space- Dr. Fauci, and others that we may have a vaccine that's ready, under an emergency use authorization by the end of the year, and then in parallel with vaccines, to kind of bridge us until we have one that is both effective and that has been deployed to a global population. We also talk about - do we have effective therapeutics -be it antivirals, something that can kind of attack, virus replication, for example, or monoclonal antibodies are another kind of space a lot of people are putting time and energy into to kind of be a preventive or help with treating the virus. So, the take away message for the lung cancer community – they don’t need to understand the details of every different vaccine or every different drug that’s being tested, they need to know that the community, the scientific community has rapidly mobilised in a way that is unprecedented. We didn’t even become aware of the existence of this virus until late December of 2019, here we are in July of 2020, barely half a year out and we are doing a phase III study of a vaccine and more similar efforts are occurring in parallel. So, I'm encouraged by the fact that we have multiple shots on goal, and I think that’s a good thing that we will have multiple different ones that are taking different approaches to solving the challenge and so, that’s a good thing. There is an unprecedented level of collaboration and data sharing among the scientific community because this is a really global threat, and so we all kind of have to bring our skills to the table.
Thom: Certainly, gives optimism when looking at it that way, especially with multiple vaccine trails with different types of vaccines happening all simultaneously. Danielle, what do you see as the impact of better education generally for lung cancer patients? Does it have a noticeable effect on their treatment outcome?
Danielle: It does and we as an organization absolutely believe that educated and empowered patients do better. We’ve got numerous examples of that, but one thing that we like to tell patients all the time on why it’s important that they know their cancer, particularly those who don’t have the benefit of being seen at an academic or a large community cancer center where they might – their physician might be a specialist in lung cancer, but often these folks are in more rural parts of the country and when they're seeing a medical oncologist, who is a general oncologist and expected to know everything about everyone that walks through that door- regardless of cancer type, whether it’s a solid tumor or a blood cancer, and I feel that’s really unfair and unrealistic to expect a general oncologist to have all of that information. So, quite often we hear that it’s the patients that are the ones that are sort of teaching their physicians something that maybe is new.
The good news in spite of all of this and even since the pandemic is that things are happening fast and furiously in the lung cancer space, so whether its new drug developments, new technologies for diagnostics, you name it – these things are happening and like I said its unfair to expect that a physician treating all these cancer types is going to be up to speed.
So, patients knowing their disease, knowing their cancer – I have a really great example of a patient that we’ve been working for several years now, he’s a stage IV lung cancer patient who just recently showed progression on one of his CT scans – he knows, because he’s been participating in the living room, he’s a peer to peer mentor through our phone buddy program and he’s been actively involved with the foundation and in advocating for lung cancer patients. He knew the right questions to go back and ask, as opposed to just simply switching to a different medication right – so I think those are really good examples of why its important for patients to be educated on their disease.
Plus it helps with the mental health aspect right, you can be prepared – quite often patients are terrified and all they really want to know is what their plan B is – like if and when Plan A no longer works and my cancer starts to progress, is there a plan b? if so – what does plan B look like and is there a plan C? is there a plan D? and we help with all of that.
Thom: Another question from the chat, Neil Osterweil from Chest Physician, a disturbingly high number of respondents to recent surveys have said that they would not take a vaccine even if an effective one was available – how do you address vaccine deniers and sceptics? Dr. Moore?
Dr. Moore: That’s a larger question that we grapple with as a society right now, unfortunately it’s a challenging time in our community and in our country. Science has become politicised in a way that unfortunately I think puts people at risk and so – it’s a larger conversation that I don’t know that we’ve fully solved yet, I hate that right now there’s so much confusion, with so much information coming out from various sources and for patients and those who don’t have the benefit of going to college and graduate school for a long time like I did – its hard to figure out what is accurate, what the value may be – there’s a lot of fear that vaccines may induce harm. Certainly, I come at this with a different appreciation and understanding than many. I think we have to figure out what is the appropriate sensitive way to encourage people to take this, because the reality is that we’re not going to achieve herd or community immunity through the route of natural infection. In other words, just letting this virus burn through us until enough people are immune. As I talked a little bit about earlier, what is apparent is that immunity may be of short duration, when we talk about the antibodies and testing for them in your blood, they may not hang along too long, that doesn’t mean there are other forms of immunity that may come into play but –
Thom: Is that the memory cells not working for a long time, is that how that works?
Dr. Moore: Well you know so there’s kind of two levels of immunity – so we talk about the humoral or antibody response and antibodies are made by B-cells and then there’s the kind of cellular or innate immune response, that’s where T-cells and other players in your immune system kind of come in to play as a first defence until you can generate that additional layer of antibody response. I think what we know is that there will be a mix response and we’ll have all those components in an effective immune response, now the reason that some people may have antibodies and some don’t – we’re still trying to understand that. In fact, GO2 foundation, and I'm going on a tangent here but we just were part of a large grant application to kind of delve into the nature of the immune response in lung cancer patients specifically, because of their heightened risk. We want to understand – 1] are lung cancer patients generating antibodies and then characterising the nature of that immune response that’s mounted by patients. Is it inherently less, is the immune response not as robust, does it not work as well, is it accounting for the reason we see this elevated mortality and more severe outcomes? So, we are working to address that layer, but getting back to the vaccine question, what we know is that just letting the virus come run and check is not going to get us where we need to be and I don’t think we’re going to achieve herd immunity outside the vaccine. So, how do we get the greatest number of people to participate and get vaccinated because we need that protection. This virus is not going to go away on its own. And that’s something that I think is a larger conversation that as a society we have to really continue to work on.
Thom: It can’t be repeated enough surely Dr. Moore. Danielle I want to ask – what if any silver linings did you see in these lessons out of the Covid pandemic and how to better treat patients and communicate them in the lung cancer community as well as more broadly – this has been an ongoing theme that we’ve seen on a lot of topics that are access to certain kinds of options for healthcare, it might become more normal such as telehealth. What silver linings do you see that are relevant to our community.
Danielle: Yeah you touched on the first one – telehealth. I think a lot of these silver linings that I’ll point out is that we have seen both inside and outside of oncology to your point, telehealth, these virtual appointments with your physician, where patients can use their smartphones, their computers, their Ipads to connect with their healthcare teams I think is huge and something that we’re going to see last well beyond the pandemic. Things such as mobile full body or blood draws as well as mobile infusion therapies, whether it’s a chemo therapy or immune therapy – virtual support – like I mentioned some of the support programs that GO2 provides for our lung cancer patients – not only support from an educational and a psychosocial standpoint but events, making people feel that they're a part of a community. We had an extremely successful virtual 5K your way back in June, so people being able to participate that way. Virtual exercise programs and meal prep programs – all of those things I think are a really positive silver lining aspect to what we’re talking about here today. Also, we talked about this a little bit earlier but hospitals, doctor’s office, restaurants, grocery stores being cleaner. Following and abiding by CDC guidelines, I think that’s something we’re going to see continuing well beyond the pandemic and then Amy touched on something a little bit ago around how quickly we’re moving towards a vaccine for this virus. So, the hope there is that – maybe we’ll be able – the proof will be in the pudding, that we can expedite the clinical trial process in getting drugs from the lab to the patients in a clinical trial setting and then out into the general population. So, I think those are just a few of the things that we’re going to see continue to live on long beyond the pandemic.
Thom: Dr. Moore any silver linings you see to the lessons we’re learnt in the last six months?
Dr. Moore: I am an optimist by nature and as challenging as these last several months have been, I have never lost hope in the power of people to do the right thing, in our community to stand together, in science to rise to the challenge, I have been doing science for a long time and like I said – the pace at which we’re moving right now, just literally takes my breath away. We’re able to do things now that we weren’t able to do a few years ago and so, I always, always have hope that – when I'm presented with concerns by some patients that lung cancer research will suffer as a result of our need to re-deploy on Covid – it’s not a choice and we’re so many brilliant minds who are more committed than ever to continue to do what they do to protect patients to save lives. So, there are so many silver linings despite all the insanity that surrounds us and I believe that we will overcome this, of that I'm sure.
Thom: With that I think we’ll draw things to a close, so I’d like to say thank you to Dr. Amy Moore and Danielle Hicks of the GO2 Foundation for Lung Cancer. For media on the call, we’ll provide you with the video and transcript of today’s session and you're more than welcome to use any portion of todays presentation as well as to reach out to the GO2 Foundation for further questions or interviews or any other material that you’d be interested in. Thank you all very much and stay healthy, stay safe – Good Luck.