The COVID-19 and Cancer Consortium (CCC19)

COVID-19, the disease caused by the SARS-coV-2 virus, has now affected at least 1,200,000 people globally, and cases are accumulating in an exponential fashion in many countries, including the United States. Cancer patients have a unique risk profile in this pandemic. Many patients, especially those actively on treatment, have high levels of contact with the health care system. This can include provider visits, phlebotomy, imaging, social work and financial consultations, and infusion room visits for anti-cancer therapy and supportive care such as blood transfusions. Despite heroic efforts to reduce viral transmission in these shared spaces, patients are at an increased risk for COVID-19 exposure. Additionally, most cancer patients are immunocompromised through the marrow toxic effects of anti-cancer drugs, supportive medications such as steroids, and/or the cancer itself; and over 60 years of age, putting them in the highest-risk category for COVID-19-related morbidity and mortality. Finally, incidences of important comorbidities can be considerably elevated in several cancers, such as chronic obstructive pulmonary disease in lung cancer or inflammatory bowel disease in colorectal cancer, further exacerbating our patients' vulnerability to this novel pathogen. Early reports on prognosis for cancer patients are conflicting and, for the most part, non-peer-reviewed. The largest study published to date includes 18 patients with cancer, who were shown to have increased risk for severe events in multivariate analysis. Lung cancer was the most common malignancy in this cohort, comprising 5 of the 18 cases (28%). Importantly, only five of the 18 patients were known to be on active systemic anti-cancer therapy. Still, these small patient numbers do not reflect the true impact of COVID-19 on cancer patients, particularly patients on active treatment. Given this acute lack of knowledge and concern for extreme vulnerability, the COVID-19 and Cancer Consortium was formed to understand how the novel virus affects cancer patients. While this national effort began organically, primarily through social media, membership has quickly grown to over 130 physicians and nurses representing over 60 institutions and organizations in the US. Included in this membership, thus far, are 35 NCI-designated Comprehensive Cancer Centers, as well as 6 NCI-designated Cancer Centers and large networks of community practices. The driving goal of the consortium is to collect prospective, granular, uniformly organized information to help generate hypotheses for translational science, and to arm treating providers with the most complete data resource as rapidly as possible on cancer patients infected with COVID-19. As the Coordinating Center for the consortium, we will establish and propagate best practices for governance, data collection, and data dissemination. We will host the main data registry and will work with participant institutions setting up mirrored local databases. We will also pilot a prospective biospecimen collection protocol focused on determining whether clonal hematopoiesis in cancer patients with COVID-19 alters their risk profile.