Cancer patients may be allowed to resume treatment with new Covid-19 test

Undated handout photo issued by The Royal Marsden of Alex Burchell, 13, a young brain cancer patient who became the first child to test-drive the MR Linac, a pioneering radiotherapy machine.
PA

London cancer doctors are hoping to develop a rapid test to check whether patients who have had coronavirus can safely restart treatment.

Cancer patients are at greater risk from Covid-19 as their immune system will have been weakened by their underlying disease and any chemotherapy or radiotherapy used to treat it.

Thousands have gone untreated for cancer during the pandemic, often because they are too scared to seek specialist help. An extra 18,000 cancer deaths are feared in England over the next year.

Researchers at the Royal Marsden, London’s specialist cancer hospital, today revealed they will start recruiting patients next week to establish whether a pregnancy-style test — but using finger-prick blood or a saliva swab rather than urine — can find antibodies from Covid-19. This could enable cancer patients to self-check at home before restarting chemotherapy or radiotherapy or undergoing surgery.

A second trial, also being led by the Marsden, will aim to establish whether “liquid biopsies” — tests that search a blood sample for DNA shed by a tumour — can be used in place of invasive endoscopies and biopsies to help determine whether a patient has cancer.

Hospitals have been trying to maintain urgent cancer treatment during the pandemic but there has been a 62 per cent reduction in patients with suspected symptoms asking their GP to refer them to a specialist. Dr Sheela Rao, the consultant medical oncologist leading the antibody test trials, said it was vital to establish if cancer patients developed the same immunity to Covid as non-cancer patients — and whether this took longer to happen.

The Government is aiming to roll out a standard antibody test for the UK but it is still undergoing verification. Dr Rao said it was “challenging” for doctors at present to decide if it was safe to restart a patient’s cancer treatment. Sixty Marsden patients who have tested positive for Covid will be recruited to the study.

She added: “If patients have Covid, we are re-swabbing and waiting until that positive is switched to a negative before restarting treatment. What would be very useful going forward would be a rapid test — one you could even do at home so it doesn’t involve patients having to come into hospital. It will then help really inform us in our decision-making in terms of treatment.”

The liquid biopsy study will look at whether a blood test can help to diagnose pancreatic, lung, bladder, colorectal and stomach cancers. This would give further information alongside CT scans, other blood tests, and a patient’s symptoms and medical history. The method is already used to help detect breast cancer and in deciding if colorectal patients receive chemotherapy after surgery.

The number of invasive “camera tests” and taking of tumour samples has declined dramatically because they cause patients to exhale “aerosols”, risking the spread of coronavirus, and as staff were diverted to the Covid frontline. Dr Naureen Starling, the trial lead investigator, said liquid biopsies could help reduce the backlog of diagnostic tests as wider NHS services resumed if they were found to deliver accurate results.

She said: “It will be informative to see whether this could be an approach for future outbreaks or indeed part of our routine approach to cancers. Invasive tests are not the most pleasant tests to undergo if you are a patient.” She said the potential to use a liquid biopsy could be a “game changer” for some tumour types. Professor Sanjay Popat, study co-investigator, said: “The long-term benefits for liquid biopsy testing are major as to how we treat these patients’ post Covid-19 pandemic.”

Dr Starling urged patients who fear they have cancer to ask their GP to refer them for specialist checks.

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