How to Ensure Equitable Access to Cancer Treatment Selection During and Beyond COVID-19

As countries begin the monumental rollout of the COVID-19 vaccine, we are awed by the work of the biomedical community and hopeful for the year ahead.

At the same time, we know the pandemic will continue to take a toll at least through 2021, especially for the millions of cancer patients globally whose diagnosis and treatment were delayed in 2020. We know, for example, that this years’ surgery backlogs will result in knock-on effects including an increase in late-stage cancer diagnosis.

Before I share some of our efforts to address such challenges ahead, I wanted to reflect on the progress we’ve made during the pandemic to ensure equitable access to cancer treatment selection. Earlier this year, Canexia Health launched Project ACTT with support from the Canadian federal government via the Digital Technology Supercluster. 

Cancer is the leading cause of death in Canada. Annually, 200,000 Canadians will be diagnosed and 80,000 will die from the disease. With ACTT, Canexia is leading a consortium to speed up and enhance cancer testing for targeted treatment selection during the pandemic through minimally invasive circulating tumor (ctDNA) testing. Consortium partners and collaborators include Queen’s University, AstraZeneca Canada, the Eastern Ontario Regional Laboratory Association, Genolife, Lifelabs, Semaphore Solutions, Xtract AI, Novateur, and Illumina.

COVID-19 has delayed hundreds of thousands of surgeries in Canada, including up to 30 percent of cancer-related surgeries such as tissue biopsies. Currently, surgery backlogs are estimated to be 1-2 years across the country. ctDNA testing is filling a critical gap to guide cancer targeted treatment​, which can improve patient outcomes two- to three-fold​. It’s proving to be an effective alternative to some surgical tissue biopsies during the pandemic for patients with advanced lung, breast, or colorectal cancer. 

ACTT highlights to date include:

• Almost 750 Canadian cancer patients have received ctDNA testing since project inception in July 2020. 
• Reportable findings were identified for 49 percent of the samples.
• The initiative has expanded across Canada with samples received from Nova Scotia, New Brunswick, Quebec, Ontario, Saskatchewan, Alberta, and British Columbia.
• Approximately 11 percent of samples (versus a target of 10 percent) are incoming from rural and remote areas, where patients may not have access to specialized testing typically offered in major urban areas and academic research hospitals. 
• The addition of new partners and collaborators every month as the initiative gains momentum.

As we fight the second wave of COVID-19, we are seeing further delays to tissue biopsies. We are looking to extend the initiative to ensure cancer patients continue to have access to ctDNA testing during and beyond the pandemic.

To that end, we have been meeting with government officials to educate them about Canexia’s innovative technology and to advocate for continued support and expansion of this initiative, so that tens of thousands of Canadian cancer patients can continue to benefit. Further, we have asked that funding be earmarked for Canadian ctDNA innovation, as well as to establish a sustainable Canadian cancer testing and data infrastructure responsive to the needs of cancer patients and researchers regardless of future pandemics.

It is critical that cancer patients have equitable access to safe, affordable, and local/remote cancer testing to protect their health over the long-term. ​We look forward to continuing this work with collaborators to make cancer testing and treatment accessible to all cancer patients.

Visit the Project ACTT hub for more information including how to access the program, downloadable resources, and patient stories.

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