The Impact of COVID-19 on Academic Cancer Clinical Trials in Canada and the Initial Response from Cancer Centers

Round 1

Reviewer 1 Report

Dear Editor, thank you so much for inviting me to revise this manuscript.

This study addresses a current topic.

The manuscript is quite well written and organized. 

Figures and tables are comprehensive and clear.

The introduction explains in a clear and coherent manner the background of this study.

We suggest the following modifications:

• Introduction section: although the authors correctly included important papers in this setting, we believe a couple of studies should be cited within the introduction ( PMID: 35109688 ), only for a matter of consistency. We think it might be useful to introduce the topic of this interesting study.
• Methods and Statistical Analysis: nothing to add.
• Discussion section: Very interesting and timely discussion. Of note, the authors should expand the Discussion section, including a more personal perspective to reflect on. For example, they could answer the following questions – in order to facilitate the understanding of this complex topic to readers: what potential does this study hold? What are the knowledge gaps and how do researchers tackle them? How do you see this area unfolding in the next 5 years? We think it would be extremely interesting for the readers.

However, we think the authors should be acknowledged for their work. In fact, they correctly addressed an important topic , the methods sound good and their discussion is well balanced.

One additional little flaw: the authors could better explain the limitations of their work, in the last part of the Discussion.

We believe this article is suitable for publication in the journal although some revisions are needed. The main strengths of this paper are that it addresses an interesting and very timely question and provides a clear answer, with some limitations.

 

Author Response

Thank you for your thoughtful review and comments provided.

The following are provided in response to noted comments and recommendations:

Introduction section:  

A reference to a recently published review of vaccine responsiveness in treated cancer patients was added to the Discussion section in the context of a factor that is expected to contribute to cancer clinical trial recovery (PMID: 34986328). We intent to provide an update to this review of trial activity for the period following March, 2021, concurrent with widespread vaccinations and emergence of the Omicron variant. 

Discussion section:  

Statements were added as suggested to better explain 3CTN’s capacity and the potential benefits that tracking of Canadian academic cancer trial activity summarized in this report and future planned publications. 

The discussion of limitations has also been updated.

Reviewer 2 Report

This is an interesting report on the impact of COIVD-19 on academic cancer clinical trials. Although it is not a scientific analysis, I think it is valuable as a primary source of information. I have following concerns on the current form.

1. The rapid recovery in patient enrollment, as shown in Figure 1, is very impressive. The activities taken by the centers are described in general terms in the Discussion, however, the data do not seem to be based on interviews with each center. I think the paper would be better if additional data on the activities taken by each facility are collected and summarized in a table.

2. Also, in terms of funding, it is stated that additional funding is needed, but the rationale for this is not adequately presented. If the authors are going to address the need for additional funding, I think they need to provide a clearer rationale based on the precise calculation.

Author Response

Thank you very much for your considered review.

 

In response to your comments,

1. Activities untaken by 3CTN-member cancer centers as described in the Discussion section are based on a mix of site-specific reporting data and status meeting logs. While the recommendation for including structured interviews with each center was beyond the scope of this initial study, it is noted as an area that will benefit from further follow-up and reporting.
   
   2. The Discussion was amended to indicate that reported data on academic trial activity and cancer patient accruals across Canada’s regions may benefit future funding decisions for addressing research gaps or supporting infrastructure needs for trial conduct. Funding statement was also removed from the Abstract.

Reviewer 3 Report

This is important and timely data. I would thank the authors for systemically collecting the data that helps to understand the magnitude of disruption in clinical trial recruitment created by the pandemic. The data presented in the manuscript support the conclusion. The manuscript, however, needs close proofreading for grammar and syntax.

Author Response

Thank you very much for your considered review.

In response to your comments citing a need for futher proofreading for grammar and syntax, the authors undertook a thorough review of all sections and have made necessary edits to improve correctness and clarity of intended messages, where applicable.

Round 2

Reviewer 1 Report

Acceptance.

Reviewer 2 Report

The authors have revised their original manuscript partly according to the reviewers’ comments. In some points, the authors decided to keep their contents unchanged, however, their rebuttal seems almost reasonable. I would think that this revised manuscript is better organized and suitable for publication.