A study looking at COVID-19 and people who have cancer (SOAP)

In 2021 the research team published early (interim) results for the SOAP trial. 

They plan to publish more results at a later date. We hope to update this page once more results are available.

This is a summary of the results so far. 

Results
This study showed that people with a solid cancer were able to fight COVID-19 in the same way as people without cancer. This was so for people with advanced cancer  as well as those having cancer treatment.  

People who had a blood cancer (haematological cancer ) varied in how well they were able to respond to the virus. For many it took much longer for them to get rid of it.

These are the results of 76 people who have taken part so far. This included:

• 23 people with a solid cancer and who had COVID-19
• 18 people with a blood cancer and who had COVID-19
• 35 people with cancer who didn’t have COVID-19

The study team looked at whether having COVID-19 meant that there was a higher risk of the cancer getting worse. The team found that there was an effect in people with cancer who had moderate to severe symptoms of COVID-19. In these people their cancer was more likely to get worse. This is compared with those who had mild symptoms or didn’t have COVID-19. 

They didn’t think this was because of the effect of COVID-19 on the cancer. It may be due to public health measures, for example:

• delays in cancer treatments for long periods because of viral shedding this is when a person has no symptoms but can still spread virus particles when talking, eating or doing other normal activities 
• or because there were changes to their treatment

The team say that this needs further investigation. 

The researchers also wanted to know whether having cancer affected how long people had COVID-19. They took weekly swabs from the nose and back of the mouth of cancer patients with COVID-19 until the swabs showed there was no virus. They then compared this to people without cancer.  

Other research shows that for people without cancer it takes 12 to 20 days for a swab to come back showing no virus. 

The team found that it took more than 20 days for the swab to show no virus:

• for 60 out of every 100 people (60%) with a blood cancer
• for 35 out of every 100 people (35%) with a solid cancer 

For one patient with a solid cancer their swab showed they still had the virus until 107 days after. But they never had any symptoms. 

The team compared how the immune system  of people with cancer and people without cancer responded to COVID-19. They found that for people with a solid cancer it was largely similar as people without cancer. They had high levels of antibodies  to COVID-19 and were able to get rid of the virus. 

For people with B cell blood cancers such as certain lymphomas  their immune response fell into 3 groups. Those whose immune system:

• developed antibodies in the same way as those with a solid cancer or who didn’t have cancer
• didn’t develop antibodies
• developed antibodies but couldn’t get rid of the virus 

The researchers also found that once cancer patients with a solid cancer had recovered from COVID-19 their immune systems returned to working as normal. 

For cancer patients with blood cancers their COVID-19 immune response had not fully resolved. What they had was similar to a long term (chronic) infection. 

Conclusion
The team conclude that most people with a solid cancer will be able to fight COVID-19 in the same way as people without cancer. People with cancer develop antibodies to COVID-19. 

But for people with certain types of blood cancer this isn’t so. And they might need more careful management such as closer follow up and vaccination boosters.

The team now want to look at how having a COVID-19 vaccination affects the immune system of people with cancer.

Where this information comes from    
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed ) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.