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

Cancer type:

All cancer types

Status:

Open

Phase:

Other

This study is looking at COVID-19 in people with and without cancer and how their immune systems deals with it.

Your immune system Open a glossary item helps your body fight infections such as COVID-19 and diseases such as cancer.

More about this trial

The symptoms of COVID-19 can range from being very mild to being very severe. How your immune system finds and deals with the virus can determine what symptoms you get.

We know that having cancer can weaken the immune system. What we don’t know is the link between how the immune system deals with the virus and the symptoms of COVID-19. This is particularly so for people with cancer. So researchers want to find out more.

They will study blood samples from people who have cancer and COVID-19. And compare these to blood samples from people who:

have cancer but tested negative for COVID-19
don’t have cancer and have COVID-19
don’t have cancer or COVID-19 (healthy volunteers)

The aims of the study are to find:

the different ways our immune system deals with COVID-19
if this can help predict what symptoms people might get
if COVID-19 has any direct or indirect effect on the cancer itself

You won’t get any benefit from taking part in this study. But the information gained can help doctors treat people with COVID-19 in the future.

Who can enter

The following are entry conditions for this study. Talk to your doctor or the study team if you are unsure about any of these. They will be able to advise you.

Who can take part

You may be able to join this study if you:

have cancer or don’t have cancer
have had a COVID-19 test
are at least 16 years old

The study team are also looking for healthy volunteers who are at least 16 years old.

Trial design

For the study the team need:

200 cancer patients who have COVID-19
100 cancer patients who don’t have COVID-19
100 people who don’t have cancer and have COVID-19
20 healthy volunteers

You give a number of blood samples during the study.

People who have symptoms of COVID-19 give blood samples:

every 2 to 4 days while they have symptoms (if possible)
at weeks 4 and 8 after they have no symptoms

For people having cancer treatment you give the samples at the same time as your routine blood samples.

For people with cancer the team ask for a sample of the cancer tissue taken from when you were first diagnosed.

Hospital visits

You see the doctor to have some blood tests when you agree to take part.

Side effects

You might have some bruising or bleeding when you have the blood samples taken.

Location

London

Early results

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 Open a glossary item 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 Open a glossary item ) 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 Open a glossary item 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 Open a glossary item 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 Open a glossary item ) 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.