  COVID-19 outbreak has rapidly evolved into a global pandemic. The impact of
COVID-19 on patient journeys in oncology represents a new risk to
interpretation of trial results and its broad applicability for future clinical
practice. We identify key intercurrent events that may occur due to COVID-19 in
oncology clinical trials with a focus on time-to-event endpoints and discuss
considerations pertaining to the other estimand attributes introduced in the
ICH E9 addendum. We propose strategies to handle COVID-19 related intercurrent
events, depending on their relationship with malignancy and treatment and the
interpretability of data after them. We argue that the clinical trial objective
from a world without COVID-19 pandemic remains valid. The estimand framework
provides a common language to discuss the impact of COVID-19 in a structured
and transparent manner. This demonstrates that the applicability of the
framework may even go beyond what it was initially intended for.
