COVID-19 Resource Center

COVID-19 Resource Center

Perspective from Ryan W. Jacobs, MD
Source:

Dana-Farber Cancer Institute. Dana-Farber to test blood cancer drug in COVID-19 patients. https://www.dana-farber.org/newsroom/news-releases/2020/dana-farber-to-test-blood-cancer-drug-in-covid-19-patients/. Accessed May 28, 2020.

Disclosures: Treon reports receiving research funding and/or consulting fees from Pharmacyclics, a division of AbbVie, Janssen Research & Development, LLC, Beigene and LOXO Pharmaceuticals The authors report no relevant financial disclosures. The study is funded and sponsored by AbbVie.
June 01, 2020
6 min read
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Trial examines cancer drug as COVID-19 treatment

Perspective from Ryan W. Jacobs, MD
Source:

Dana-Farber Cancer Institute. Dana-Farber to test blood cancer drug in COVID-19 patients. https://www.dana-farber.org/newsroom/news-releases/2020/dana-farber-to-test-blood-cancer-drug-in-covid-19-patients/. Accessed May 28, 2020.

Disclosures: Treon reports receiving research funding and/or consulting fees from Pharmacyclics, a division of AbbVie, Janssen Research & Development, LLC, Beigene and LOXO Pharmaceuticals The authors report no relevant financial disclosures. The study is funded and sponsored by AbbVie.
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Dana-Farber Cancer Institute announced the launch of a randomized clinical trial evaluating the use of ibrutinib — an oral medication used to treat blood cancer — in patients with COVID-19.

The clinical trial follows multiple case reports of patients who were receiving treatment with ibrutinib (Imbruvica; Janssen, Pharmacyclics) for Waldenström's macroglobulinemia and developed COVID-19 but did not experience shortness of breath, did not need to be hospitalized and improved steadily.

“This could be an important development if you consider that most admissions to hospitals for COVID-19 are because of breathing problems, and many of these patients require mechanical ventilation,” Steven P. Treon, MD, PhD, director of the Bing Center for Waldenström's Macroglobulinemia and a professor of medicine at Harvard Medical School, said in a press release.

In a report published in Blood, Treon and colleagues found that among six patients with Waldenström's macroglobulinemia being treated with ibrutinib who became infected with COVID-19, five who received the standard dose of 420 mg per day did not experience shortness of breath or need to be hospitalized.

Pill bottle knocked over 
Dana-Farber Cancer Institute announced the launch of a randomized clinical trial evaluating the use of ibrutinib — an oral medication used to treat blood cancer — in patients with COVID-19.
Source: Adobe Stock

The sixth patient, who was receiving a reduced dose of ibrutinib, was hospitalized because of worsening shortness of breath and hypoxia. The patient was taken off ibrutinib and received other treatments, including hydroxychloroquine and azithromycin. After being on a ventilator for 10 days, physicians restarted the patient on the standard dose of ibrutinib, and he rapidly improved. He was removed from the ventilator and was discharged from the hospital on day 14.

“These experiences have given us the inspiration to do prospective randomized trials of ibrutinib and a similar drug, zanubrutinib, in COVID-19 patients in respiratory distress,” Treon said in the press release.

The randomized trial, which will involve 46 patients, is being conducted at Brigham and Women’s Hospital. Those enrolled in the trial are required to be hospitalized for COVID-19, test positive for SARS-COV-2, have received supplemental oxygen for pulmonary distress for no more than 48 hours and have adequate hematologic, hepatic and renal function.

The goal of the trial is to determine if treatment with ibrutinib in patients with COVID-19 can reduce the need for supplemental oxygen, shorten hospitalizations and improve survival, according to the release.

Patients with cancer and those who were placed on mechanical ventilation will not be eligible to participate in the trial.

According to the press release, part of the rationale for testing ibrutinib in patients with COVID-19 is that the drug targets molecular pathways overactive in Waldenström's macroglobulinemia and in the lungs of patients with COVID-19.

In addition, Treon noted that mouse studies have shown that ibrutinib protects against viral infections that target the lungs, which “is why we have worked with the AbbVie team to initiate this randomized trial comparing ibrutinib and supportive care vs. supportive care with placebo.” – by Erin Michael

References:

ClinicalTrials.gov. Study of oral ibrutinib capsules to assess respiratory failure in adult participants with coronavirus-induced disease 2019 (COVID-19) and pulmonary distress. https://clinicaltrials.gov/ct2/show/NCT04375397?term=ibrutinib&cond=COVID-19&draw=2&rank=1. Accessed May 28, 2020.

Dana-Farber Cancer Institute. Dana-Farber to test blood cancer drug in COVID-19 patients. https://www.dana-farber.org/newsroom/news-releases/2020/dana-farber-to-test-blood-cancer-drug-in-covid-19-patients/. Accessed May 28, 2020.

Treon SP, et al. Blood. 2020;doi:10.1182/blood.2020006288.