19 May COVID-19: Experience in Using Cancer Drugs
MedicalResearch.com Interview with:
Paolo A. Ascierto, MD
Melanoma. Cancer Immunotherapy and Development Therapeutics Unit
Istituto Nazionale Tumori IRCCS Fondazione “G. Pascale”
Napoli – Italy
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: As we know, in Covid-19 pneumonia, especially in its complication “acute respiratory distress syndrome (ARDS)”, a key role is played by the immune system. We know that when we treat a tumor with immunotherapy, it could give side effects because the stimulated immune system produces a series of substances to destroy the tumor. Sometimes, the immune system can also give side effects related to a hypersecretion of some cytokines, such as IL 6, the target of tocilizumab. This condition is called cytokine storm, or better, cytokine release syndrome (CRS).Oncologists use tocilizumab in the management of CRS that can occur following the use of bispecific antibodies, or recently, the use of CAR-T cell therapy, where such drug is approved for CRS treatment.
MedicalResearch.com: What should readers take away from your report?
Response: During the COVID-19 pandemic, it’s crucial to simultaneously consider both the needs of cancer patients (treatments, visit, controls …) and minimize the risk of SARS-CoV2 infection. To do this it is important to balance and give higher priority to high risk patients, optimizing the access to surgical unit and day hospital for treatments (in order to avoid gathering), and if possible, entrusting to telemedicine controls for patients with low cancer risk.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Having understood that the immune system hyperactivation is involved in complications from covid infection, targeting the pathways involved in the cytokine storm, and mainly IL-6, may be crucial for reducing the mortality from ARDS-COVID-19 related. At moment, there are also ongoing some phase 2 or 3 trial or expanded access program with drugs active in reducing the CRS like anti-IL-6, JAK inhibitors, complement inhibitors, toll like receptor inhibitors, anti TNF drugs and others.
MedicalResearch.com: Is there anything else you would like to add?
Response: It is important to be very cautious and keep everybody safe: patients, nurses, and physicians, since they could be good carriers of infection. Submit patients to appropriate serological tests in order to check possible contact with the virus, or nasopharyngeal swab in case of doubt for ongoing infection. In addition, in case of pneumonia/ARDS early detection and treatment of cytokine storm may be essential to help the patients in such condition.
AACR 2020 abstract:
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