Cancer Immunotherapy May Not Worsen COVID-19 Symptoms

Killer T-lymphocyte attacking a cancer cell
Killer T-lymphocyte (green) beginning to attack a cancer cell (mauve). [Maciej Frollow/Getty Images]

Data collected by researchers based at the University of Cincinnati Cancer Center suggests that immunotherapy may not worsen COVID-19 symptoms in patients with cancer who are infected with the virus.

One of the most dangerous symptoms of severe infection with SARS-CoV-2 is the overreaction of the immune system caused by excessive production of inflammatory proteins known as cytokines.

Patients with cancer are at increased risk for developing severe COVID-19 and clinicians were concerned that continuing to treat these patients with cancer drugs that activate the immune system, such as immune checkpoint inhibitors, could make symptoms of the virus worse by increasing cytokine production.

However, Layne Weatherford, Ph.D., and Trisha Wise-Draper, PhD, both researchers based at the University of Cincinnati, have collected preliminary data that suggests this might not actually be the case. They presented their results in a presentation during the American Association of Cancer Research virtual meeting on COVID-19 and cancer held this week.

“We are continuing to investigate whether immunotherapy causes an increased production of these proteins by immune cells from COVID-19 patients, but our initial findings are showing that immunotherapy is not significantly impacting it,” commented Wise-Draper.

Weatherford and Wise-Draper used data collected from the University of Cincinnati COVID-19 biorepository for their analysis, a resource set up by the university in April to collect samples from patients infected with the virus to aid research into treatments, tests and vaccines.

If confirmed, these findings would be a relief for clinicians treating cancer patients. Several other recent studies have also looked at risks associated with cancer immunotherapy in COVID-19 patients, specifically use of checkpoint inhibitors.

A Memorial Sloan Kettering Cancer Center study found that use of these therapies did not worsen immune-related virus symptoms in patients with lung cancer and a Spanish preprint paper in Melanoma patients also found no difference between patients given checkpoint inhibitor therapies versus other cancer drugs. Another more general analysis published by UK-based researchers at the Universities of Birmingham and Oxford showed no increased risk of death in COVID-19 patients with cancer who had been treated with immunotherapies.

There is no doubt that more information is needed, as a different paper published in June contradicts these findings. The researchers in that study, also from Memorial Sloan Kettering Cancer Center in New York, found that treatment with immune checkpoint inhibitors in cancer patients was actually a predictor for hospitalization and severe disease, whereas chemotherapy and major surgery were not.

In an additional analysis carried out by Wise-Draper and colleagues using the biorepository, the team also found that the type 2 diabetes drug metformin might be able to suppress the production of excess cytokines in the cells of patients with COVID-19.

“These are promising initial findings,” Wise-Draper says. “Additional research is needed, but our results show that we might be able to treat COVID-19 complications with metformin or a similar drug one day.”

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