COVID-19 can cascade quickly, even in an otherwise healthy patient. But for a cancer patient, the risks are significantly greater for poorer outcomes. In a desperate search to help identify potential treatments, researchers hope an existing arthritis drug will make a difference.
For many cancer patients, COVID-19 is a threat their already weakened immune systems can’t defend.
Dr Sanjeet Dadwal is an infectious disease expert at City of Hope, a cancer center in California.
“On top of that you put chemotherapy or transplant and if they get COVID and don’t have an appropriate immune function to fight virus, they are at very high risk for poorer outcomes,” he said.
Encouraged by an early study out of China, he and his colleagues turned to leflunomide — a drug long used to treat rheumatoid arthritis. When they gave it to one patient, Dadwal said there was a difference.
“We added this drug and this patient is off of oxygen who is on active treatment for a cancer,” he said. “So really nice result but again it’s only one patient.”
Leflunomide appears to pack a double punch. It helps stop SARS-CoV-2 from replicating and decreases expression of the ACE2 receptor, which the virus uses to infect cells.
“It is a cheap drug. It’s available in oral formulation, so you don’t have to hospitalize patients, if you can give it to patients with moderate disease who don’t need to be in hospital” Dadwal said. “I really think there is a niche for this drug.”
The center hopes to enroll a total of nine cancer patients in a phase one clinical trial. Participants will receive the drug for 14 days.
“And if it turns out to be safe, then it’s really worthy to go to phase two trials and not just cancer patients in my opinion,” Dadwal said.
City of Hope would like to partner with other centers across the country to expand the study – ultimately opening it up to the general population.