Posted on Friday 29 May 2020
A new trial repurposing a blood cancer drug for patients with COVID-19 is being launched at Guy’s and St Thomas’.
The trial will study the use of ruxolitinib (Novartis Pharmaceuticals), a drug currently used to treat certain types of blood cancer, to see if it can help reduce complications in COVID-19 patients. It is hoped that this could help more patients survive the disease, and reduce the number of patients being taken to intensive care.
Researchers from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust will begin the trial next week. The research has been funded by both the Masterstroke Polycythaemia Fund and LifeArc.
Patients with severe COVID-19 can experience hyperinflammation. This occurs when the patients’ bodies respond to the virus by producing high levels of inflammation-causing cells resulting in harmful inflammation. This reaction can send the body into shock and ultimately damage multiple organs, such as the heart, lungs and vascular system.
Ruxolitinib is a type of drug called a JAK inhibitor. It blocks the signals required to produce the inflammation-causing cells and therefore reduces inflammation in the patient. It is currently approved for use in certain myeloproliferative neoplasms, rare forms of blood cancer, but researchers want to see if it can prevent hyperinflammation in COVID-19 patients.
Initially 19 patients will participate in the trial, which is based at Guy’s and St Thomas’. If the first phase is successful, the trial will proceed to the next stage and a total of 59 patients will be enrolled.
Dr Shahram Kordasti, Senior Lecturer in Applied Cancer Immunopathology at King’s College London and the scientific lead, said: “This is a very exciting project and thanks to support from LifeArc we aim to identify immune signatures which predict a response to JAK inhibitors in patients with severe form of COVID-19.
“This is extremely important for identifying the right time for intervention. We will use cutting edge methods to identify the best time and most suitable patients for therapy and to evaluate the immune response following therapy.”
Dr Sophie Papa is Clinical Reader in Immuno-oncology at King’s College London, consultant oncologist at Guy’s and St Thomas’ and study co-investigator. She said: “Repurposing of drugs to temper the immune dysregulation associated with severe COVID-19 illness is a widely shared ambition.
"Understanding the impact of treatment on the human immune system in the context of COVID-19 through quality translational science is the goal of this project led by Dr Kordasti and Dr McLornan. This is rapid, robust science to guide healthcare decisions at a time when clinicians need confidence.”
The team will also be collaborating with the investigators of a similar on-going study at the Princess Margaret Hospital, Canada, and receive serial samples from their trial for immune monitoring which will increase the power of this study. Researchers will also collaborate with Dr Jonathan Irish from Vanderbilt University, US, who will work closely on the data analysis of the project.
Chief investigator of the trial Dr Donal McLornan, consultant haematologist at Guy’s and St Thomas’, said: “If effective, this drug could reduce the number of COVID-19 infected patients needing ventilation and requiring critical care unit support.
"This trial is a result of medics, scientists, trial specialists and nurses working closely together to provide novel therapeutic approaches for patients unfortunately deteriorating due to the COVID-19 virus.”
A spokesperson from LifeArc said: “This study is being supported by a grant from the medical research charity LifeArc, as part of its activities to address the need for new therapies for COVID-19. LifeArc has made £10m available to repurpose existing medicines or those in the late stage of development as this approach offers one of the fastest routes to develop new treatments that could tackle the virus and its impact.”