AstraZeneca to test blood cancer drug Calquence in COVID-19 after finding 'some clinical benefit by NIH

On 14 April 2020, AstraZeneca will launch a blood cancer drug clinical trial Calquence in patients hospitalized with COVID-19 after receiving reports from the NIH about early signs of clinical benefit. (Zeneca Astra).

To the list of those repurposing existing COVID-19 drugs add another drugmaker. Currently, AstraZeneca is seeking to switch a blood cancer drug on critically ill patients against severe immune complications. In what has been called the fastest launch of a clinical trial in AstraZeneca's history, the British pharmaceutical firm will begin testing Calquence to investigate its effects on the potentially lethal storm of immune overreaction associated with COVID-19 infection. Currently the drug is approved for mantle cell lymphoma and chronic lymphocytic leukemia in the US.

The recommendation came after researchers at the NIH National Cancer Institute reported "some clinical gain" from the use of the drug in a limited number of hospitalized COVID-19 patients with advanced lung disease at the Walter Reed Army Medical Center.

As the body’s immune system fights the novel coronavirus, the reaction can spin out of control in a phenomenon known as cytokine storm, which can cause serious lung damage.

Previous studies suggest that BTK, the oncogenic protein Calquence targets, is also a key regulator of the production of multiple inflammatory molecules in the lung. Therefore, BTK inhibition could theoretically reduce the release of these cytokines and dampen an excessive immune response. In real life, blood cancer patients who got BTK inhibitors also experienced decreased proinflammatory cytokines and chemokines, according to AstraZeneca.

The new court, called Calavi, is to take place in two parts. The first would check calquence in patients who are admitted but not on ventilation or in intensive care, in addition to the existing standard of care. The second portion will assess protocol in ICU patients who are seriously ill. Since Calquence comes as a tablet, AZ recommends doctors to offer the drug in a liquid solution made up of Coca-Cola to utilize the acid property of the drink for those patients still on ventilators.

The goal is to show that Calquence "reduces the need to put patients on ventilators and increases their chances of survival," said José Baselga, head of oncology R&D at AstraZeneca, in a statement on 14th April 2020. Baselga added that the company had finished writing the trial protocol and sent it to the FDA within three days of obtaining early evidence from NCI, setting a new record for the fastest launch of a clinical trial in company history.

While COVID-19 continues to wreak havoc across the globe, in the absence of an approved cure, biopharmaceutical firms have been busy finding inspiration from existing drugs — and Calquence is not the first cancer medication that has been diverted in this way.

Karyopharm Therapeutics said last week that it will study its own blood cancer drug Xpovio—recently approved by the FDA to treat advanced multiple myeloma patients—in extreme COVID-19 patients. The drug blocks the XPO1, which the Massachusetts biotech said plays important roles in both the interaction of various viruses with host cells and the pro-inflammatory molecules activities. Hence it holds promise as a blocker of both viral replication and immune-related injury, argues Karyopharm.