BTK Inhibitors in Cancer Patients with COVID-19: "The Winner Will be the One Who Controls That Chaos" (Napoleon Bonaparte).
Clin Cancer Res
; 26(14): 3514-3516, 2020 07 15.
Article
in English
| MEDLINE | ID: covidwho-693869
ABSTRACT
As the SARS-CoV-2 (COVID-19) pandemic spreads and the number of Bruton's tyrosine kinase inhibitor (BTKi)-treated COVID-19-affected patients grows, we must consider the pros and cons of BTKi discontinuation for our patients. In favor of BTKi continuation, BTK plays an active role in macrophage polarization. By modulating key transcription factors, BTK may regulate macrophage polarization downstream of classic M1 and M2 polarizing stimuli and mitigate the hyperinflammatory state associated with COVID-19. In favor of BTKi discontinuation, we note a potentially increased risk of secondary infections and impaired humoral immunity. We hypothesize that the potential benefit of blunting a hyperinflammatory response to SARS-CoV-2 through attenuation of M1 polarization outweighs the potential risk of impaired humoral immunity, not to mention the risk of rapid progression of B-cell malignancy following BTKi interruption. On the basis of this, we suggest continuing BTKi in patients with COVID-19.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Leukemia, Lymphocytic, Chronic, B-Cell
/
Lymphoma, B-Cell
/
Coronavirus Infections
/
Protein Kinase Inhibitors
/
Anti-Inflammatory Agents
Type of study:
Prognostic study
Limits:
Humans
Language:
English
Journal:
Clin Cancer Res
Journal subject:
Neoplasms
Year:
2020
Document Type:
Article
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