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BTK Inhibitors in Cancer Patients with COVID-19: "The Winner Will be the One Who Controls That Chaos" (Napoleon Bonaparte).
Clin Cancer Res. 2020 07 15; 26(14):3514-3516.CC

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.

Authors+Show Affiliations

Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.Memorial Sloan Kettering Cancer Center, New York, New York.Fred Hutchinson Cancer Research Center, Seattle, Washington.Dana Farber Cancer Institute, Boston, Massachusetts.Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.Memorial Sloan Kettering Cancer Center, New York, New York. matoa@mskcc.org.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32345646

Citation

Chong, Elise A., et al. "BTK Inhibitors in Cancer Patients With COVID-19: "The Winner Will Be the One Who Controls That Chaos" (Napoleon Bonaparte)." Clinical Cancer Research : an Official Journal of the American Association for Cancer Research, vol. 26, no. 14, 2020, pp. 3514-3516.
Chong EA, Roeker LE, Shadman M, et al. BTK Inhibitors in Cancer Patients with COVID-19: "The Winner Will be the One Who Controls That Chaos" (Napoleon Bonaparte). Clin Cancer Res. 2020;26(14):3514-3516.
Chong, E. A., Roeker, L. E., Shadman, M., Davids, M. S., Schuster, S. J., & Mato, A. R. (2020). BTK Inhibitors in Cancer Patients with COVID-19: "The Winner Will be the One Who Controls That Chaos" (Napoleon Bonaparte). Clinical Cancer Research : an Official Journal of the American Association for Cancer Research, 26(14), 3514-3516. https://doi.org/10.1158/1078-0432.CCR-20-1427
Chong EA, et al. BTK Inhibitors in Cancer Patients With COVID-19: "The Winner Will Be the One Who Controls That Chaos" (Napoleon Bonaparte). Clin Cancer Res. 2020 07 15;26(14):3514-3516. PubMed PMID: 32345646.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - BTK Inhibitors in Cancer Patients with COVID-19: "The Winner Will be the One Who Controls That Chaos" (Napoleon Bonaparte). AU - Chong,Elise A, AU - Roeker,Lindsey E, AU - Shadman,Mazyar, AU - Davids,Matthew S, AU - Schuster,Stephen J, AU - Mato,Anthony R, Y1 - 2020/04/28/ PY - 2020/04/16/received PY - 2020/04/17/revised PY - 2020/04/24/accepted PY - 2021/01/15/pmc-release PY - 2020/4/30/pubmed PY - 2020/7/28/medline PY - 2020/4/30/entrez SP - 3514 EP - 3516 JF - Clinical cancer research : an official journal of the American Association for Cancer Research JO - Clin. Cancer Res. VL - 26 IS - 14 N2 - 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. SN - 1078-0432 UR - https://www.unboundmedicine.com/medline/citation/32345646/BTK_Inhibitors_in_Cancer_Patients_with_COVID_19:_"The_Winner_Will_be_the_One_Who_Controls_That_Chaos"__Napoleon_Bonaparte__ L2 - http://clincancerres.aacrjournals.org/cgi/pmidlookup?view=long&pmid=32345646 DB - PRIME DP - Unbound Medicine ER -