Andrew Ip, MD, MS, a hematologist/oncologist, John Theurer Cancer Center, Hackensack Meridian Health, discusses the utility of investigational treatments for COVID-19 in patients with cancer.

Patients with COVID-19 and cancer may benefit from a combination of monoclonal antibodies that target the spike protein rather than a single-agent inhibitor, says Ip. However, data are lacking, and additional research is needed, Ip explains.

Other investigational agents that have demonstrated efficacy in treating patients with COVID-19, such as remdesivir (Veklury), have the potential to be given as outpatient treatment in inhaled or subcutaneous formulations, says Ip.

Additionally, increased dosing regimens with steroids, such as dexamethasone, could be beneficial in patients with leukemia, lymphoma, or multiple myeloma who often develop pneumonitis or bronchiolitis obliterans organizing pneumonia from COVID-19, says Ip.

Finally, convalescent plasma could improve outcomes for patients who received prior rituximab (Rituxan); however, more data are needed, concludes Ip.

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Andrew Ip, MD, MS, discusses the utility of investigational treatments for COVID-19 in patients with cancer.  



Dr. Ip on the Utility of Investigational Treatments for COVID-19 in Oncology 

Andrew Ip, MD, MS, a hematologist/oncologist, John Theurer Cancer Center, Hackensack Meridian Health, discusses remaining questions with the COVID-19 vaccine in patients with cancer. 

Patients with cancer were among the first groups to be offered the first doses of COVID-19 vaccines per the CDC guidelines, says Ip. Vaccination is important for this patient population because they can develop severe complications from COVID-19 and some are on active treatment for their cancer, Ip explains. 

Despite this, patients with cancer were not included in the COVID-19 vaccine clinical trials, so limited data are available to inform how efficacious the vaccines are in this population, Ip says. Moreover, these data could be particularly relevant for patients on active treatment, those with B-cell depletion from cancer therapies, and those post-transplant or post–CAR T-cell therapy, Ip adds. More data could inform the optimal time patients should get the vaccine, the efficacy of the vaccine, and whether patients have B- or T-cell immunity, Ip says. 

Currently, patients with cancer should likely receive an mRNA-based vaccine because the adenovirus-based products appear to be more toxic, which could be detrimental to immunocompromised individuals, Ip concludes.

Andrew Ip, MD, MS, discusses remaining questions with the COVID-19 vaccine in patients with cancer.  



Dr. Ip on Remaining Questions With the COVID-19 Vaccine in Oncology

Andrew Ip, MD, MS, a hematologist/oncologist, John Theurer Cancer Center, Hackensack Meridian Health, discusses the challenges of treating patients with hematologic malignancies and COVID-19.

Treating COVID-19 has been difficult; however, unique challenges have emerged with regard to patients with lymphoma, leukemia, and myeloma, says Ip. Currently, approved agents to treat patients with COVID-19 include antiviral drugs, such as remdesivir (Veklury) alone or in combination with baricitinib (Olumiant). Dexamethasone has also demonstrated activity in managing inflammation related to COVID-19. Convalescent plasma, an immune-based therapy that can provide passive immunity, has also been granted Emergency Use Authorization to treat patients with COVID-19. Finally, tocilizumab (Actemra), a monoclonal antibody that is used to treat patients with hematologic malignancies who develop cytokine storm from cellular therapies, has also demonstrated efficacy in treating patients with COVID-19. 

Despite these advances, treating patients with hematologic malignancies who develop COVID-19 is challenging because many are on immunosuppressive medications, such as rituximab (Rituxan), CD20-directed monoclonal antibodies or chemotherapy, says Ip. Additionally, patients with cancer and COVID-19 can have severe and prolonged COVID-19 symptoms, Ip explains. As such, additional research is needed to determine the utility of these therapies among patients with hematologic malignancies, concludes Ip.

Andrew Ip, MD, MS, discusses the challenges of treating patients with hematologic malignancies and COVID-19.  



Andrew Ip, MD, MS

Articles

Dr. Ip on the Utility of Investigational Treatments for COVID-19 in Oncology

Dr. Ip on Remaining Questions With the COVID-19 Vaccine in Oncology

Dr. Ip on the Challenges of Treating Patients With Hematologic Malignancies and COVID-19