Anticancer drug effective against severe COVID-19

Therapy Breakthroughs 7. may 2021 2 min Professor Yihai Cao Written by Kristian Sjøgren

A small trial with participants from Italy and China shows that the anticancer drug bevacizumab is extremely effective in reducing severe COVID-19 symptoms.

The whole world is looking for new ways to combat COVID-19.

This mainly relates to manufacturing vaccines, but pharmaceutical companies have also developed many antibody treatments to the clinical trial stage and launched them on the market.

The anticancer drug bevacizumab may be able to lend the world an unexpected helping hand. A new study shows that bevacizumab can significantly reduce severe respiratory symptoms and fever from COVID-19. It can also reduce the risk of dying from COVID-19 and alleviate a severe COVID-19 trajectory.

The results have been published in Nature Communications.

“The results are very promising. We hope that this initial trial can pave the way for larger randomized controlled trials to obtain supportive clinical evidence that bevacizumab can reduce the number of people who become severely ill or die from COVID-19. The disease may not be so intimidating if we can demonstrate this,” explains a researcher behind the new study, Yihai Cao, Professor, Department of Microbiology, Karolinska Institutet, Stockholm, Sweden and Honorary Professor, University of Copenhagen, Denmark.

Signal molecule may play a major role in COVID-19 symptoms

Yihai Cao is an oncologist and is therefore primarily interested in cancer.

However, when the COVID-19 pandemic broke out in Wuhan, China in late 2019, he noticed some interesting characteristics among those with the disease.

COVID-19 attacks the lungs and leads to respiratory problems, which for many means low oxygen levels that can prove fatal.

The researchers hypothesized that anti-vascular endothelial growth factor (VEGF) may strongly influence COVID-19 symptoms. VEGF is best known as a signalling molecule in forming new blood vessels and therefore plays an important role in restoring the blood supply to cells and tissues when they lack oxygen.

However, VEGF also induces vascular leakiness in lung tissue among people with COVID-19, leading to fluid accumulation in the alveoli of the lungs and poorer oxygenation of the lung tissue. VEGF is also involved in pneumonia and appears to be especially active in COVID-19.

“We therefore hypothesized that blocking VEGF could reduce some COVID-19 symptoms, including shortness of breath. Bevacizumab is promising because it is an anti-VEGF drug that has already been approved for treating humans,” says Yihai Cao.

Significant improvement following treatment

In a clinical trial with participants from China and Italy, 26 people hospitalized with severe COVID-19 who needed supplemental oxygen were treated with bevacizumab to relieve their symptoms.

The results were dramatic.

· A single dose of bevacizumab improved the oxygen-support status of 92% of the participants, and 17 were discharged during the 28-day follow-up without any deaths.

· No one had increased respiratory problems.

· Fever was reduced within 3 days among 13 of 14 participants with high fever.

· The participants treated with bevacizumab experienced greater improvement in blood oxygen saturation and less need for supplemental oxygen than those not treated.

“Oxygen saturation began to improve within 24 hours. The results were consistent no matter how long people had been ill beforehand. These are quite significant results,” explains Yihai Cao.

Yihai Cao hopes that the results of this small exploratory trial can lead to larger clinical trials to definitively determine the efficacy of bevacizumab for treating people with severe COVID-19.

Efficacy and tolerability of bevacizumab in patients with severe COVID-19” has been published in Nature Communications. In 2019, the Novo Nordisk Foundation awarded a grant to co-author Yihai Cao for the project Mechanistic Study of the Vasculature-derived Cellular and Molecular Signalling in Controlling Brown Adipose Tissue Mass and Functions.

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