High levels of TNFalpha in patients with COVID-19 refractory to tocilizumab
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
Recently, Feldmann et al. in Lancet suggested investigating TNF alpha blocker therapies for patients with COVID-19 at high risk of developing a life-threatening form. The cytokine release syndrome and immuno-thrombosis induced by Sars-CoV2 mostly explains the severity of coronavirus disease 2019 (COVID-19). In a recent issue of Nature Medicine, Del Valle et al. reported the plasma levels of IL-6, IL-8, tumor necrosis factor (TNF)-
α and IL-1β in patients hospitalized for COVID-19. They highlighted in a comprehensive multivariate analysis that high plasma levels of IL-6 and TNF-α remained significantly associated with a poor prognosis of patients with COVID-197. They proposed to measure IL-6 and TNF-α to stratify patients in further prospective clinical trials treating COVID-19 patients. Targeting interleukin-6 (IL6) - one of the more proinflammatory cytokine - with anti-IL6 receptor (anti-IL6R) have shown encouraging although controversial preliminary efficacy in the treatment of severe COVID-19 patients, while definitive results of clinical trials are still pending (COVACTA trial [NCT04320615]; CORIMUNO-TOCI trial [NCT04331808]; RECOVERY trial [NCT04381936
European Journal of Cancer , éditorial en libre accès, 2020