BTK inhibitors in cancer patients with COVID-19: "The winner will be the one who controls that chaos" (Napoleon Bonaparte) Journal Article


Authors: Chong, E. A.; Roeker, L. E.; Shadman, M.; Davids, M. S.; Schuster, S. J.; Mato, A. R.
Article Title: BTK inhibitors in cancer patients with COVID-19: "The winner will be the one who controls that chaos" (Napoleon Bonaparte)
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. ©2020 American Association for Cancer Research.
Journal Title: Clinical Cancer Research
Volume: 26
Issue: 14
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2020-07-15
Start Page: 3514
End Page: 3516
Language: English
DOI: 10.1158/1078-0432.CCR-20-1427
PUBMED: 32345646
PROVIDER: scopus
PMCID: PMC7367762
DOI/URL:
Notes: Article -- Export Date: 3 August 2020 -- Source: Scopus
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MSK Authors
  1. Anthony R Mato
    128 Mato
  2. Lindsey Elizabeth Roeker
    49 Roeker