Effective Combination Therapy for COVID-19 Featured in a Patient With Lung Cancer
Posted: Friday, August 20, 2021
A case study in Clinical Case Reports focused on a 50-year-old male patient treated with pembrolizumab for squamous cell carcinoma of the lungs. A total of 52 days after his last dose of pembrolizumab, while being treated with prednisolone for arthritis, the patient was diagnosed with COVID-19. “Combination therapy with methylprednisolone, baricitinib, and remdesivir” was successful in treating this patient’s COVID infection, according to Ichiro Takata, MD, of the Fukuyama City Hospital, Japan, and colleagues, and further clinical trials may be warranted.
Before contracting COVID-19, the patient received four cycles of carboplatin, nab-paclitaxel, and pembrolizumab and four cycles of pembrolizumab maintenance. Treatment was successful in reducing the tumor size, but resulting arthritis required prednisolone and injections of betamethasone. After 30 days of arthritis treatments, the patient was diagnosed with COVID-19. On the second day of treatment, the antiviral agent favipiravir was administered, and prednisolone was withheld.
After 7 days, the patient required oxygen and hospitalization. Ground-glass opacities were revealed on a CT scan of both lungs, and therapy with high-flow oxygen, methylprednisolone, remdesivir, and heparin calcium began. This intervention proved insufficient, and treatment with the rheumatoid arthritis medication baricitinib, tracheal intubation, and mechanical ventilation were administered. The patient then improved. He was extubated on day 14 of treatment and discharged 33 days after his COVID diagnosis.
Despite prednisolone being reduced to 10 mg daily, no recurrence of arthritis was reported. Furthermore, his lung cancer had not progressed 4 months after the end of cancer treatments.
The researchers highlighted that the combination therapy used in this case might effectively treat other critical COVID-19 cases, including those of patients with cancer taking immunosuppressive agents.
Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.