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Hydroxychloroquine Combination Risky for Cancer Patients with COVID-19

Julie Steenhuysen  |  May 29, 2020

CHICAGO (Reuters)—Cancer patients with COVID-19 who were treated with a drug combination promoted by U.S. President Donald Trump to counter the coronavirus were three times more likely to die within 30 days than those who got either drug alone, U.S. researchers reported on May 28.

The preliminary results suggest doctors may want to refrain from prescribing the decades-old malaria treatment hydroxychloroquine (HCQ) with the antibiotic azithromycin for these patients until more study is done, researchers say.

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“Treatment with HCQ and azithromycin were strongly associated with increased risk of death,” Howard Burris, MD, president of the American Society of Clinical Oncology (ASCO), said in a briefing with reporters on the results.

The drug combination initially was thought to help COVID-19 patients, but recent data has cast doubt on the regimen.

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The preliminary findings, to be presented this week at ASCO’s virtual scientific meeting, show that the combination may pose a significant risk to cancer patients.

“Taking the combination gives a three times increased risk of dying within 30 days of any cause,” Jeremy Warner, MD, MS, of Vanderbilt University Medical System told reporters.

Pres. Trump, who has often promoted HCQ, in a March 21 tweet called the combination potentially “one of the biggest game changers in the history of medicine.”

That was based on a study of fewer than 40 patients in the International Journal of Antimicrobial Agents. More recent studies have shown little or no benefit and increased risks.

Dr. Warner and colleagues analyzed data on 925 patients with cancer who became infected with the coronavirus between March and April. Thirteen percent of the patients died within 30 days of their diagnosis.

Overall, patients whose cancers were actively progressing at the time of infection were five times more likely to die within 30 days than those who were in remission or had no current evidence of cancer.

In the trial, 180 patients were taking HCQ in combination with azithromycin, and 90 were taking HCQ alone.

The U.S. Food and Drug Administration (FDA) has allowed healthcare providers to prescribe the drugs for COVID-19 through an emergency-use authorization, but has not approved the treatment.

The governments of France, Italy and Belgium moved on Wednesday to halt the use of HCQ for COVID-19 patients following a World Health Organization decision on Monday to pause a large trial of the drug due to safety concerns.

Dr. Warner said HCQ alone was not a significant risk factor when adjusting for other risks, noting that the number of individuals taking the drug alone was relatively small.

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Filed under:Drug Updates Tagged with:Cancercombination therapyCOVID-19HCQHydroxychloroquine (HCQ)

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