COVID-19 research at Swedish

July 29, 2020

Swedish Health Team

Swedish starts REACT COVID-19 to collect data and analyze outcomes of innovative COVID-19 treatments

International, multicenter study captures information that offers insight into potential care options for coronavirus patients.
Registry documents effects of treatments typically used in cancer immunotherapy or rheumatologic diseases.

[3 MIN READ]

Cancer specialists at Swedish are using the knowledge they’ve gained doing leading-edge oncology research to learn more about the coronavirus (COVID-19) and how it responds to certain treatments.

Real world Evidence for Anti-Cytokine Therapy or REACT COVID-19 is an international, multicenter study designed to collect and record clinical data about how patients respond to a treatment that is used in cancer care and rheumatologic conditions but may offer relief from COVID-19.

Dr. Krish Patel, Co-principal Investigator for the REACT COVID-19 study, offers his insights into the registry’s importance and explains why an oncologist decided to study an infectious disease. According to him, the decision wasn’t as big a stretch as it might initially seem.

“As researchers, we have a desire to learn more. To try and answer questions that are not previously answered. That’s something that’s very much in our DNA,” Dr. Patel said.

Immunotherapy

To understand how REACT got started, it's important to know the basics of the immunotherapy cancer treatment called CAR T-cell therapy. CAR T-cell therapy activates your immune system and uses it to recognize and destroy your cancer cells. It can be an effective treatment for several types of blood cancers.

“In CAR T-cell immunotherapy, we take the patient’s immune cells, modify them in the lab and re-insert them into the patient’s body. The modified immune cells then attack the patient’s cancer,” said Dr. Patel. Although CAR T-cell therapy can often produce positive results, it can also prompt a serious reaction.

“During treatment, immune cells can sometimes bring on such a strong reaction it can make people quite sick with an illness called Cytokine Release Syndrome (CRS),” he explains. “Cytokines are proteins, or messengers, that your immune system uses to ramp up or dial down your immune system’s response to some kind of injury or foreign invader.”

Symptoms of CRS include rapid onset of fever, low blood pressure, rapid heartbeat, headache, rash and difficulty breathing. Dr. Patel and others realized they’d seen these symptoms in patients with COVID-19.

“Some COVID-19 patients would come in with symptoms that looked typical for an infection. They were short of breath; they had a fever; they had a hard time breathing. They’d come in like that and then would very rapidly have worsening symptoms like extremely high fever or greatly diminished ability to breathe. It looked very similar to CRS," said Dr. Patel.

Other doctors, some located in China and Italy, reported similar experiences. To manage these symptoms, experts turned to anti-cytokine treatments used to battle CRS (and other rheumatologic conditions). The REACT registry is a way to document their efforts and record the results they produce.

The study is observational, which means it does not recommend or advocate a specific treatment. Instead, it documents treatment and attempts to “bridge knowledge gaps” about COVID-19 and its effect on the body.

Results so far

So far, the results have been promising. “We’ve had a tremendous amount of interest right from the start,” said Dr. Patel. REACT currently has 10 – 12 sites contributing data on about 150 patients from a wide range of locations, including France, the United Kingdom, Brazil and multiple facilities across the United States. The registry's organizers hope to collect data on about 500 patients worldwide. They plan to publish their findings at the end of the study but have not yet determined a final cutoff date.

Getting REACT up and running in a very short time would not have been possible without the support of Swedish leadership and the organization’s tradition of clinical research, according to Dr. Patel.

“The existing research structure that we have in the Swedish Cancer Institute and the fact that we do clinical research in oncology allowed us to quickly create a secure database, communicate with outside institutions and get perspective from the frontline doctors caring for these patients,” said Dr. Patel.

“It’s important to see what happens to patients when they receive medicine like this,” he explained. "We created REACT to catalog these outcomes, collect data and determine what's helpful and what's harmful. A registry allows us to capture information about how patients who are treated with these types of medicines are doing."

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