Clinical trials are currently underway to investigate the effectiveness of bevacizumab for the treatment of COVID-19, with results expected as early as May 2020.
The outbreak and rapid spread of the novel coronavirus, COVID-19, has resulted in the worldwide search for a viable treatment option. There are several drug candidates currently being investigated to treat COVID-19, such as remdesivir, ritonavir/lopinavir, and hydroxychloroquine. Another drug that is receiving significant attention in the fight against COVID-19 is bevacizumab.
Bevacizumab (Avastin) is a drug that is currently used to treat cancer (colorectal, lung, breast, renal, brain, and ovarian), as well as age-related macular degeneration and diabetic retinopathy. This drug has been used as an anti-tumour treatment for almost 20 years, so the safety of the drug is already known. Some of the most common adverse reactions to bevacizumab include hypertension, fatigue, diarrhea, and abdominal pain.
Bevacizumab is a human monoclonal antibody that works by
attaching to a growth factor called vascular endothelial growth factor A
(VEGF-A). By blocking the activity of this growth factor, the drug is able to
inhibit the process of angiogenesis (formation of new blood vessels), which is
an important process in cancer development.
What’s the evidence to support using bevacizumab for the treatment of COVID-19?
The basis for using bevacizumab to treat COVID-19 comes from research that has identified elevated levels of VEGF in the blood of patients with COVID-19. It has been suggested that the increase in levels of VEGF is due to hypoxia (low oxygen) and severe inflammation, with evidence that VEGF plays a key role, and is therefore a prime treatment target, in acute lung injury and acute respiratory distress syndrome. Prior research suggests that suppression of VEGF could suppress pulmonary edema (accumulation of fluid in the lungs leading to respiratory failure), thereby reducing overall mortality in patients with severe COVID-19 infection.
Clinical trials assessing the effectiveness of bevacizumab for the treatment of COVID-19
An interventional clinical trial is underway at the Qilu Hospital of Shandong University in Jinan, China. The trial aims to assess the safety of bevacizumab and its effectiveness in treating severe and severe new crown pneumonia and dyspnea (shortness of breath) and diffuse pulmonary lesions in patients with COVID-19. The trial aims to enroll over 100 participants and its estimated completion date is May 31, 2020.
A second trial of bevacizumab is a Phase II/III trial, also being conducted by Qilu Hospital of Shandong University. This is an open-label, single-group trial that will include 20 participants with severe COVID-19 and pneumonia, with an estimated completion date of May 2020.
The advantage of testing drugs that are already used for other purposes is that the testing phase can be significantly shortened since the activity and side effects have already been extensively studied. This means that clinical trials can focus on whether the drug is effective specifically against COVID-19.
Written by Deborah Tallarigo, PhD
Clinical Trial – Bevacizumab in Severe or Critical Patients With COVID-19 Pneumonia-RCT – NCT04305106
Clinical Trial – Bevacizumab in Severe or Critical Patients With COVID-19 Pneumonia (BEST-CP) – NCT04275414
Avastin Fact Sheet.
Image by Miguel Á. Padriñán from Pixabay