The cytokine interleukin 17 (IL-17) may be a possible therapeutic target worth investigating for patients with lung cancer who are simultaneously infected with SARS-CoV-2, according to existing literature that was evaluated in a journal article in the Journal of Thoracic Oncology.1
IL-17 has a possible role in SARS-CoV-2 infection, the study author explained, given that it mediates the cytokine storm in the lung and inhibits apoptosis in infected cells; IL-17 is also thought to increase the virulence of a virus. In addition, in an experimental model, it was shown that the viral persistence caused by a “continuous increase” in IL-17 can elicit acute distress respiratory syndrome (ARDS), “just as it happens in SARS-CoV-2 infection.”
In addition, the IL-17 pathway is altered in patients with risk factors associated with a poor prognosis for COVID-19, such as being of older age, being male, smoking, or having asthma, diabetes, or heart disease — all of which are believed to increase production of IL-17.
IL-17 also has a well-known role in lung cancer, the study author explained. High levels of serum IL-17 have been linked to poorer survival in patients, and preclinical experiments have shown that exposure to IL-17 has promoted tumor growth and increased neoangiogenesis. Also, IL-17 has been shown to upregulate proangiogenic CXC chemokines, which was reversed with monoclonal antibodies that block IL-17.
The study author wrote that anti–IL-17 antibodies have demonstrated a therapeutic role not only in different cancer types, but also in the treatment of lung infection with H1N1 virus, in ARDS, and in pulmonary fibrosis.
“There seem to be theoretic elements to test in a clinical trial,” he wrote.
He asserted that if a clinical trial showed that IL-17 target therapy could control tumor disease and resolution of SARS-CoV-2 infection, the findings could also be applied to other tumors in which IL-17 plays a role. In addition, a trial in cancer-free individuals could present an “opportunity” for a COVID-19 treatment.
Cafarotti S. SARS-CoV2 infection and lung cancer patients: The potential role of IL17 target therapy [published online April 27, 2020]. J Thorac Oncol. doi: 10.1016/j.jtho.2020.04.015