PT  - JOURNAL ARTICLE
AU  - Fernanda I Arnaldez
AU  - Steven J O'Day
AU  - Charles G Drake
AU  - Bernard A Fox
AU  - Bingqing Fu
AU  - Walter J Urba
AU  - Vincenzo Montesarchio
AU  - Jeffrey S Weber
AU  - Haiming Wei
AU  - Jon M Wigginton
AU  - Paolo Antonio Ascierto
TI  - The Society for Immunotherapy of Cancer perspective on regulation of interleukin-6 signaling in COVID-19-related systemic inflammatory response
AID  - 10.1136/jitc-2020-000930
DP  - 2020 May 01
TA  - Journal for ImmunoTherapy of Cancer
PG  - e000930
VI  - 8
IP  - 1
4099  - http://jitc.bmj.com/content/8/1/e000930.short
4100  - http://jitc.bmj.com/content/8/1/e000930.full
SO  - J Immunother Cancer2020 May 01; 8
AB  - The pandemic caused by the novel coronavirus SARS-CoV-2 has placed an unprecedented burden on healthcare systems around the world. In patients who experience severe disease, acute respiratory distress is often accompanied by a pathological immune reaction, sometimes referred to as ‘cytokine storm’. One hallmark feature of the profound inflammatory state seen in patients with COVID-19 who succumb to pneumonia and hypoxia is marked elevation of serum cytokines, especially interferon gamma, tumor necrosis factor alpha, interleukin 17 (IL-17), interleukin 8 (IL-8) and interleukin 6 (IL-6). Initial experience from the outbreaks in Italy, China and the USA has anecdotally demonstrated improved outcomes for critically ill patients with COVID-19 with the administration of cytokine-modulatory therapies, especially anti-IL-6 agents. Although ongoing trials are investigating anti-IL-6 therapies, access to these therapies is a concern, especially as the numbers of cases worldwide continue to climb. An immunology-informed approach may help identify alternative agents to modulate the pathological inflammation seen in patients with COVID-19. Drawing on extensive experience administering these and other immune-modulating therapies, the Society for Immunotherapy of Cancer offers this perspective on potential alternatives to anti-IL-6 that may also warrant consideration for management of the systemic inflammatory response and pulmonary compromise that can be seen in patients with severe COVID-19.