The right immune-modulation at the right time: thymosin α1 for prevention of severe COVID-19 in cancer patients

Abstract

We presented the rationale for the use of thymosin α1 as prophylaxis of severe COVID-19 in cancer patients undergoing active treatment, constituting the background for the PROTHYMOS study, a prospective, multicenter, open-label, Phase II randomized study, currently in its start-up phase (Eudract no. 2020-006020-13). We aim to offer new hope for this incurable disease, especially to frail patient population, such as patients with cancer. The hypothesis of an effective prophylactic approach to COVID-19 would have immediate clinical relevance, especially given the lack of curative approaches. Moreover, in the 'COVID-19 vaccine race era' both clinical and biological results coming from the PROTHYMOS trials could even support the rationale for future combinatorial approaches, trying to rise vaccine efficacy in frail individuals.

Keywords: COVID-19; SARS-CoV-2; cancer; cancer patients; prevention; prophylaxis; vaccination.

Figure 1.. Proof of concept for thymosin α1 use in COVID-19.

Thymosin α1 might have the ability to modulate the immune response to SARS-CoV-2 infection in the viremic phase, influencing the activity of T cells, NK lymphocytes and dendritic cells, modulating their cytokine production and avoiding progression into cytokine storm, thus preventing the evolution in severe forms of COVID-19. NK: Natural killer; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2.