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Clinical Trial
. 2022 May;14(7):521-530.
doi: 10.2217/imt-2022-0027. Epub 2022 Mar 21.

Blocking EGFR with nimotuzumab: a novel strategy for COVID-19 treatment

Henrry Diaz Londres  1 , Jorge Jiménez Armada  2 , Aray Hernández Martínez  1 , Anselmo A Abdo Cuza  3 , Yamilka Hernández Sánchez  2 , Aylin Granado Rodríguez  2 , Sarahy Sepúlveda Figueroa  1 , Egda M Llanez Gregorich  1 , Mery L Torres Lahera  1 , Francisco Gómez Peire  3 , Teresita Montero González  4 , Yaneth Zamora González  5 , Ana L Añé Kouri  6 , Addys González Palomo  6 , Mayelin Troche Concepción  6 , Loipa Medel Pérez  6 , Patricia Lorenzo Luaces-Alvarez  6 , Daymys Estévez Iglesias  6 , Danay Saavedra Hernández  6 , Mayra Ramos Suzarte  6 , Tania Crombet Ramos  6
Affiliations
Clinical Trial

Blocking EGFR with nimotuzumab: a novel strategy for COVID-19 treatment

Henrry Diaz Londres et al. Immunotherapy. 2022 May.

Erratum in

  • Corrigendum.
    [No authors listed] [No authors listed] Immunotherapy. 2022 Oct;14(14):1181. doi: 10.2217/imt-2022-0027c1. Immunotherapy. 2022. PMID: 36106709 Free PMC article. No abstract available.

Abstract

Background: Lung injury and STAT1 deficit induce EGFR overexpression in SARS-CoV-2 infection. Patients & methods: A phase I/II trial was done to evaluate the safety and preliminary effect of nimotuzumab, an anti-EGFR antibody, in COVID-19 patients. Patients received from one to three infusions together with other drugs included in the national guideline. Results: 41 patients (31 severe and 10 moderate) received nimotuzumab. The median age was 62 years and the main comorbidities were hypertension, diabetes and cardiovascular disease. The antibody was very safe and the 14-day recovery rate was 82.9%. Inflammatory markers decreased over time. Patients did not show signs of fibrosis. Conclusion: Nimotuzumab is a safe antibody that might reduce inflammation and prevent fibrosis in severe and moderate COVID-19 patients. Clinical Trial Registration: RPCEC00000369 (rpcec.sld.cu).

Keywords: COVID-19; EGFR; SARS-CoV-2; fibrosis; inflammation; monoclonal antibody; nimotuzumab.

Plain language summary

Background: After SARS-CoV-2 infection, many cells in the lung express a new receptor called EGFR. Overexpression of EGFR can worsen the pulmonary disease and provoke fibrosis. Patients & methods: The initial impact of using a drug that blocks EGFR, nimotuzumab, was evaluated in COVID-19 patients. Results: 41 patients received nimotuzumab by the intravenous route together with other medications. The median age was 62 years, and patients had many chronic conditions including hypertension, diabetes and cardiac problems. Treatment was well tolerated and 82.9% of the patients were discharged by day 14. Serial laboratory tests, x-rays and CT scan evaluations showed the improvement of the patients. Conclusion: Nimotuzumab is a safe drug that can be useful to treat COVID-19 patients.

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Conflict of interest statement

Financial & competing interests disclosure

This study was funded by the Cuban Ministry of Health and the Center of Molecular Immunology. TCR, MRS, DSH, DEI, PLLA, LMP, MTC, AGP and ALAK currently work for the Center of Molecular Immunology, the institution that generated and originally patented nimotuzumab. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Figures

Figure 1.
Figure 1.. Representative microscopic images (40× and 100×) of the EGFR expression in the lung tissue from two deceased COVID-19 patients.
Black arrows show the positive cells including pneumocytes, alveolar macrophages and fibroblasts.
Figure 2.
Figure 2.. Axial chest CT scans of three patients treated with nimotuzumab.
Sequential images on admission (column A), at discharge (column B) and follow-up (30–60 days after discharge). (A & B) Extensive areas of ground-glass opacities, airspace consolidation in exudative phase and decreased lung volumes in organizing and fibrotic phases. (C) Follow-up: the three patients showed resolution of the lung inflammatory lesions and no sign of fibrosis.
See this image and copyright information in PMC

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