This phase II trial studies how well lopinavir/ritonavir works in treating COVID-19 positive patients with cancer and a weakened immune system (immune-suppression) in the last year and have mild or moderate symptoms caused by COVID-19. Lopinavir/ritonavir may help to lessen or prevent COVID-19 symptoms from getting worse in cancer patients.
PRIMARY OBJECTIVE: I. To determine if treatment with lopinavir/ritonavir will decrease progression of symptoms compared to control/placebo. SECONDARY OBJECTIVES: I. Determine if treatment improves time to symptom resolution. II. Determine the time to symptom progression. III. Determine time to improvement of participants as defined by complete resolution of symptoms. IV. Determine the proportion of participants who have severe or critical symptoms and hospital admission. V. Determine the time to hospital admission for those who develop severe of critical symptoms VI. Determine the proportion of participants with an intensive care unit (ICU) admission. VII. Determine the proportion of participants receiving ventilator support. VIII. Determine survival of participants enrolled on the study. EXPLORATORY OBJECTIVES: I. For patients admitted to the hospital, will determine the following parameters: potassium level, blood oxygen level, creatinine, and blood pressure. II. Identify obstacles and barriers encountered while implementing a clinical trial in the context of a pandemic caused by a contagious disease and associated social distancing. OUTLINE: Patients are randomized to 1 of 2 groups. GROUP I: Patients receive lopinavir/ritonavir orally (PO) twice daily (BID) for 14 days in the absence of disease progression or unacceptable toxicity. GROUP II: Patients receive placebo PO BID for 14 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up 3 times a week until symptoms resolve plus 2 additional weeks thereafter, for up to 3 months, whichever occurs first.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Given PO
Given PO
Ancillary studies
Severity of symptoms
Will be compared to the time of randomization. The severity of symptoms will be categorized as mild, moderate, severe, or critical according to the grading of symptoms. The proportion of participants with progression to more severe symptoms between treatments groups will be compared using a Fisher's Exact test at a 0.05 significance level.
Time frame: 3 months
Clinical benefit rate of lopinavir/ritonavir
Will be defined as improvement on symptoms: yes or no. Will be compared between treatment groups using log-rank test. A 95% confidence interval of treatment rate difference in symptom progression will be calculated by the Wald method.
Time frame: 3 months
Time to symptom progression
Will be compared between treatment groups using log-rank test.
Time frame: From randomization to the first documented symptoms progression, assessed up to 3 months
Time to improvement of participants
Will be compared between treatment groups using log-rank test.
Time frame: From randomization to first documented complete resolution of symptoms, assessed up to 3 months
Time to hospital admission for those who develop severe of critical symptoms
Will be compared between treatment groups using log-rank test.
Time frame: From time of randomization to the time of hospital admission, assessed up to 3 months
Intensive care unit (ICU) admission: yes or no
Will be compared using Fisher's exact test, and point and interval estimates will be provided.
Time frame: 3 months
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Receiving ventilator support: yes or no
Will be compared using Fisher's exact test, and point and interval estimates will be provided.
Time frame: 3 months
Overall survival
Will be compared using Fisher's exact test, and point and interval estimates will be provided.
Time frame: From randomization to death due to any cause, assessed up to 3 months