Combination treatments with hydroxychloroquine and azithromycin are compatible with the therapeutic induction of anticancer immune responses

Oncoimmunology. 2020 Jul 8;9(1):1789284. doi: 10.1080/2162402X.2020.1789284.


Amid controversial reports that COVID-19 can be treated with a combination of the antimalarial drug hydroxychloroquine (HCQ) and the antibiotic azithromycin (AZI), a clinical trial (ONCOCOVID, NCT04341207) was launched at Gustave Roussy Cancer Campus to investigate the utility of this combination therapy in cancer patients. In this preclinical study, we investigated whether the combination of HCQ+AZI would be compatible with the therapeutic induction of anticancer immune responses. For this, we used doses of HCQ and AZI that affect whole-body physiology (as indicated by a partial blockade in cardiac and hepatic autophagic flux for HCQ and a reduction in body weight for AZI), showing that their combined administration did not interfere with tumor growth control induced by the immunogenic cell death inducer oxaliplatin. Moreover, the HCQ+AZI combination did not affect the capacity of a curative regimen (cisplatin + crizotinib + PD-1 blockade) to eradicate established orthotopic lung cancers in mice. In conclusion, it appears that HCQ+AZI does not interfere with the therapeutic induction of therapeutic anticancer immune responses.

Keywords: COVID-19; SARS-CoV-2; cancer; hydroxychloroquine; immune checkpoint; immunotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / pharmacokinetics
  • Azithromycin / administration & dosage*
  • Azithromycin / pharmacokinetics
  • COVID-19 / immunology
  • COVID-19 / virology
  • COVID-19 Drug Treatment*
  • Cell Line, Tumor
  • Cisplatin / administration & dosage
  • Cisplatin / pharmacokinetics
  • Clinical Trials, Phase II as Topic
  • Crizotinib / administration & dosage
  • Crizotinib / pharmacokinetics
  • Disease Models, Animal
  • Drug Evaluation, Preclinical
  • Drug Interactions
  • Drug Therapy, Combination / methods
  • Female
  • France
  • Humans
  • Hydroxychloroquine / administration & dosage*
  • Hydroxychloroquine / pharmacokinetics
  • Mice
  • Neoplasms / drug therapy*
  • Neoplasms / immunology
  • Oxaliplatin / administration & dosage
  • Oxaliplatin / pharmacokinetics
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors
  • Programmed Cell Death 1 Receptor / immunology
  • SARS-CoV-2 / immunology
  • SARS-CoV-2 / isolation & purification


  • Pdcd1 protein, mouse
  • Programmed Cell Death 1 Receptor
  • Oxaliplatin
  • Hydroxychloroquine
  • Crizotinib
  • Azithromycin
  • Cisplatin