Arizona researchers are studying a potential treatment for COVID-19 that does not have some of the more damaging side effects associated with other drugs undergoing trials right now. 

The HonorHealth Research Institute and HonorHealth in collaboration with the nonprofit research institute TGen are starting a clinical trial to use a combination of an antimalarial drug called atovaquone and the antibiotic azithromycin in patients with moderate-to-severe COVID-19 infection. 

A combination of the two has been previously studied in other infectious conditions and, if proven effective, may represent a “well tolerated” option for patients with COVID-19, said Dr. Michael Gordon, medical director of HonorHealth Research Institute and co-principal investigator of the trial.

“Relatively safer” than other drugs being tested 

COVID-19 is primarily a respiratory disease, but it also can damage the heart. 

Certain drugs being used in patient trials, like hydroxychloroquine, appear to also increase cardiac complications. 

“We know that a related regimen like hydroxychloroquine and azithromycin is being tried in clinical trials around the world and one of the problems with that regimen is that it can cause some cardiac toxicity,” said Dr. Sunil Sharma, one of the clinical trial’s principal investigators with dual appointments at HonorHealth Research Institute and TGen. “Atovaquone and azithromycin is relatively safer compared to that regimen.”

Homegrown treatment and analysis of COVID-19 

HonorHealth is enrolling approximately 25 infected patients into the study. 

Conducted in collaboration with TGen, an affiliate of City of Hope, the new clinical trial is one of 10 that the HonorHealth Research Institute is working on related to COVID-19 to understand the biology, spread and treatment of the infectious disease.

“This is the first trial in the United States, and the first trial made available to patients in Arizona, that involves this specific combination of therapies,” said Kiran Avancha, COO of the HonorHealth Research Institute in Scottsdale. 

“We are proud to be supporting this homegrown innovation here at the Institute, where we have been working with other front line providers, scientists and experts across the globe to bring several COVID-19 trials up in record time to support our patients and providers amid this pandemic.”

Volunteers wanted for COVID-19 clinical trials 

TGen is involved in a number of other studies of COVID-19 as well. Currently, it is seeking up to a hundred volunteer patients who have recovered from the coronavirus and may have built up antibodies to it. 

The study could eventually lead to new methods of diagnosing COVID-19 and help in the development of antibody therapies, and possibly vaccines.

“We are using cutting-edge research tools to study in depth the immune response to COVID-19,” said John Altin, an assistant professor in TGen’s Pathogen and Microbiome Division, the institute’s infectious-disease branch in Flagstaff, also known as TGen North. “Our goal is to enable urgently-needed new diagnostics and treatments for this virus.”

Dr. David Engelthaler, director of TGen North and Arizona’s former state epidemiologist, said this “citizen-science” study could help researchers better understand how the virus has moved through our community.

“This will help us learn more about how, when and why we produce antibodies in response to a COVID-19 infection. One class of antibodies tackles the infection first, and then another comes in to finish the job,” Dr. Engelthaler said. “Knowing when these different immune responses occur, and how long they last, could help us understand if some patients gain a certain degree of immunity against reinfection. We need to know how that works.”

To participate, volunteers must be U.S. residents, age 18 or older, have tested positive for COVID-19, and then recovered. To sign up, go to: .

About HonorHealth

HonorHealth is a non-profit Arizona healthcare network that operates five acute-care hospitals, an extensive medical group, outpatient surgery centers, a cancer care network, clinical research, medical education, and a foundation in the Phoenix metro region. It has approximately 12,300 employees, 3,700 affiliated physicians and 3,100 volunteers. HonorHealth was formed by a merger between Scottsdale Healthcare and John C. Lincoln Health Network. Learn more at .

About HonorHealth Research Institute

HonorHealth Research Institute is dedicated to finding cures and improving treatments in areas like gene therapy, early drug/device development, early detection and prevention of disease. Through our clinical trials and applied research, the institute has  improved the lives of patients from all 50 states and 28 different countries Find a clinical trial or learn more at , or contact a TGen Clinical Research Coordinator at: crc@tgen.org.

About TGen, an affiliate of City of Hope

Translational Genomics Research Institute (TGen) is a Phoenix, Arizona-based non-profit organization dedicated to conducting groundbreaking research with life-changing results. TGen is affiliated with, a world-renowned independent research and treatment center for cancer, diabetes and other life-threatening diseases.  For more information, visit: . Follow TGen on , and .

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Diagnosis, surgery, radiation therapy, repeat. This is the typical process for a patient with a brain tumor.

Neurosurgeons must be extremely cautious when removing a tumor mass from a patient’s brain due to the brain’s vitally important role in all mental and physical functions, said Matthew Likens, president and CEO of GT Medical Technologies, a Tempe-based startup with a mission to improve the lives of brain tumor patients.

“If they’re too aggressive, then there’s a high likelihood they can affect very critical areas of the brain that affect memory and movement and speech,” Likens said. “As a result, they know they’re leaving residual tumor cells behind.”

Those residual cells mean the tumor can come back. If the cells are cancerous, the .

Patients often must wait anywhere between two to four weeks for the surgical wound to heal. To prevent the tumor’s recurrence — stop it from growing back — patients undergo an intensive treatment called .

“That is a miserable experience for the patients,” Likens said. “Many of them lose their hair during the daily external beam radiation. They’re shuttled back and forth to a radiation center. Each day they’re reminded that ‘by the way, you have a brain tumor, and we need to take care of it.’”

Enter the founders of GT Medical Technologies: Dr. Peter Nakaji, a neurosurgeon; Dr. Emad Youssef, a radiation oncologist; Dr. David Brachman, a radiation oncologist; Dr. Heyoung McBride, a radiation oncologist; and Theresa Thomas, a certified clinical research coordinator.

“They were desperate for new treatment options for patients with brain tumors — especially those patients with recurrent brain tumors,” Likens said. “In spite of really great surgeons and really careful therapy afterward, tumors recur. And if you’re fortunate enough to survive that recurrence, and you have another procedure, then they recur again.”

The GT Medical Technologies team developed a new way to treat patients: GammaTile. The small “tiles” of collagen are infused with radiation.

After a successful brain tumor resection (removal), the surgeon places these tiles inside the tumor cavity in the patient’s brain, delivering two-and-a-half times stronger radiation than the external beam.

“On average, this takes about five minutes, so it doesn’t extend surgery time significantly,” Likens said. “After the tiling is done, the surgical wound is closed, and within a day or two… the patient is eligible to go home. And that’s it.”

That’s it. No six-week therapy session and quarantine, no three-week waiting period before radiation, no time for the tumors to return.

“The founders commissioned an IRB-approved study at the in downtown Phoenix, and in that study they treated 108 patients across just about every type of brain tumor,” Likens said. “And the safety results reported from that study were very impressive. This mode of radiation is as-safe or safer than today’s current standard of care.”

All of the GT Medical Technologies founders were at BNI at one point, and three — Nakaji, Youssef and Thomas — still are. The company formed at LaunchPoint, a startup incubator in downtown Mesa. As such, it is “an .”

“We’re keeping it here,” Likens said. “Our chief technology officer, Dr. David Brachman, left his role as director of radiation oncology at Barrow just about a year ago, last March, and he joined us full-time to get his invention out into the marketplace as effectively as we can.”

But the company’s plans are not purely local. Right now, GammaTile is in a limited market release, meaning it has been approved by the Food and Drug Administration but does not yet have the funding to be everywhere at once.

GT Medical Technologies recently received its Series A round of funding, which allows for limited commercialization of the product, and the company is several months in.

The first patient treated in a hospital setting received GammaTile at the University of Minnesota Medical Center, and two more were treated at the center on March 27.

Dr. Clark Chen, chairman of neurosurgery, is “seeking to establish a culture of innovation at the University of Minnesota Medical Center in neurosurgery” and took an immediate interest in GammaTile, Likens said.

“Our purpose is simply to improve the lives of patients with brain tumors, and we think GammaTile will accomplish that,” he said.

The founders of GT Medical Technologies hope to replace the current standard of care for patients with brain tumors, which they believe to be insufficient, he said.

The company is still in its beginning stages, but it has big plans. With FDA clearance, the company can move forward commercializing its product in the U.S., and the founders hope to expand the product’s scope soon.

“This is certainly a global opportunity,” Likens said.

In the future, GammaTile may be used in other parts of the body; Likens said the company has already claimed patents for “extra-cranial” tumors outside the brain.

“We just think there are so many advantages to applying the radiation in this way that every patient should have the benefit from it.”

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