{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T03:49:48Z","timestamp":1784000988262,"version":"3.55.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Australian Medical Research Future Fund Respiratory Medicine Clinical Trials Research","award":["2002213"],"award-info":[{"award-number":["2002213"]}]},{"name":"National Health Medical Research Council Centre of Research Excellence","award":["1116876"],"award-info":[{"award-number":["1116876"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We evaluated whether a daily nasal spray of interferon-alpha (IFN-\u03b1) would reduce the incidence of COVID-19 or community-acquired respiratory viral infections in adult cancer patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicenter, randomized, double-blinded, placebo-controlled trial, participants were randomized 1:1 to receive daily 40 000\u2005IU IFN-\u03b1 nasal spray or normal saline placebo. Participants who developed influenza-like symptoms self-collected nasal swabs for PCR testing of SARS-CoV-2, influenza A\/B, respiratory syncytial virus, parainfluenza, adenovirus, seasonal coronavirus, picornavirus, human metapneumovirus, and\/or SARS-CoV-2 rapid antigen testing. Co-primary endpoints were incidence of COVID-19 and\/or other respiratory viruses \u226490 days of randomization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four hundred and thirty-three participants were randomized to IFN-\u03b1 (n = 217) or placebo (n = 216). The incidence of COVID-19 was lower in the IFN-\u03b1 group versus placebo (8.3% vs 14.4%), indicating a 40% reduced risk of infection (relative risk [RR]: .60; 95% credible interval [CrI]: .33\u2013.97). Other respiratory viral infection incidence was 5.1% and 5.1% in both groups (RR: 1.12; .43\u20132.34). In the per-protocol cohort (n = 389), the incidence of COVID-19 in IFN-\u03b1 and placebo groups was 7.7% and 16.0% (RR: .50; .26\u2013.84) with other respiratory virus incidence of 4.6% and 5.7%, respectively. Subgroup analysis demonstrated lower COVID-19 in the IFN-\u03b1 group for ages &amp;lt;65 years (RR: .48; .20\u2013.92), female sex (RR: .44; .19\u2013.85), and COVID-19 vaccinated (RR: .50; .26\u2013.82), but no difference by underlying malignancy. No differences were observed in secondary endpoints of severity, hospitalization, and mortality. IFN-\u03b1 was well tolerated and safe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IFN-\u03b1 nasal spray prophylaxis reduced the incidence of COVID-19 among adult cancer patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT04534725 (ANZCTR: ACTRN12620000843954)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf409","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T11:49:31Z","timestamp":1753271371000},"page":"e208-e216","source":"Crossref","is-referenced-by-count":2,"title":["Interferon-\u03b1 Nasal Spray Prophylaxis Reduces COVID-19 in Cancer Patients: A Randomized, Double-Blinded, Placebo-Controlled Trial"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8692-4145","authenticated-orcid":false,"given":"Michelle K","family":"Yong","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]},{"name":"Sir Peter MacCallum Department of Oncology, The University of Melbourne , Melbourne, Victoria ,","place":["Australia"]},{"name":"Department of Infectious Diseases, Royal Melbourne Hospital , Melbourne, Victoria ,","place":["Australia"]},{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7400-232X","authenticated-orcid":false,"given":"Karin","family":"Thursky","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]},{"name":"Sir Peter MacCallum Department of Oncology, The University of Melbourne , Melbourne, Victoria ,","place":["Australia"]},{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]},{"name":"Department of Health Services Research, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Crane","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]},{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9204-3216","authenticated-orcid":false,"given":"Tim","family":"Spelman","sequence":"additional","affiliation":[{"name":"Sir Peter MacCallum Department of Oncology, The University of Melbourne , Melbourne, Victoria ,","place":["Australia"]},{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]},{"name":"Department of Health Services Research, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3643-923X","authenticated-orcid":false,"given":"Robert K","family":"Mahar","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne , Melbourne, Victoria 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M","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Molecular Imaging and Therapy, Austin Health , Heidelberg, Victoria ,","place":["Australia"]},{"name":"Olivia Newton-John Cancer Research Institute , Tumour Targeting Laboratory, Heidelberg, Victoria ,","place":["Australia"]},{"name":"Faculty of Medicine, University of Melbourne , Melbourne, Victoria ,","place":["Australia"]},{"name":"School of Cancer Medicine, LaTrobe University , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon J","family":"Harrison","sequence":"additional","affiliation":[{"name":"Sir Peter MacCallum Department of Oncology, The University of Melbourne , Melbourne, Victoria ,","place":["Australia"]},{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne, Victoria ,","place":["Australia"]},{"name":"Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital , 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