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. 2022 Aug:171:64-74.
doi: 10.1016/j.ejca.2022.04.036. Epub 2022 May 23.

Vaccination against SARS-CoV-2 protects from morbidity, mortality and sequelae from COVID19 in patients with cancer

David J Pinato  1 , Daniela Ferrante  2 , Juan Aguilar-Company  3 , Mark Bower  4 , Ramon Salazar  5 , Oriol Mirallas  6 , Anna Sureda  7 , Alexia Bertuzzi  8 , Joan Brunet  9 , Matteo Lambertini  10 , Clara Maluquer  7 , Paolo Pedrazzoli  11 , Federica Biello  12 , Alvin J X Lee  13 , Christopher C T Sng  13 , Raquel Liñan  9 , Sabrina Rossi  8 , M Carmen Carmona-García  9 , Rachel Sharkey  4 , Simeon Eremiev  6 , Gianpiero Rizzo  14 , Hamish Dc Bain  13 , Tamara Yu  13 , Claudia A Cruz  15 , Marta Perachino  10 , Nadia Saoudi-Gonzalez  6 , Roser Fort-Culillas  9 , Kris Doonga  4 , Laura Fox  16 , Elisa Roldán  6 , Federica Zoratto  17 , Gianluca Gaidano  18 , Isabel Ruiz-Camps  19 , Riccardo Bruna  18 , Andrea Patriarca  18 , Marianne Shawe-Taylor  13 , Vittorio Fusco  20 , Clara Martinez-Vila  21 , Rossana Berardi  22 , Marco Filetti  23 , Francesca Mazzoni  24 , Armando Santoro  25 , Sara Delfanti  26 , Alessandro Parisi  27 , Paola Queirolo  28 , Avinash Aujayeb  29 , Lorenza Rimassa  25 , Aleix Prat  30 , Josep Tabernero  31 , Alessandra Gennari  12 , Alessio Cortellini  32 ; OnCovid study group
Collaborators, Affiliations

Vaccination against SARS-CoV-2 protects from morbidity, mortality and sequelae from COVID19 in patients with cancer

David J Pinato et al. Eur J Cancer. 2022 Aug.

Abstract

Background: Although SARS-CoV-2 vaccines immunogenicity in patients with cancer has been investigated, whether they can significantly improve the severity of COVID-19 in this specific population is undefined.

Methods: Capitalizing on OnCovid (NCT04393974) registry data we reported COVID-19 mortality and proxies of COVID-19 morbidity, including post-COVID-19 outcomes, according to the vaccination status of the included patients.

Results: 2090 eligible patients diagnosed with COVID-19 between 02/2020 and 11/2021 were included, of whom 1930 (92.3%) unvaccinated, 91 (4.4%) fully vaccinated and 69 (3.3%) partially vaccinated. With the exception of a higher prevalence of patients from the UK (p = 0.0003) and receiving systemic anticancer therapy at COVID-19 diagnosis (p = 0.0082) among fully vaccinated patients, no demographics/oncological features were associated with vaccination status. The 14-days case fatality rate (CFR) (5.5% vs 20.7%, p = 0.0004) and the 28-days CFR (13.2% vs 27.4%, p = 0.0028) demonstrated a significant improvement for fully vaccinated patients in comparison with unvaccinated patients. The receipt of prior full vaccination was also associated with reduced symptomatic COVID-19 (79.1% vs 88.5%, p = 0.0070), need of COVID-19 oriented therapy (34.9% vs 63.2%, p < 0.0001), complications from COVID-19 (28.6% vs 39.4%, p = 0.0379), hospitalizations due to COVID-19 (42.2% vs 52.5%, p = 0.0007) and oxygen therapy requirement (35.7% vs 52%, p = 0.0036). Following Inverse Probability Treatment Weighting (IPTW) procedure no statistically significant difference according to the vaccination status was confirmed; however, all COVID-19 related outcomes were concordantly in favour of full vaccination. Among the 1228 (58.8%) patients who underwent a formal reassessment at participating centres after COVID-19 resolution, fully vaccinated patients experienced less sequelae than unvaccinated patients (6.7% vs 17.2%, p = 0.0320).

Conclusions: This analysis provides initial evidence in support of the beneficial effect of SARS-CoV-2 vaccines against morbidity and mortality from COVID-19 in patients with cancer.

Keywords: COVID-19; Cancer; Clinical efficacy; Prevention; SARS-CoV-2; Vaccines.

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Conflict of interest statement

Conflict of interest statement The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: As corresponding author of the abovementioned manuscript, I declare on behalf of my co-authors the following conflict of interests: David J Pinato received lecture fees from ViiV Healthcare, Bayer Healthcare, BMS, Roche, EISAI, Falk Foundation, travel expenses from BMS and Bayer Healthcare; consulting fees for Mina Therapeutics, EISAI, Roche, DaVolterra and Astra Zeneca; research funding (to institution) from MSD and BMS.Aleix Prat has declared personal honoraria from Pfizer, Roche, MSD Oncology, Eli Lilly, and Daiichi Sankyo; travel, accommodations, and expenses paid by Daiichi Sankyo; research funding from Roche and Novartis; and consulting/advisory role for NanoString Technologies, Amgen, Roche, Novartis, Pfizer and Bristol-Myers Squibb.Matteo Lambertini acted as consultant for Roche, Novartis, Lilly, AstraZeneca, Exact Sciences, MSD, Pfizer, Seagen and received speaker honoraria from Roche, Novartis, Lilly, Pfizer, Takeda, Ipsen and Sandoz outside the submitted work.Joan Brunet has declared consulting/advisory role for MSD and Astra Zeneca.Alessandra Gennari has declared consulting/advisory role for Roche, MSD, Eli Lilly, Pierre Fabre, EISAI, and Daichii Sankyo; speakers bureau for Eisai, Novartis, Eli Lilly, Roche, Teva, Gentili, Pfizer, Astra Zeneca, Celgene, and Daichii Sankyo; research funds: EISAI, Eli Lilly, and Roche. CMV has received travel grants and other honoraria from BMS, MSD, Novartis and Roche.Gianluca Gaidano has declared consulting/advisory role for Janssen, Abbvie, Astra-Zeneca and BeiGene, and speaker fees from Janssen and Abbvie.Lorenza Rimassa received consulting fees from Taiho Oncology, Servier, Amgen, ArQule, AstraZeneca, Basilea, Bayer, BMS, Celgene, Eisai, Exelixis, Genenta, Hengrui, Incyte, Ipsen, IQVIA, Lilly, MSD, Nerviano Medical Sciences, Roche, Sanofi, Zymeworks; lecture fees from AbbVie, Amgen, Bayer, Eisai, Gilead, Incyte, Ipsen, Lilly, Merck Serono, Roche, Sanofi; travel expenses from Ipsen; and institutional research funding from Agios, ARMO BioSciences, AstraZeneca, BeiGene, Eisai, Exelixis, Fibrogen, Incyte, Ipsen, Lilly, MSD, Nerviano Medical Sciences, Roche, Zymeworks.Joseph Tabernero reported consulting fees from Array Biopharma, AstraZeneca, Avvinity, Bayer, Boehringer Ingelheim, Chugai, Daiichi Sankyo, F. Hoffmann-La Roche Ltd, Genentech Inc, HalioDX SAS, Hutchison MediPharma International, Ikena Oncology, Inspirna Inc, IQVIA, Lilly, Menarini, Merck Serono, Merus, MSD, Mirati, Neophore, Novartis, Ona Therapeutics, Orion Biotechnology, Peptomyc, Pfizer, Pierre Fabre, Samsung Bioepis, Sanofi, Seattle Genetics, Scandion Oncology, Servier, Sotio Biotech, Taiho, Tessa Therapeutics and TheraMyc. He also reported speaker's fees from Imedex, Medscape Education, MJH Life Sciences, PeerView Institute for Medical Education and Physicians Education Resource (PER). He also declared institutional research support from Amgen Inc, Array Biopharma Inc, AstraZeneca Pharmaceuticals LP, BeiGene, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Debiopharm International SA, F. Hoffmann-La Roche Ltd, Genentech Inc, HalioDX SAS, Hutchison MediPharma International, Janssen-Cilag SA, MedImmune, Menarini, Merck Health KGAA, Merck Sharp & Dohme, Merus NV, Mirati, Novartis Farmacéutica SA, Pfizer, Pharma Mar, Sanofi Aventis Recherche & Développement, Servier, Taiho Pharma USA Inc, Spanish Association Against Cancer Scientific Foundation and Cancer Research UK.Alessio Cortellini received consulting fees from MSD, BMS, AstraZeneca, Roche; speakers' fee from AstraZeneca, MSD, Novartis and Eisai.All remaining authors have declared no conflicts of interest.London, April 18th, 2022.

Figures

Fig. 1
Fig. 1
Study flow diagram.
Fig. 2
Fig. 2
Summary of COVID-19 outcomes according to vaccination status (A). Patients were categorized as fully vaccinated at the time of COVID-19 diagnoses if they had received two doses for the BNT162b2, mRNA-1273, and ChAdOx1-S vaccines or in case of infection diagnosed at least 28 days after a single dose of the Ad.26.COV2.S vaccine. (B) Summary COVID-19 sequelae analysis according to the vaccination status.
Fig. 3
Fig. 3
Forest plot graph reporting the (A) unadjusted odds ratio (OR) and the (B) adjusted odds ratio (aOR) from the Inverse Probability of Treatment Weighting (IPTW) fitted multivariable logistic regression models for each COVID-19 outcomes. The following covariates were included in each model: country (United Kingdom vs Spain vs Italy), biological sex (male vs female), age (≥65 vs < 65 years), number of co-morbidities (≥2 vs 0–1), tumour status (presence of active vs non-active disease), and the receipt of systemic anticancer therapy (SACT) within 4 weeks of SARS-CoV-2 infection (yes vs no). CFR: case fatality rate. Complete multivariable models for each COVID-19 outcomes are reported in Supplementary Table 2.
See this image and copyright information in PMC

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