According to a study, fully vaccinated cancer patients with breakthrough Covid-19 infections are still at high risk of hospitalisation and death.
According to the study, which was published in the journal Annals of Oncology, fully vaccinated patients who experienced breakthrough infections had a hospitalisation rate of 65%, an ICU or mechanical ventilation rate of 19%, and a death rate of 13%.
“Patients with cancer who develop breakthrough Covid-19 even following full vaccination can still experience severe outcomes, including death,” said Toni Choueiri, Director of the Lank Center for Genitourinary Care at Dana-Farber Cancer Institute.
“That is why a multilayered approach that includes masking and social-distancing, along with vaccination plus booster against Covid-19 remains an essential approach for the foreseeable future,” Choueiri added.
The information was gathered between November 1, 2020, and May 31, 2021, prior to the recommendation of booster vaccines for cancer patients.
“Because measures of immunity are not routinely collected in clinical care, we don’t know whether these were patients who mounted effective immune responses after vaccination, a lot of emerging data have suggested that patients with cancer, especially blood cancers, don’t mount adequate protective antibody responses,” said Jeremy Warner, Associate Professor at Vanderbilt-Ingram Cancer Center.
“It’s important to note that many of the same factors that we identified prior to the availability of vaccinationa”age, comorbidities, performance status, and progressing cancera”still seem to drive many of the bad outcomes,” he noted.
For the study, the researchers identified 1,787 patients with cancer and Covid-19, the vast majority of whom were unvaccinated.
The number of people who had been fully vaccinated was 54, and 46% of those who had been fully vaccinated had lower levels of lymphocytes, which are T and B cells that are responsible for immune responses to viruses. Lymphopenia is a common complication in cancer patients receiving anti-CD20 monoclonal antibodies or CAR-T cell treatments for hematologic malignancies such as lymphoma and leukaemia.
The study appears to support previous findings that patients with hematologic malignancies are at a higher risk of severe Covid-19 outcomes.
The number of patients in the study, however, is too small to draw definitive conclusions about specific types of anticancer therapies that may be associated with breakthrough infections, according to the researchers. Patients on corticosteroid treatment appeared to be more vulnerable to hospitalisation.