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Cancer patients have 13% mortality from breakthrough cases: study

Cancer patients remain at a much higher risk of hospitalization and death from COVID-19 even when they are fully vaccinated, according to a new small-scale study.

Research published Friday in the journal Annals of Oncology found that cancer patients have a 13 percent mortality rate if they develop a breakthrough infection.

The study was conducted by COVID-19 and the Cancer Consortium (CCC19), a group of 129 research centers that are monitoring the impact of the virus on cancer patients. This is the first study to investigate the risk of cancer patients experiencing breakthrough events, the researchers say.

Dr Toni Choueiri, Director of the Lank Center for Genitourinary Care at Dana-Farber Cancer Institute and senior author of the report: “Patients with cancer develop breakthrough COVID-19 even after injections A full vaccine can still have serious outcomes, including death. , said in a press release. “That’s why a layered approach including masking and social distancing, along with vaccination plus booster against COVID-19 remains a necessary approach for the future. near future.”

The study used data collected by CCC19 through an international survey conducted on their website, focusing on people with current or previous cancer and a confirmed COVID-19 case. laboratory confirmed from November 2020 to the end of May 2021.

A total of 1,787 patients with cancer contracted COVID-19 during that time period, with most of them unvaccinated.

Only 54 patients were fully immunized when they contracted the virus, with full immunization counted as those who received two doses of Pfizer-BioNtech or Moderna COVID-19 vaccine or one shot of Johnson & Johnson.

Of those with breakthrough cases, 65% were hospitalized, 19% were in the ICU on mechanical ventilators, and 13% died of the virus within 30 days.

Although the researchers note that the study had a small sample size and therefore may not be entirely accurate, the 13% mortality rate for breakthrough cases in cancer patients is still significantly higher. than the average population mortality rate. According to Canadian data, more than 88,000 people contracted COVID-19 while fully immunized, but only 1,017 of those people later died from the virus, a mortality rate of about 1.14%.

The researchers note that previous research has shown that cancer patients may not produce the same immune response as the general population when vaccinated.

A study from June found that antibody levels were significantly lower in people with blood cancers than in those with solid tumours.

“Because immunoassays are not routinely collected in clinical care, we do not know whether these are patients with an effective immune response following vaccination; Many emerging data suggest that cancer patients, especially leukemia, do not have an adequate protective antibody response,” said Dr. Jeremy Warner, director of the CCC19 Research Coordination Center and author lead author of the new study, said in a release.

He also noted that their study found that the presence of other risk factors in a patient, as well as whether their cancer was active and advanced, increased the risk of death. their death.

“It is important to note that many of the same factors that we identified before vaccination – age, comorbidities, active status, and advanced cancer – still seem to lead to many outcomes. bad results,” he said.

This study appears to support previous research that found people with blood cancers have a higher risk of developing COVID-19. In both vaccinated and unvaccinated patients participating in the new study, ICU and hospitalization rates increased if the patient had a blood cancer rather than a solid tumour.

The new study also found that among fully vaccinated cancer patients, 46 percent had reduced levels of lymphocytes, a type of white blood cell important to the immune system.

Having lower levels of these types of cells is called lymphadenopathy, and it often occurs in patients being treated for certain types of cancer, such as treatment for lymphoma and leukemia. According to the study, patients in both the vaccinated and unvaccinated groups with lymphopenia had a higher incidence of ICU and hospitalization compared with other patients.

Because of the small size of the new study, the researchers say they were unable to pinpoint which anticancer treatments might be associated with the breakthrough infection or worse outcomes from the breakthrough infection. .

“Similar results (high mortality in fully immunized individuals) have been reported in populations of patients with impaired other immunocompromised patients, such as organ transplant recipients, before receiving additional doses of vaccine. Brown University School of Medicine and senior author of the study, said in the release.

The study results highlight the importance of not only vaccinating but also implementing a multi-pronged response to protect those at higher risk, including cancer patients, the researchers say.

“These findings come at a time of concern that immune escape mutations such as the Omicron strain may emerge from chronically infected patients with weakened immune systems,” Farmakiotis said. “Therefore, immunosuppressed persons and their close contacts should be target groups for treatment and prevention interventions, including community-level education and outreach efforts. .”

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