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At the Leukemia & Lymphoma Society (LLS), we hear every day from blood cancer patients talk about how COVID-19 affects all aspects of their lives, including critical decisions about their cancer care. This is of particular concern because patients with blood cancer who are infected with COVID-19 may have a longer duration of infection, higher hospitalization rates, and higher death rates than patients with COVID-19. solid tumor cancer or people without cancer. In addition, some patients with blood cancer have prolonged infections that allow the emergence of COVID-19 variants.
Now that life-saving vaccines are available, we’re hearing new concerns from cancer patients who don’t experience the same relief as those who don’t: many wonder if the vaccines will protect them. As MedPage today recently reported, they are right to be concerned.
In a UK study, patients who had solid or hematologic cancer had a reduced ability to generate antibodies in response to the first dose of Pfizer / BioNTech vaccine compared to healthy individuals. Only 13% of patients with blood cancer produced significant amounts of antibodies in response to the first dose, compared to 95% of non-cancer patients. This finding is even more concerning in the UK, where policymakers have delayed second doses in favor of using their limited vaccine supply to deliver the first doses to a larger percentage of the population. These data suggest that cancer patients may be more susceptible to COVID-19 infections after vaccination than the general public.
The United States, on the other hand, adheres to the recommended dosing intervals – 21 days for the Pfizer-BioNTech vaccine and 28 days for the Moderna vaccine. The good news from the UK study is that the second dose of the vaccine partially restored the immune response in patients with solid cancers. But this study still reveals something we suspected to be true: COVID-19 vaccines won’t work as well in some cancer patients.
The study did not include enough patients with hematologic cancers to draw conclusions about their immune response at two doses, but even if it did, patients with blood cancer and patients with solid tumors do not constitute a homogeneous group. There are more than 100 types of blood cancer and a range of treatments with immunosuppressive effects, including commonly used drugs like rituximab and BTK inhibitors for blood cancer that could put some patients at high risk of cancer. COVID-19 infections after vaccinations.
What we need is a large-scale evaluation of vaccine responses in all types of blood cancer patients at different points in their care. Since cancer patients have been excluded from trials used for FDA and EU clearance of COVID-19 vaccines, we must support efforts to involve them in post-market trials. Fortunately, many large trials are underway in the United States and the United Kingdom to study the response of patients with specific blood cancers to COVID-19 vaccinations.
LLS has also initiated a research project through its National Patient Registry to collect real-world data (NCT04794387). Nearly 2,500 current and former blood cancer patients have enrolled in the last month alone and recruitment is underway. Our researchers are collecting data to improve our understanding of how people with different blood cancers respond to COVID-19 and vaccines so that vaccination strategies and timing can be tailored to maximize their protection. LLS is committed to sharing the results with the medical and patient communities as soon as possible.
The large number of patients who will be vaccinated in the coming months as well as the continued risk of community transmission of the SAR-CoV-2 virus make this a unique opportunity to gather vital information to learn more about the immune response in all. types of cancer patients. But patients want and need answers today. Here’s what we say to those who contact us:
- Vaccines are safe: there is no reason to believe that COVID-19 vaccines are less safe for cancer patients than for the general population.
- Plan early: talk to your healthcare team as soon as possible to establish a vaccination plan. For cancer patients on treatment, the question should not be if, but when to get the vaccine for better protection.
- Encourage everyone in your household to get vaccinated: herd immunity can be seen even through the small lens of a single household. If everyone around you is protected, you are much safer.
- Play it safe: continue with CDC recommended good infection control practices. This is especially important for patients who may not obtain optimal protection against vaccines. Until we can get the data necessary to determine which patients fall into this category, all blood cancer patients should continue to wear masks, social distances, and hand washing.
While some cancer patients may be well protected against COVID-19 infections after vaccination, we have emerging data indicating that this will not be true for all cancer patients, and in particular, cancer patients. immunocompromised blood. It is essential to encourage every cancer patient to discuss vaccines with their doctor. Every patient should be aware that any level of protection is better than none, two doses of Pfizer-BioNTech and Moderna vaccines are better than one, and they should continue to follow infection prevention protocols.
Lee Greenberger, Doctorate, is Scientific Director of the Leukemia & Lymphoma Society (LLS). He has over 25 years of experience in the discovery and development of oncology drugs. He leads the planning and strategy of LLS research programs.
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