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dc.contributor.authorSong, Qianqian
dc.contributor.authorBates, Benjamin
dc.contributor.authorShao, Yu Raymond
dc.contributor.authorHsu, Fang-Chi
dc.contributor.authorLiu, Feifan
dc.contributor.authorMadhira, Vithal
dc.contributor.authorMitra, Amit Kumar
dc.contributor.authorBergquist, Timothy
dc.contributor.authorKavuluru, Ramakanth
dc.contributor.authorLi, Xiaochun
dc.contributor.authorSharafeldin, Noha
dc.contributor.authorSu, Jing
dc.contributor.authorTopaloglu, Umit
dc.date2022-08-11T08:11:04.000
dc.date.accessioned2022-08-23T17:30:32Z
dc.date.available2022-08-23T17:30:32Z
dc.date.issued2022-03-14
dc.date.submitted2022-05-19
dc.identifier.citation<p>Song Q, Bates B, Shao YR, Hsu FC, Liu F, Madhira V, Mitra AK, Bergquist T, Kavuluru R, Li X, Sharafeldin N, Su J, Topaloglu U. Risk and Outcome of Breakthrough COVID-19 Infections in Vaccinated Patients With Cancer: Real-World Evidence From the National COVID Cohort Collaborative. J Clin Oncol. 2022 May 1;40(13):1414-1427. doi: 10.1200/JCO.21.02419. Epub 2022 Mar 14. PMID: 35286152; PMCID: PMC9061155. <a href="https://doi.org/10.1200/JCO.21.02419">Link to article on publisher's site</a></p>
dc.identifier.issn0732-183X (Linking)
dc.identifier.doi10.1200/JCO.21.02419
dc.identifier.pmid35286152
dc.identifier.urihttp://hdl.handle.net/20.500.14038/50537
dc.description.abstractPURPOSE: To provide real-world evidence on risks and outcomes of breakthrough COVID-19 infections in vaccinated patients with cancer using the largest national cohort of COVID-19 cases and controls. METHODS: We used the National COVID Cohort Collaborative (N3C) to identify breakthrough infections between December 1, 2020, and May 31, 2021. We included patients partially or fully vaccinated with mRNA COVID-19 vaccines with no prior SARS-CoV-2 infection record. Risks for breakthrough infection and severe outcomes were analyzed using logistic regression. RESULTS: A total of 6,860 breakthrough cases were identified within the N3C-vaccinated population, among whom 1,460 (21.3%) were patients with cancer. Solid tumors and hematologic malignancies had significantly higher risks for breakthrough infection (odds ratios [ORs] = 1.12, 95% CI, 1.01 to 1.23 and 4.64, 95% CI, 3.98 to 5.38) and severe outcomes (ORs = 1.33, 95% CI, 1.09 to 1.62 and 1.45, 95% CI, 1.08 to 1.95) compared with noncancer patients, adjusting for age, sex, race/ethnicity, smoking status, vaccine type, and vaccination date. Compared with solid tumors, hematologic malignancies were at increased risk for breakthrough infections (adjusted OR ranged from 2.07 for lymphoma to 7.25 for lymphoid leukemia). Breakthrough risk was reduced after the second vaccine dose for all cancers (OR = 0.04; 95% CI, 0.04 to 0.05), and for Moderna's mRNA-1273 compared with Pfizer's BNT162b2 vaccine (OR = 0.66; 95% CI, 0.62 to 0.70), particularly in patients with multiple myeloma (OR = 0.35; 95% CI, 0.15 to 0.72). Medications with major immunosuppressive effects and bone marrow transplantation were strongly associated with breakthrough risk among the vaccinated population. CONCLUSION: Real-world evidence shows that patients with cancer, especially hematologic malignancies, are at higher risk for developing breakthrough infections and severe outcomes. Patients with vaccination were at markedly decreased risk for breakthrough infections. Further work is needed to assess boosters and new SARS-CoV-2 variants.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=35286152&dopt=Abstract">Link to Article in PubMed</a></p>
dc.rightsCopyright © 2022 by American Society of Clinical Oncology. Licensed under the Creative Commons Attribution 4.0 License: https://creativecommons.org/licenses/by/4.0/
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectcancer
dc.subjecthematologic malignancies
dc.subjectCOVID-19
dc.subjectbreakthrough infections
dc.subjectUMCCTS funding
dc.subjectClinical Epidemiology
dc.subjectImmunology and Infectious Disease
dc.subjectInfectious Disease
dc.subjectNeoplasms
dc.subjectOncology
dc.subjectTranslational Medical Research
dc.subjectVirus Diseases
dc.titleRisk and Outcome of Breakthrough COVID-19 Infections in Vaccinated Patients With Cancer: Real-World Evidence From the National COVID Cohort Collaborative
dc.typeJournal Article
dc.source.journaltitleJournal of clinical oncology : official journal of the American Society of Clinical Oncology
dc.source.volume40
dc.source.issue13
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1292&amp;context=umccts_pubs&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/umccts_pubs/282
dc.identifier.contextkey29264563
refterms.dateFOA2022-08-23T17:30:32Z
html.description.abstract<p>PURPOSE: To provide real-world evidence on risks and outcomes of breakthrough COVID-19 infections in vaccinated patients with cancer using the largest national cohort of COVID-19 cases and controls.</p> <p>METHODS: We used the National COVID Cohort Collaborative (N3C) to identify breakthrough infections between December 1, 2020, and May 31, 2021. We included patients partially or fully vaccinated with mRNA COVID-19 vaccines with no prior SARS-CoV-2 infection record. Risks for breakthrough infection and severe outcomes were analyzed using logistic regression.</p> <p>RESULTS: A total of 6,860 breakthrough cases were identified within the N3C-vaccinated population, among whom 1,460 (21.3%) were patients with cancer. Solid tumors and hematologic malignancies had significantly higher risks for breakthrough infection (odds ratios [ORs] = 1.12, 95% CI, 1.01 to 1.23 and 4.64, 95% CI, 3.98 to 5.38) and severe outcomes (ORs = 1.33, 95% CI, 1.09 to 1.62 and 1.45, 95% CI, 1.08 to 1.95) compared with noncancer patients, adjusting for age, sex, race/ethnicity, smoking status, vaccine type, and vaccination date. Compared with solid tumors, hematologic malignancies were at increased risk for breakthrough infections (adjusted OR ranged from 2.07 for lymphoma to 7.25 for lymphoid leukemia). Breakthrough risk was reduced after the second vaccine dose for all cancers (OR = 0.04; 95% CI, 0.04 to 0.05), and for Moderna's mRNA-1273 compared with Pfizer's BNT162b2 vaccine (OR = 0.66; 95% CI, 0.62 to 0.70), particularly in patients with multiple myeloma (OR = 0.35; 95% CI, 0.15 to 0.72). Medications with major immunosuppressive effects and bone marrow transplantation were strongly associated with breakthrough risk among the vaccinated population.</p> <p>CONCLUSION: Real-world evidence shows that patients with cancer, especially hematologic malignancies, are at higher risk for developing breakthrough infections and severe outcomes. Patients with vaccination were at markedly decreased risk for breakthrough infections. Further work is needed to assess boosters and new SARS-CoV-2 variants.</p>
dc.identifier.submissionpathumccts_pubs/282
dc.contributor.departmentDepartment of Population and Quantitative Health Sciences
dc.source.pages1414-1427


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Copyright © 2022 by American Society of Clinical Oncology. Licensed under the Creative Commons Attribution 4.0 License: https://creativecommons.org/licenses/by/4.0/
Except where otherwise noted, this item's license is described as Copyright © 2022 by American Society of Clinical Oncology. Licensed under the Creative Commons Attribution 4.0 License: https://creativecommons.org/licenses/by/4.0/