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Table of Contents
LETTER TO EDITOR
Year : 2021  |  Volume : 4  |  Issue : 3  |  Page : 570-571

Need for a national consortium of clinical registries of cancer and COVID-19 for vaccine surveillance


Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India

Date of Submission08-Aug-2021
Date of Decision09-Aug-2021
Date of Acceptance10-Aug-2021
Date of Web Publication08-Oct-2021

Correspondence Address:
Sharmila Pimple
Professor & Physician, Department of Preventive Oncology, Center for Cancer Epidemiology (CCE), Homi Bhabha National Institute, Tata Memorial Center, Mumbai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/crst.crst_180_21

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How to cite this article:
Pimple S, Mishra G. Need for a national consortium of clinical registries of cancer and COVID-19 for vaccine surveillance. Cancer Res Stat Treat 2021;4:570-1

How to cite this URL:
Pimple S, Mishra G. Need for a national consortium of clinical registries of cancer and COVID-19 for vaccine surveillance. Cancer Res Stat Treat [serial online] 2021 [cited 2021 Dec 9];4:570-1. Available from: https://www.crstonline.com/text.asp?2021/4/3/570/327771



Patients with cancer are at risk of coronavirus disease 2019 (COVID-19) due to immune dysregulation related to underlying malignant disease as well as receipt of immunomodulatory cancer therapy.[1] Batra et al. in their study have reported statistically significant differences in COVID-19 infection rates between vaccinated and unvaccinated patients with cancer.[2] Additionally, the authors reported full recovery among patients with cancer who were vaccinated against COVID-19 and 11.9% deaths due to COVID-19-related complications among those who were not vaccinated. These results highlight the importance of the protective effects of COVID-19 vaccines. However, there is significant heterogeneity in risk among different cancer subgroups. Therefore, conclusions from such data among high-risk patients with cancer may not be reliable if underlying factors such as an active malignancy, type and stage of cancer, age, type of treatment, and other comorbidities are not taken into consideration.

In a cohort of 800 adult patients with cancer enrolled in the UK Coronavirus Cancer Monitoring Project (UKCCMP), it was observed that COVID-19-related mortality was principally driven by the age, sex, and comorbidities. Additionally, the risk of mortality was found to be significantly associated with advanced age of the patient (odds ratio [OR], 9.42 [95% CI, 6.56–10.02]; p<0.0001), male sex (OR, 1.67 [CI 1.19–2.34]; p=0.003) and the presence of comorbidities like cardiovascular diseases (OR, 2.32 [95% CI, 1.47–3.64]) and hypertension (OR, 1.95 [95% CI, 1.36–2.80]; p<0.001).[3] Another study, conducted across four countries, evaluated the risk of COVID-19 mortality among adult patients with cancer receiving chemotherapy. It was observed that the risk of mortality was significantly higher among those with advanced age as well as among men.[4]

To assess the safety and efficacy of COVID-19 vaccination among patients with cancer, two large cohort studies investigated the immune response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using antibody assays, in patients with solid malignancies and valid control groups. Both the studies highlight the importance of optimizing the delivery of a full course of vaccination to patients with cancer, who are at an increased risk of mortality due to COVID-19.[5],[6] An interim analysis of the data obtained from a prospective observational study on the BNT162b2 mRNA vaccine in patients with cancer showed poor vaccine efficacy after a single dose, but substantially improved efficacy following a booster dose on day 21. Therefore, it is recommended that patients with cancer, especially those receiving active systemic therapy should receive an early second dose of the BNT162b2 vaccine on day 21.[7]

With the availability of multiple candidate vaccines in the near future, large, well-designed cohort studies with valid control groups will be particularly critical to determine the effectiveness and the risk-benefit ratio of these new COVID-19 vaccines in patients with cancer. Thus, establishing and incorporating a national consortium of clinical registries of cancer with COVID-19 within the Indian Council of Medical Research's (ICMR's) National Clinical Registry of COVID-19 (NCRC) would go a long way in understanding the demographic characteristics, clinical course, cancer treatment, and outcomes of COVID-19 in patients with cancer.[8] Vaccine surveillance among patients with cancer will allow for monitoring, detecting, and documenting breakthrough infections among fully or partially vaccinated patients with cancer, which can result in hospitalizations or deaths given the emerging variants of the virus and requirements of boosters in the face of duration of protection offered and the type of vaccines received. Vaccine surveillance will also help to better understand and address the causes of inequities in access to vaccines and other cancer interventions.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Bansal N, Ghafur A. COVID-19 in oncology settings. Cancer Res Stat Treat 2020;3, Suppl S1:13-4.  Back to cited text no. 1
    
2.
Batra U, Nathany S, Bansal N, Sharma M. COVID-19 vaccination status in Indian patients with cancer: An observational study. Cancer Res Stat Treat 2021;4:219-23.  Back to cited text no. 2
  [Full text]  
3.
Lee LY, Cazier JB, Angelis V, Arnold R, Bisht V, Campton NA, et al. UK coronavirus monitoring project team. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: A prospective cohort study. Lancet 2020;395:1919-26.  Back to cited text no. 3
    
4.
Williams M, Mi E, Le Calvez K, Chen J, Pakzad-Shahabi L, Dadhania S, et al. Estimating the risk of death from COVID-19 in adult cancer patients. Clin Oncol (R Coll Radiol) 2021;33:e172-9.  Back to cited text no. 4
    
5.
Massarweh A, Eliakim-Raz N, Stemmer A, Levy-Barda A, Yust-Katz S, Zer A, et al. Evaluation of seropositivity following BNT162b2 messenger RNA vaccination for SARS-CoV-2 in patients undergoing treatment for Cancer. JAMA Oncol 2021;2021:e212155:10.1001/jamaoncol. 2021.2155.  Back to cited text no. 5
    
6.
Yazaki S, Yoshida T, Kojima Y, Yagishita S, Nakahama H, Okinaka K, et al. Difference in SARS-CoV-2 antibody status between patients with cancer and health care workers during the COVID-19 pandemic in Japan. JAMA Oncol 2021:2021:e212159.10.1001/jamaoncol. 2021.2159.  Back to cited text no. 6
    
7.
Monin L, Laing AG, Muñoz-Ruiz M, McKenzie DR, Del Molino Del Barrio I, Alaguthurai T, et al. Safety and immunogenicity of one versus two doses of the COVID-19 vaccine BNT162b2 for patients with cancer: Interim analysis of a prospective observational study. Lancet Oncol 2021;22:765-78.  Back to cited text no. 7
    
8.
ICMR_August_eNewsletter_01092020_English.pdf. Available from: https://www.icmr.gov.in/pdf/press_realease_files/ICMR_August_eNewsletter_01092020_English.pdf. [Last accessed on 2021 Aug 10].  Back to cited text no. 8
    




 

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