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癌症患者中的新冠病毒疫苗。血清阳性率与安全性。系统评价与荟萃分析。

COVID-19 Vaccines in Cancer Patients. Seropositivity and Safety. Systematic Review and Meta-Analysis.

作者信息

Cavanna Luigi, Citterio Chiara, Toscani Ilaria

机构信息

Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy.

出版信息

Vaccines (Basel). 2021 Sep 20;9(9):1048. doi: 10.3390/vaccines9091048.

Abstract

Patients with cancer are among the most vulnerable groups of the COVID-19 pandemic, whereas vaccinations can represent a cornerstone in overcoming the pandemic itself. However, cancer patients were excluded from clinical trials for COVID-19 vaccinations, and thus the data on the immunogenicity and safety of COVID-19 vaccines in cancer patients are limited. In this systematic review, we assessed the seroconversion rate and the safety of COVID-19 vaccinations in cancer patients. We searched a bibliographic database up until 31 July 2021. Utilizing inclusion criteria, six studies were selected and analyzed for this meta-analysis. This included 621 cancer patients and 256 controls. Results show that patients with solid tumors show adequate antibody responses (>90%), though the antibody titers were significantly lower than those of healthy controls. Similarly, a significantly lower rate of seroconversion was registered in patients with hematologic malignances. The vaccines showed a good safety profile; no grade 3-4 adverse events were registered. This review demonstrates generally high immunogenicity from COVID-19 vaccines in patients with cancer, with better results for solid tumors than hematological malignances, and with a good safety profile.

摘要

癌症患者是新冠疫情中最脆弱的群体之一,而疫苗接种是战胜疫情的基石。然而,癌症患者被排除在新冠疫苗临床试验之外,因此关于新冠疫苗在癌症患者中的免疫原性和安全性的数据有限。在这项系统评价中,我们评估了癌症患者接种新冠疫苗后的血清转化率和安全性。我们检索了截至2021年7月31日的文献数据库。利用纳入标准,选取了6项研究进行此项荟萃分析。这包括621名癌症患者和256名对照。结果显示,实体瘤患者表现出足够的抗体反应(>90%),尽管抗体滴度显著低于健康对照。同样,血液系统恶性肿瘤患者的血清转化率明显较低。这些疫苗显示出良好的安全性;未记录到3-4级不良事件。本评价表明,新冠疫苗在癌症患者中总体具有较高的免疫原性,实体瘤患者的结果优于血液系统恶性肿瘤患者,且安全性良好。

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