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俄罗斯患有泌尿生殖系统恶性肿瘤的患者中 Gam-COVID-Vac 疫苗的安全性和初步疗效以及 SARS-CoV-2 感染的结局。

Safety and preliminary efficacy of the Gam-COVID-Vac vaccine and outcomes of SARS-CoV-2 infection in Russian patients with genitourinary malignancies.

机构信息

Kidney Cancer Research Bureau, Mayakovskogo pereulok 2, Moscow, 109147, Russia.

N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia.

出版信息

J Hematol Oncol. 2021 Nov 13;14(1):192. doi: 10.1186/s13045-021-01205-z.

Abstract

BACKGROUND

To our knowledge, there is no clinical data pertaining to COVID-19 outcomes and safety of COVID-19 vaccination in Russian patients with genitourinary (GU) malignancies. Aim of our analysis was to describe the characteristics of the COVID-19 infection course as well as preliminary safety and efficacy of Gam-COVID-Vac vaccine in patients with active GU malignancies.

METHODS

Patients were retrospectively identified at nine cancer centers in different regions. Patients were included if COVID-19 was diagnosed by a polymerase chain reaction. Data from additional patients with GU cancers who had no positive SARS-CoV-2 RT-PCR test before vaccination and who received two doses of Gam-COVID-Vac (Sputnik V) between 11 February and 31 August 2021 were collected for safety assessment. Anonymized data were collected through an online registry covering demographics, treatments, and outcomes.

RESULTS

The Gam-COVID-Vac vaccine was well tolerated; no grade 3-5 toxicities were reported in 112 vaccinated metastatic GU cancer patients. The most common grade 1 adverse events (81%) were injection site reactions (76%), flu-like illness (68%), and asthenia (49%). Five patients experienced grade 2 chills (4.5%) and 3 patients had grade 2 fever (2.7%). With median follow-up of 6.2 months, two COVID-19 cases were confirmed by RT-PCR test in the vaccine group (of 112 participants; 1.8%). Eighty-eight patients with COVID-19 disease were included in the analysis. The average age as of the study enrollment was 66 (range 39-81) and the majority of patients were male with renal cell carcinoma (RCC). Thirty-six patients (41%) had evidence of metastatic disease, of these 22 patients were receiving systemic therapy. More than half of patients required hospitalization. Fifty-four patients (61%) experienced complications. Sixteen patients who developed COVID-19 pneumonia required mechanical ventilator support. Sixteen patients (18%) died in a median of 23.5 days after the date of COVID-19 diagnosis was established. The 3-month survival rate was 82%. Clinical and/or radiographic progression of cancer during COVID-19 infection or the subsequent 3 months was observed in 10 patients (11.4%).

CONCLUSION

Patients with GU malignancies are at increased risk of mortality from COVID-19 infection when compared to the general population. Vaccination could be safe in GU cancer patients.

TRIAL REGISTRATION

retrospectively registered.

摘要

背景

据我们所知,目前尚无关于俄罗斯泌尿生殖系统(GU)恶性肿瘤患者 COVID-19 结局和 COVID-19 疫苗接种安全性的临床数据。我们分析的目的是描述 COVID-19 感染过程的特征,以及 Gam-COVID-Vac 疫苗在活动性 GU 恶性肿瘤患者中的初步安全性和有效性。

方法

在不同地区的九家癌症中心回顾性地确定患者。如果 COVID-19 通过聚合酶链反应(PCR)诊断,则纳入患者。收集了另外一些 GU 癌症患者的数据,这些患者在接种疫苗前没有 SARS-CoV-2 RT-PCR 检测呈阳性,并且在 2021 年 2 月 11 日至 8 月 31 日期间接种了两剂 Gam-COVID-Vac(Sputnik V),用于安全性评估。通过涵盖人口统计学、治疗和结局的在线登记册收集了匿名数据。

结果

Gam-COVID-Vac 疫苗耐受性良好;112 名转移性 GU 癌症接种疫苗的患者中没有报告 3-5 级毒性。最常见的 1 级不良事件(81%)是注射部位反应(76%)、流感样疾病(68%)和乏力(49%)。5 例患者出现 2 级寒战(4.5%),3 例患者出现 2 级发热(2.7%)。中位随访 6.2 个月时,疫苗组有 2 例 COVID-19 病例通过 RT-PCR 检测确诊(112 名参与者中占 1.8%)。88 例 COVID-19 疾病患者纳入分析。研究入组时的平均年龄为 66 岁(范围 39-81 岁),大多数患者为男性,患有肾细胞癌(RCC)。36 例患者(41%)有转移疾病证据,其中 22 例患者正在接受全身治疗。超过一半的患者需要住院治疗。54 例患者(61%)发生并发症。16 例发生 COVID-19 肺炎的患者需要机械通气支持。16 例患者(18%)在 COVID-19 诊断确立后平均 23.5 天死亡。3 个月生存率为 82%。在 COVID-19 感染期间或随后的 3 个月内,观察到 10 例(11.4%)癌症出现临床和/或影像学进展。

结论

与一般人群相比,GU 恶性肿瘤患者因 COVID-19 感染而死亡的风险增加。在 GU 癌症患者中,疫苗接种可能是安全的。

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