Evidence map›Paper›PMID 38296596›Full record

Observational studyJournal for immunotherapy of cancer2024

Effects of antineoplastic and immunomodulating agents on postvaccination SARS-CoV-2 breakthrough infections, antibody response, and serological cytokine profile.

Jacob New, Jason Cham, Lana Smith, Leah Puglisi, Tridu Huynh, Sunil Kurian, Samantha Bagsic, Russel Fielding, Lee Hong, Priya Reddy and 7 more

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in Journal for immunotherapy of cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 3 institutions in 1 country.

Jacob NewMedicine, Scripps Health, La Jolla, California, USA.ORCID 0000-0003-0707-9324
Jason ChamScripps Research Translational Institute, La Jolla, California, USA.
Lana SmithScripps Research Translational Institute, La Jolla, California, USA.
Leah PuglisiMedicine, Scripps Health, La Jolla, California, USA.
Tridu HuynhScripps Research Translational Institute, La Jolla, California, USA.
Sunil KurianScripps Organ Transplantation Research & Biorepository, Scripps Health, La Jolla, California, USA.
Samantha BagsicMedicine, Scripps Health, La Jolla, California, USA.
Russel FieldingStrategy & Planning, Scripps Health, La Jolla, California, USA.
Lee HongMedicine, Scripps Health, La Jolla, California, USA.
Priya ReddyMedicine, Scripps Health, La Jolla, California, USA.
Ki Suk EumMedicine, Scripps Health, La Jolla, California, USA.
Allison MartinScripps Organ Transplantation Research & Biorepository, Scripps Health, La Jolla, California, USA.
Bethany BarrickScripps Organ Transplantation Research & Biorepository, Scripps Health, La Jolla, California, USA.
Christopher MarshScripps Organ Transplantation Research & Biorepository, Scripps Health, La Jolla, California, USA.
Michael QuigleyPathology, Scripps Health, La Jolla, California, USA.
Laura J Nicholson *Medicine, Scripps Health, La Jolla, California, USA apandey@tulane.edu nicholson.laura@scrippshealth.org.
Amitabh C Pandey *Scripps Research Translational Institute, La Jolla, California, USA apandey@tulane.edu nicholson.laura@scrippshealth.org.ORCID 0000-0002-1541-7023
Scripps Health · USScripps Research Institute · USTulane University · US

Funding

Scripps Translational Science InstituteUL1TR002550 · NCATS · SCRIPPS RESEARCH INSTITUTE, THE · PI TOPOL, ERIC JEFFREY · 2018 to 2022
$28.9M
Institutional Career Development CoreKL2TR002552 · NCATS · SCRIPPS RESEARCH INSTITUTE, THE · PI NICHOLSON, LAURA · 2018 to 2022
$5.2M
NCATS NIH HHS KL2 TR002552NCATS NIH HHS UL1 TR002550
6 · The paper itself

Abstract

backgroundDespite immunization, patients on antineoplastic and immunomodulating agents have a heightened risk of COVID-19 infection. However, accurately attributing this risk to specific medications remains challenging.

methodsAn observational cohort study from December 11, 2020 to September 22, 2022, within a large healthcare system in San Diego, California, USA was designed to identify medications associated with greatest risk of postimmunization SARS-CoV-2 infection. Adults prescribed WHO Anatomical Therapeutic Chemical (ATC) classified antineoplastic and immunomodulating medications were matched (by age, sex, race, and number of immunizations) with control patients not prescribed these medications yielding a population of 26 724 patients for analysis. From this population, 218 blood samples were collected from an enrolled subset to assess serological response and cytokine profile in relation to immunization.

resultsPrescription of WHO ATC classified antineoplastic and immunomodulatory agents was associated with elevated postimmunization SARS-CoV-2 infection risk (HR 1.50, 95% CI 1.38 to 1.63). While multiple immunization doses demonstrated a decreased association with postimmunization SARS-CoV-2 infection risk, antineoplastic and immunomodulatory treated patients with four doses remained at heightened risk (HR 1.23, 95% CI 1.06 to 1.43). Risk variation was identified among medication subclasses, with PD-1/PD-L1 inhibiting monoclonal antibodies, calcineurin inhibitors, and CD20 monoclonal antibody inhibitors identified to associate with increased risk of postimmunization SARS-CoV-2 infection. Antineoplastic and immunomodulatory treated patients also displayed a reduced IgG antibody response to SARS-CoV-2 epitopes alongside a unique serum cytokine profile.

conclusionsAntineoplastic and immunomodulating medications associate with an elevated risk of postimmunization SARS-CoV-2 infection in a drug-specific manner. This comprehensive, unbiased analysis of all WHO ATC classified antineoplastic and immunomodulating medications identifies medications associated with greatest risk. These findings are crucial in guiding and refining vaccination strategies for patients prescribed these treatments, ensuring optimized protection for this susceptible population in future COVID-19 variant surges and potentially for other RNA immunization targets.

Indexed as

Antineoplastic AgentsCOVID-19AdultAntibody FormationBreakthrough InfectionsCytokinesHumansImmunomodulating AgentsSARS-CoV-2Antineoplastic AgentsCytokinesImmunomodulating AgentsCOVID-19Immune Checkpoint InhibitorsImmunogenicity, VaccineImmunomodulationImmunotherapy

Identifiers

PMID38296596
PMCPMC10831464
OpenAlexW4391383504

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.