1. Efficacy and safety of the BNT162b2 mRNA COVID-19 vaccine in participants with a history of cancer: subgroup analysis of a global phase 3 randomized clinical trial
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Stephen J. Thomas, John L. Perez, Stephen P. Lockhart, Subramanian Hariharan, Nicholas Kitchin, Ruth Bailey, Katherine Liau, Eleni Lagkadinou, Özlem Türeci, Ugur Şahin, Xia Xu, Kenneth Koury, Samuel S. Dychter, Claire Lu, Teresa C. Gentile, and William C. Gruber
- Subjects
safety ,Male ,NAAT, nucleic acid amplification test ,COVID-19 Vaccines ,Adolescent ,mRNA, messenger ribonucleic acid ,efficacy ,modRNA, modified ribonucleic acid ,APC, antigen presenting cell ,Article ,US, United States ,LNP, lipid nanoparticles ,MedDRA, Medical Dictionary for Regulatory Activities ,COVID-19, coronavirus disease 2019 ,vaccine ,Neoplasms ,Humans ,RNA, Messenger ,Child ,Pandemics ,BNT162 Vaccine ,General Veterinary ,General Immunology and Microbiology ,SARS-CoV-2 ,Public Health, Environmental and Occupational Health ,COVID-19 ,VE, vaccine efficacy ,FDA, Food and Drug Administration ,IR, incidence rate ,CI, confidence interval ,HIV, human immunodeficiency virus ,UTR, untranslated region ,Infectious Diseases ,Molecular Medicine ,BNT162b2 ,AE, adverse event ,malignancy - Abstract
Introduction Individuals with an underlying malignancy have high risk of poor COVID-19 outcomes. In clinical trials, COVID-19 vaccines were safe and efficacious against infection, hospitalization, and death, but most trials excluded participants with cancer. We report results from participants with a history of past or active neoplasm (malignant or benign/unknown) and up to 6 months’ follow-up post-dose 2 from the placebo-controlled, observer-blinded trial of the 2-dose BNT162b2 mRNA COVID-19 vaccine. Patients and methods Between July 2020–January 2021, 46,429 participants aged ≥12 years were randomized at 152 sites in 6 countries. Healthy participants with pre-existing stable neoplasm could participate; those receiving immunosuppressive therapy were excluded. Data are reported for participants, aged ≥16 years for safety and ≥12 years for efficacy, who had any history of neoplasm at baseline (data cut-off: March 13, 2021). Adverse-event (AE) data are controlled for follow-up time before unblinding and reported as incidence rates (IRs) per 100 person-years follow-up. Results At baseline, 3813 participants had a history of neoplasm; most common malignancies were breast (n = 460), prostate (n = 362), and melanoma (n = 223). Four BNT162b2 and 71 placebo recipients developed COVID-19 from 7 days post-dose 2; vaccine efficacy was 94.4% (95% CI: 85.2, 98.5) after up to 6 months’ follow-up post-dose 2. This compares favorably with vaccine efficacy of 91.1% in the overall trial population after the same follow-up. AEs were reported at IRs of 95.4 (BNT162b2) and 48.3 (placebo) per 100 person-years. Most common AEs were reactogenicity events (injection-site pain, fatigue, pyrexia). Three BNT162b2 and 1 placebo recipients withdrew because of vaccine-related AEs. No vaccine-related deaths were reported. Conclusion In participants with past or active neoplasms, BNT162b2 vaccine has a similar efficacy and safety profile as in the overall trial population. These results can inform BNT162b2 use during the COVID-19 pandemic and future trials in participants with cancer. Clinical trial number: NCT04368728
- Published
- 2022
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