PracticeUpdate: What are the implications of COVID-19 in patients with cancer?
Dr. Grivas: I'm very excited about some very important data that we saw at the ESMO 2021 virtual meeting regarding COVID-19 and cancer. This a very important topic. We have been dealing with this pandemic for a long time, and we have been working hard as a community to generate data that can inform clinical discussions regarding outcomes and risk factors in patients with cancer and COVID-19. We saw some very recent data also at the ESMO meeting and I will try to summarize this for you very briefly.
I would say overall, we received data validation regarding the negative outcome or worse outcomes to be more specific, in patients with cancer affected with COVID-19 compared to people without cancer. Cancer by itself, and especially hematological malignancies and immunosuppression is associated with worse outcomes.
PracticeUpdate: As per data presented, what is the impact of cancer on the COVID-19 vaccine efficacy?
Dr. Grivas: There's definitely a need for prioritization for vaccination in patients with cancer. We saw a lot of data sets at the ESMO meeting regarding the safety and efficacy of COVID-19 vaccines in patients with cancer.
There is some heterogeneity in the population of patients, of course, some differential effects from different treatments. For example, chemotherapy can cause some immunosuppression and maybe patients may mount less immune response to the vaccine. But overall, the take-home message has been that patients with cancer should be vaccinated against COVID-19, should be prioritized for this vaccination, and the vaccines appear to be, and were, safe and effective overall. I think it's an important message. Again, with some variability in the antibody titers and measurements of immune response in patients, especially those, those who get chemotherapy.
PracticeUpdate: What are the important considerations that would ensure COVID-19 vaccination for all?
Dr. Grivas: I think it's important to number one, have enough supply, adequate supply of vaccines globally, and ensure access to vaccination, not only to developed countries, but also to the developing and underdeveloped countries in the third world, as we say, because it's very important to have enough access and equitable and equal access to care and vaccination across the globe, and that applies also to patients with cancer.
I think it's important also to try as a community to overcome the hesitancy that exists and let the science pave the way. I will encourage the audience to look and review these important sessions at ESMO virtual 2021, and look at the different presentations, data sets and discussions. There is also significant concern about burnout of healthcare providers and significant effort on building resilience and the supported infrastructure to support the workforce and remove and reduce attrition. Overall very important data raising again, the important need to widely spread the word about safety and efficacy of vaccines, also in patients with cancer and again, a need for equitable and equal access to vaccination across all the countries in the world.
PracticeUpdate: How do you view booster doses and cancer patients in light of vaccine equity and broad population coverage?
Dr. Grivas: I think the data about the booster third dose for the mRNA vaccine are developing right now and we have to see more data as we see the field evolving. Right now our current practice at University of Washington Seattle Cancer Care Alliance has been to actually offer the vaccination to patients with cancer receiving active treatment. Any patient who is considered immunosuppressed, moderately or severely immunosuppressed should be vaccinated with a booster dose. We take an approach of vaccinating as many as we can, including the booster dose of vaccine. Again, this applies only to the mRNA vaccines so far, and I think that it was an advisory board, the FDA advisory board a few days ago, if I remember correctly made suggestions about favoring the booster dose to specific patient populations. For example, patients who were, I think 60 or older, healthcare providers, and immunosuppressed patients. More to come, but I think the booster dose will probably become a reality for most patients with cancer, especially those who are getting active treatment.