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0 0.5 1 1.5 2+ Mortality 76% Improvement Relative Risk Case 90% Tixagevimab/c..  Ollila et al.  Prophylaxis Is prophylaxis with tixagevimab/cilgavimab beneficial for COVID-19? Retrospective 37 patients in the USA (February 2021 - February 2022) Fewer cases with tixagevimab/cilgavimab (p=0.028) Ollila et al., Cancer, July 2022 Favors tixagevimab/ci.. Favors control

Seroconversion and outcomes after initial and booster COVID‐19 vaccination in adults with hematologic malignancies

Ollila et al., Cancer, doi:10.1002/cncr.34354
Jul 2022  
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37th treatment shown to reduce risk in May 2022
*, now known with p = 0.00002 from 15 studies, recognized in 29 countries. Efficacy is variant dependent.
Lower risk for mortality, hospitalization, and cases.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Retrospective 378 patients with hematologic malignancies analyzing seroconversion and outcomes post-vaccination. Among 25 seronegative patients after booster vaccination who received tixagevimab/cilgavimab prophylaxis, no COVID-19 infections occurred, whereas 3 infections and 1 death occurred among 12 comparable patients not receiving prophylaxis.
Efficacy is variant dependent. In Vitro research suggests a lack of efficacy for omicron BA.2.75.2, BA.4.6, BQ.1.1 Planas, BA.5, BA.2.75, XBB Haars, ХВВ.1.9.1, XBB.1.9.3, XBB.1.5.24, XBB.1.16, XBB.2.9, BQ.1.1.45, CL.1, and CH.1.1 Pochtovyi.
risk of death, 75.5% lower, RR 0.24, p = 0.32, treatment 0 of 25 (0.0%), control 1 of 12 (8.3%), NNT 12, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of case, 90.2% lower, RR 0.10, p = 0.03, treatment 0 of 25 (0.0%), control 3 of 12 (25.0%), NNT 4.0, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ollila et al., 11 Jul 2022, retrospective, USA, peer-reviewed, 13 authors, study period February 2021 - February 2022. Contact:
This PaperTixagev../c..All
Seroconversion and outcomes after initial and booster COVID‐19 vaccination in adults with hematologic malignancies
MD Thomas A Ollila, MD Rebecca H Masel, MD John L Reagan, MD, PhD Shaolei Lu, Ralph D Rogers, BS, MT, ASCP Kimberly J Paiva, MPH, PA-C Rashida Taher, Ella Burguera‐couce, Adam S Zayac, NP Inna Yakirevich, MD Rabin Niroula, MD Peter Barth, MD Adam J Olszewski
Cancer, doi:10.1002/cncr.34354
BACKGROUND: Patients with hematologic malignancies have impaired humoral immunity secondary to their malignancy and its treatment, placing them at risk of severe coronavirus disease-19 (COVID-19) infection and reduced response to vaccination. METHODS: The authors retrospectively analyzed serologic responses to initial and booster COVID-19 vaccination in 378 patients with hematologic malignancy and subsequently tracked COVID-19-related outcomes. RESULTS: Seroconversion occurred in 181 patients (48%) after initial vaccination; patients who had active malignancy or those who were recently treated with a B-cell-depleting monoclonal antibody had the lowest rates of seroconversion. For initial nonresponders to vaccination, seroconversion after a booster dose occurred in 48 of 85 patients (56%). The seroconversion rate after the booster was similar for patients on (53%) and off (58%) active therapy (p = .82). Thirty-three patients (8.8%) developed a COVID-19 infection, and there were three COVID-19-related deaths (0.8%). Although no significant association was observed between postvaccination seroconversion and the incidence of COVID-19 infection, no patient with seroconversion died from COVID-19, and no patient who received tixagevimab/cilgavimab (N = 25) was diagnosed with a COVID-19 infection. CONCLUSIONS: Booster vaccinations can promote seroconversion in a significant proportion of patients who are seronegative after the initial vaccination course regardless of the specific vaccine or on/off treatment status at the time of revaccination. Although postvaccination seroconversion may not be associated with a decrease in any (including asymptomatic) COVID-19 infection, the authors' experience suggested that effective vaccination (including a booster), supplemented by passive immunization using tixagevimab/cilgavimab in case of lack of seroconversion, effectively eliminated the risk of COVID-19 death in the otherwise high-risk population.
CONFLICT OF INTEREST Thomas A. Ollila reports a grant from the Rhode Island Foundation outside the submitted work. Peter Barth reports personal fees from Celgene and advisory board service at AbbVie, Janssen, and Sanofi-Aventis outside the submitted work. Adam J. Olszewski reports research funding from Genentech, TG Therapeutics, Celldex Pharmaceuticals, and Precision Bio; and grants from Acrotech Pharma, Adaptive Biotechnologies outside the submitted work. The remaining authors made no disclosures.
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