The risk of COVID-19-related death after breakthrough SARS-CoV-2 infection “remains high” for patients with cancer, according to researchers.

The team also found that patients with a SARS-CoV-2 infection prior to COVID-19 vaccination had an increased risk of death after a breakthrough SARS-CoV-2 infection.

These findings were published in the European Journal of Cancer.

Continue Reading

For this study, researchers compared outcomes in cancer patients and health care workers (HCWs) who were vaccinated against COVID-19.

Data from 2391 cancer patients were included. Their median age was 65 years, and 52% were women. Cancer types included hematologic malignancies (22%), breast cancer (19%), lung cancer (12%), and prostate cancer (5%). About half of patients (51%) had metastatic disease, and 3% had received anti-CD20 therapy within 3 months of vaccination.

Ninety-five patients (4%) had a prior SARS-CoV-2 infection and received a single COVID-19 vaccine dose (in compliance with guidelines at the time). Among patients without a prior infection, 63% received 2 vaccine doses, 28% received 1 dose, and 6% received 3 doses.

Among the 2285 HCWs, 11.3% had received 1 vaccine dose, and 88.7% had received 2 or 3 doses.

Results: Breakthrough Infections and Death

The median follow-up was 142 days in the cancer patients and 199 days in the HCWs. The rate of breakthrough SARS-CoV-2 infection was 1.6% in the cancer patients and 1.5% in the HCWs (P =.07).

Among the cancer patients, the incidence of breakthrough infection was 4% in those who received 1 vaccine dose and 0.7% in those who received 2 doses. None of the patients who received 3 doses had a breakthrough infection.

For the cancer patients, independent risk factors for developing COVID-19 after vaccination included being younger than 60 years of age, receiving only 1 vaccine dose, and receiving anti-CD20 therapy in the last 3 months.

Six of the 39 cancer patients with a breakthrough infection died of COVID-19. The cumulative death rate at 50 days post-infection was 17.6%. On the other hand, none of the HCWs died from COVID-19.

The independent risk factors for death in the cancer patients were being male and having a hematologic malignancy, metastatic disease, or a SARS-CoV-2 infection prior to vaccination.

Based on these results, the researchers concluded that 2 or more doses of a COVID-19 vaccine reduce the risk of COVID-19 for cancer patients. However, the risk of death is high, and SARS-CoV-2 infection before vaccination is associated with an increased risk of death.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures. 


Heudel P, Favier B, Solodky M-L, et al. Survival and risk of COVID-19 after SARS-COV-2 vaccination in a series of 2391 cancer patients. Eur J Cancer. Published online February 9, 2022. doi:10.1016/j.ejca.2022.01.035

This article originally appeared on Cancer Therapy Advisor