Retrospective Study of COVID-19 Vaccines in Patients Undergoing Immunotherapy for Cancer. (IVACOV)

January 17, 2022 updated by: Centre Hospitalier Universitaire de Nīmes

Pharmaco-epidemiological Study of COVID 19 Vaccines in Patients Undergoing Immunotherapy for Cancer. A Retrospective Open Cohort Study.

The investigators wish to set up a pharmaco-epidemiological cohort within the Hospital Territorial Groups of the Cévennes-Gard Camargue, East-Hérault and Haute-Garonne and West Tarn on a specific population, patients undergoing immunotherapy for cancer, as currently there is no data available under "real life" conditions following anti-COVID vaccination19. The hypothesis is that patients undergoing immunotherapy will not develop more vaccine-related adverse events than those observed in the efficacy and safety validation studies of the BNT162b2 mRNA Covid-19, mRNA-1273 SARS CoV-2, Oxford/AstraZeneca and Ad26COV2.S, JMJ Vaccine or J & J COVID-19 Vaccine.

Study Overview

Status

Recruiting

Conditions

Detailed Description

The recent outbreak of Coronavirus 2019 (COVID-19) caused by a new zoonotic coronavirus SARS-Cov-2 poses a major public health threat, with at least 100,000,000 people infected worldwide by the end of January 2021 and over 2 million deaths. Given the scale of the pandemic, it has become imperative to quickly develop a vaccine and over 30 vaccine candidates have entered clinical evaluation. The first vaccine to receive marketing authorization in Europe and France was an mRNA vaccine, Comirnaty® (Bnt162b2; Pfizer/BioNtech). In a Phase III study of 43,448 participants, after a median follow-up of 2 months, the number of cases of COVID-19 was 8 in the vaccine arm vs. versus 162 in the placebo arm, respectively, with 1 versus 9 serious cases (Polack et al. 2020). Adverse events occurred in more than 50% of vaccinated participants and included local reactions as well as frequent systemic reactogenicity such as fatigue and headache. Fever occurred in about 15% of the participants who received the vaccine. The second vaccine to be licensed was also an mRNA vaccine: the Moderna COVID-19 mRNA (nucleoside modified) vaccine (mRNA-1273, Moderna). A Phase III trial involving 30,420 volunteers reported efficacy and safety comparable to the Pfizer/BioNtech vaccine. A severe form of COVID-19 occurred in 30 subjects, with one death; all 30 cases were in the placebo group. Moderate and transient reactogenicity after vaccination occurred more frequently in the mRNA-1273 group.

Serious adverse events were rare and the incidence was similar in both groups. Within the vaccination strategy implemented on a national level, the Comirnaty® vaccine (Pfizer/BioNtech) and the Moderna COVID-19 mRNA vaccine (nucleoside modified) may be used interchangeably, depending on logistical constraints.

For several weeks now, the Oxford-AstraZeneca chimpanzee adenovirus vector vaccine ChAdOx1 nCoV-19 (AZD1222) has been available in France and its efficacy and safety of use have been evaluated. Also the non-replicating viral vector (adenovirus) vaccine for CVD 19 from Janssen Laboratories (a subsidiary of Johnson & Johnson; other names: Ad26COV2.S; JMJ Vaccine or J & J COVID-19 Vaccine) was launched in France a few weeks ago. Its efficacy and safety have been validated in a phase III trial. A number of other candidate vaccines using various techniques such as mRNA, protein subunit, viral vector or inactivated vaccines are currently under investigation and will be available soon.

Cancer patients are particularly at risk of developing a severe form of COVID-19. Patients with solid tumors appear to be at a greater risk, particularly in the first year after diagnosis. Severity and mortality rates in the COVID-19 and Cancer Consortium (CCC19) registry and other cohorts range from 5% to 61% (a meta-analysis showed 26%), which is well above the general population. Although data on vaccination in cancer patients are limited, there is sufficient evidence to support anti-infective vaccination in general, even in cancer patients on immunosuppressive therapy. In its notice dated January 25th, 2021, the National Cancer Institute defined its recommendations for prioritizing cancer patients for vaccination against SARS-CoV-2. This report stresses that the data acquired from science is limited in quantity and quality concerning the emerging field of vaccination against SARS-CoV-2 and even more so in sub-populations including cancer patients. It reminds us that the challenge remains to vaccinate the entire population of patients who have or have had cancer, i.e. approximately 3.8 million people.

The level of efficacy can be expected to be generally reduced in certain cancer patient populations with intense immunosuppression, such as haematopoietic stem cell transplant recipients. However, based on extrapolation of data from other vaccines and the mechanism of action of COVID-19 (non-live) vaccines, it is conceivable that the efficacy and safety of COVID-19 vaccination could be estimated to be similar to that of non-cancer patients, although data from clinical trials are lacking. The efficacy and duration of immunity in cancer patients is still unknown and unexplored. It is therefore legitimate to propose surveillance through dedicated registries and clinical trials. Furthermore, close monitoring and follow-up of cancer patients is required after COVID-19 vaccination to assess potential adverse events and measure clinical outcomes, e.g. infection, severity and mortality from COVID-19, cancer complications etc… The investigators wish to set up a pharmaco-epidemiological cohort within the Hospital Territorial Groups of the Cévennes-Gard Camargue, East-Hérault and Haute-Garonne and West Tarn on a specific population, patients undergoing immunotherapy for cancer, as currently there is no data available under "real life" conditions following anti-COVID vaccination19. Our hypothesis is that patients undergoing immunotherapy will not develop more vaccine-related adverse events than those observed in the efficacy and safety validation studies of the BNT162b2 mRNA Covid-19, mRNA-1273 SARS CoV-2, Oxford/AstraZeneca and Ad26COV2.S, JMJ Vaccine or J & J COVID-19 Vaccine.

Study Type

Observational

Enrollment (Anticipated)

500

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

      • Albi, France, 81000
        • Recruiting
        • Clinique Claude Bernard
      • Albi, France
        • Recruiting
        • Centre Hospitalier D'Albi
      • Alès, France, 30100
        • Recruiting
        • Centre Hospitalier d'Alès
      • Auch, France, 32008
        • Recruiting
        • CH d'Auch
      • Bagnols-sur-Cèze, France
        • Recruiting
        • CH de Bagnols sur Cèze
        • Contact:
          • Phone Number: 04 66 79 10 11
      • Cahors, France
        • Recruiting
        • CH de Cahors
      • Cornebarrieu, France, 31700
        • Recruiting
        • Clinique des Cèdres - Capio
      • Montpellier, France, 34000
        • Recruiting
        • Institut de Cancer de Montpellier
        • Contact:
          • Jesus Diaz
      • Quint-Fonsegrives, France
        • Recruiting
        • Clinique La Croix du Sud
      • Saint-Gaudens, France
        • Not yet recruiting
        • Centre Hospitalier COMMINGES PYRENEES
      • Sete, France, 34200
        • Recruiting
        • Centre Hospitalier du bassin de Thau
      • Tarbes Cedex 9, France, 65013
        • Recruiting
        • CH de Bigorre
      • Toulouse, France
        • Recruiting
        • Centre Hospitalier de Toulouse

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

The study population consists of all patients with cancer requiring anti-PD, anti-PDL1 or antiCTLA4 immunotherapy for any tumour (solid, liquid) who have been vaccinated or eligible for vaccination against COVID19 (of any kind, except live, attenuated virus) and treated in the medical oncology departments of the Occitanie region.

Description

Inclusion Criteria:

  • Patient having been vaccinated or eligible for inoculation with one of the available anti-COVID19 vaccines (except live attenuated virus) while they were or are undergoing immunotherapy with anti-PD1, anti-PDL1 or anti-CTLA4 immunotherapy whatever the tumor (solid, liquid) managed within the medical oncology services of the Occitanie region.
  • Patients affiliated to or beneficiaries of a health insurance scheme.
  • Patients who have received written and oral information about the study and who have no objection to participation.
  • Adult patients (≥ 18 years).

Exclusion Criteria:

  • Patients who have been vaccinated with a live attenuated vaccine.
  • Patients with a contraindication to inclusion (including hypersensitivity to the active substance or to one of the excipients, COVID+ PCR test in the last 3 months).
  • Minor patients, pregnant women, parturients, nursing mothers, persons in nursing mothers, persons in emergency situations, persons unable to persons unable to express their consent and persons under persons under court protection, subguardianship or subguardianship may not be included in this research.
  • Patients in an exclusion period determined by another study.
  • Patients for whom it is impossible to give clear information.
  • Patients who have expressed an objection to participating in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Patients treated for cancer, vaccinated or eligible for anti-COVID vaccination.

Patients undergoing treatment with anti-PD immunotherapy, anti-PDL1 or anti-CTLA4 immunotherapy for any tumour (solid, liquid) treated in the medical oncology departments of the Occitanie area.

who have been vaccinated or who are eligible for inoculation with one of the available anti-COVID19 vaccines.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Tolerance of immunotherapy following anti-COVID-19 vaccination
Time Frame: 24 hours after the vaccination
All local adverse events (pain, rashes, bruising, lymphadenopathy) and systemic adverse events (fever, headaches, fatigue, myalgia, arthralgia, nausea, shivering, diarrhoea, allergic reaction) will be recorded.
24 hours after the vaccination
Tolerance of immunotherapy following anti-COVID-19 vaccination
Time Frame: 48 hours after the vaccination
All local adverse events (pain, rashes, bruising, lymphadenopathy) and systemic adverse events (fever, headaches, fatigue, myalgia, arthralgia, nausea, shivering, diarrhoea, allergic reaction) will be recorded.
48 hours after the vaccination
Tolerance of immunotherapy following anti-COVID-19 vaccination
Time Frame: 8 days after the vaccination
All local adverse events (pain, rashes, bruising, lymphadenopathy) and systemic adverse events (fever, headaches, fatigue, myalgia, arthralgia, nausea, shivering, diarrhoea, allergic reaction) will be recorded.
8 days after the vaccination
Tolerance of immunotherapy following anti-COVID-19 vaccination
Time Frame: 24 hours after the following vaccination
All local adverse events (pain, rashes, bruising, lymphadenopathy) and systemic adverse events (fever, headaches, fatigue, myalgia, arthralgia, nausea, shivering, diarrhoea, allergic reaction) will be recorded.
24 hours after the following vaccination
Tolerance of immunotherapy following anti-COVID-19 vaccination
Time Frame: 48 hours after the following vaccination
All local adverse events (pain, rashes, bruising, lymphadenopathy) and systemic adverse events (fever, headaches, fatigue, myalgia, arthralgia, nausea, shivering, diarrhoea, allergic reaction) will be recorded.
48 hours after the following vaccination
Tolerance of immunotherapy following anti-COVID-19 vaccination
Time Frame: 8 days after the following vaccination
All local adverse events (pain, rashes, bruising, lymphadenopathy) and systemic adverse events (fever, headaches, fatigue, myalgia, arthralgia, nausea, shivering, diarrhoea, allergic reaction) will be recorded.
8 days after the following vaccination
Tolerance of immunotherapy following anti-COVID-19 vaccination
Time Frame: 1 month after the following vaccination
All local adverse events (pain, rashes, bruising, lymphadenopathy) and systemic adverse events (fever, headaches, fatigue, myalgia, arthralgia, nausea, shivering, diarrhoea, allergic reaction) will be recorded.
1 month after the following vaccination
Tolerance of immunotherapy following anti-COVID-19 vaccination
Time Frame: 3 months after the following vaccination
All local adverse events (pain, rashes, bruising, lymphadenopathy) and systemic adverse events (fever, headaches, fatigue, myalgia, arthralgia, nausea, shivering, diarrhoea, allergic reaction) will be recorded.
3 months after the following vaccination
Tolerance of immunotherapy following anti-COVID-19 vaccination
Time Frame: 6 months after the following vaccination
All local adverse events (pain, rashes, bruising, lymphadenopathy) and systemic adverse events (fever, headaches, fatigue, myalgia, arthralgia, nausea, shivering, diarrhoea, allergic reaction) will be recorded.
6 months after the following vaccination

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
A. Tolerance of immunotherapy after anti-COVID-19 vaccination
Time Frame: 24 hours after the vaccination
Any adverse events related to the immunotherapy qualified as Grade ≥3 according to the Common Terminology Criteria for Adverse Events classification (NCI CTCAE V5.0) will be recorded.
24 hours after the vaccination
A. Tolerance of immunotherapy after anti-COVID-19 vaccination
Time Frame: 48 hours after the vaccination
Any adverse events related to the immunotherapy qualified as Grade ≥3 according to the Common Terminology Criteria for Adverse Events classification (NCI CTCAE V5.0) will be recorded.
48 hours after the vaccination
A. Tolerance of immunotherapy after anti-COVID-19 vaccination
Time Frame: 8 days after the vaccination
Any adverse events related to the immunotherapy qualified as Grade ≥3 according to the Common Terminology Criteria for Adverse Events classification (NCI CTCAE V5.0) will be recorded.
8 days after the vaccination
A. Tolerance of immunotherapy after anti-COVID-19 vaccination
Time Frame: 24 hours after the following vaccination
Any adverse events related to the immunotherapy qualified as Grade ≥3 according to the Common Terminology Criteria for Adverse Events classification (NCI CTCAE V5.0) will be recorded.
24 hours after the following vaccination
A. Tolerance of immunotherapy after anti-COVID-19 vaccination
Time Frame: 48 hours after the following vaccination
Any adverse events related to the immunotherapy qualified as Grade ≥3 according to the Common Terminology Criteria for Adverse Events classification (NCI CTCAE V5.0) will be recorded.
48 hours after the following vaccination
A. Tolerance of immunotherapy after anti-COVID-19 vaccination
Time Frame: 1 month after the following vaccination
Any adverse events related to the immunotherapy qualified as Grade ≥3 according to the Common Terminology Criteria for Adverse Events classification (NCI CTCAE V5.0) will be recorded.
1 month after the following vaccination
A. Tolerance of immunotherapy after anti-COVID-19 vaccination
Time Frame: 3 months after the following vaccination
Any adverse events related to the immunotherapy qualified as Grade ≥3 according to the Common Terminology Criteria for Adverse Events classification (NCI CTCAE V5.0) will be recorded.
3 months after the following vaccination
A. Tolerance of immunotherapy after anti-COVID-19 vaccination
Time Frame: 6 months after the following vaccination
Any adverse events related to the immunotherapy qualified as Grade ≥3 according to the Common Terminology Criteria for Adverse Events classification (NCI CTCAE V5.0) will be recorded.
6 months after the following vaccination
B.Response to vaccine: dosage of anti-Spike antibodies (ELISA)
Time Frame: Day 0
Quantification of anti-Spike IgG by ELISA.
Day 0
B.Response to vaccine: dosage of anti-RBD antibodies (ELISA)
Time Frame: Day 0
Quantification of anti-RBD IgG by ELISA.
Day 0
B. Response to vaccine: Lymphocyte count by Quantiferon
Time Frame: Day 0
Lymphocytes will be measured in µg/ml
Day 0
B. Response to vaccine: dosage of anti-Spike antibodies (ELISA)
Time Frame: 1 month after the injection
Quantification of anti-Spike IgG by ELISA.
1 month after the injection
B. Response to vaccine: dosage of anti-RBD antibodies (ELISA)
Time Frame: 1 month after the injection
Quantification of anti-RBD IgG by ELISA.
1 month after the injection
B. Response to vaccine: Lymphocyte count by Quantiferon
Time Frame: 1 month after the injection
Lymphocytes will be measured in µg/ml
1 month after the injection
B. Response to vaccine: dosage of anti-spike antibodies (ELISA)
Time Frame: 1 month after the following injection
Quantification of anti-Spike IgG by ELISA.
1 month after the following injection
B. Response to vaccine: dosage of anti-RBD antibodies (ELISA)
Time Frame: 1 month after the following injection
Quantification of anti-RBD IgG by ELISA.
1 month after the following injection
B. Response to vaccine: Lymphocyte count by Quantiferon
Time Frame: 1 month after the following injection
Lymphocytes will be measured in µg/ml
1 month after the following injection
B. Response to vaccine: dosage of anti-spike antibodies (ELISA)
Time Frame: 3 months after the following injection
Quantification of anti-Spike IgG by ELISA.
3 months after the following injection
B. Response to vaccine: dosage of anti-RBD antibodies (ELISA)
Time Frame: 3 months after the following injection
Quantification of anti-RBD IgG by ELISA.
3 months after the following injection
B. Response to vaccine: Lymphocyte count by Quantiferon
Time Frame: 3 months after the following injection
Lymphocytes will be measured in µg/ml
3 months after the following injection
B. Response to vaccine: dosage of anti-spike antibodies (ELISA)
Time Frame: 6 months after the following injection
Quantification of anti-Spike IgG by ELISA .
6 months after the following injection
B. Response to vaccine: dosage of anti-RBD antibodies (ELISA)
Time Frame: 6 months after the following injection
Quantification of anti-RBD IgG by ELISA .
6 months after the following injection
B. Response to vaccine: Lymphocyte count by Quantiferon
Time Frame: 6 months after the following injection
Lymphocytes will be measured in µg/ml
6 months after the following injection
C. Efficacy of vaccination against the incidence of COVID-19
Time Frame: 1 month after vaccination
The efficacy of vaccination against the incidence of COVID-19 will be evaluated based on the main clinical symptoms noted and a PCR test. Qualitative: YES/NO
1 month after vaccination
C. Efficacy of vaccination against the incidence of COVID-19
Time Frame: 3 months after vaccination
The efficacy of vaccination against the incidence of COVID-19 will be evaluated based on the main clinical symptoms noted and a PCR test. Qualitative: YES/NO
3 months after vaccination
C. Efficacy of vaccination against the incidence of COVID-19
Time Frame: 6 months after vaccination
The efficacy of vaccination against the incidence of COVID-19 will be evaluated based on the main clinical symptoms noted and a PCR test. Qualitative: YES/NO
6 months after vaccination
D. Constitution of a biobank
Time Frame: Up to 6 months after vaccination
Unused sample aliquots (tube bottoms) at the end of the tests will be kept; constitution of a serum library and an immune bank. Samples will be stored at -80°C (plasma) and -196°C (Peripheral Blood Mononuclear Cells) at the Biological Resource Centre at Nîmes University Hospital.
Up to 6 months after vaccination

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Age of patients
Time Frame: Day 0
In years
Day 0
Weight of patients
Time Frame: Day 0
In kilograms
Day 0
Height of patients
Time Frame: Day 0
In centimeters
Day 0
Sex of patients
Time Frame: Day 0
Male/Female
Day 0
Patients' WHO status
Time Frame: Day 0
The clinical status on the WHO COVID-19 ordinal scale. The WHO ordinal scale ranges from 0 to 8 in which 0 = no COVID-19 infection and 8 = death
Day 0
Type of cancer and its location
Time Frame: Day 0
The type of cancer and its location will be recorded
Day 0
Treatment type
Time Frame: Day 0
The type of treatment will be recorded
Day 0
Therapeutic line
Time Frame: Day 0
The therapeutic line will be noted
Day 0
Other vaccinations
Time Frame: Day 0
All vaccinations received other than anti-COVID-19 in the previous 6 months will be recorded.
Day 0
Lymphocyte count
Time Frame: Day 0
A lymphocyte count will be made at the time of vaccination and measured as the number of cells/μL
Day 0
COVID-19 serology test
Time Frame: Day 0
A COVID-19 serology test will be made and COVID-19-specific antibodies will be measured in μg/mL
Day 0

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 19, 2021

Primary Completion (Anticipated)

January 1, 2024

Study Completion (Anticipated)

June 1, 2024

Study Registration Dates

First Submitted

August 25, 2021

First Submitted That Met QC Criteria

August 25, 2021

First Posted (Actual)

August 27, 2021

Study Record Updates

Last Update Posted (Actual)

February 1, 2022

Last Update Submitted That Met QC Criteria

January 17, 2022

Last Verified

January 1, 2022

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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