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Tantiyavarong W, Sungkasubun P, Chaiwiriyawong W, Supavavej A, Limpawittayakul P, Weerasubpong B, Siripaibun J, Phanthunane C, Lamlertthon W, Ungtrakul T, Tawinprai K, Tantiyavarong P, Samdaengpan C. Difference in Immunogenic Responses to COVID-19 Vaccines in Patients With Cancer Receiving Chemotherapy Versus Nonchemotherapy Treatment. JCO Glob Oncol 2023; 9:e2200331. [PMID: 36821802 PMCID: PMC10166411 DOI: 10.1200/go.22.00331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
PURPOSE The COVID-19 pandemic has affected public health worldwide. The efficacy and safety of COVID-19 vaccines have been evaluated in the general population; however, data on patients with malignancies are limited. METHODS This prospective longitudinal observational cohort study was conducted between June and July 2021. Enrolled adult patients with cancer were divided into chemotherapy and nonchemotherapy groups. All participants were immunized with two doses of the ChAdOx1 nCoV-19 or CoronaVac COVID-19 vaccines. The primary outcome was a comparison of the immunogenicity (as assessed by spike protein [anti-S] immunoglobulin G [IgG] antibody titers) of two doses of COVID-19 vaccine in the chemotherapy and nonchemotherapy groups. The secondary outcomes included the anti-S IgG seroconversion rate and vaccine safety in both groups. RESULTS Among the 173 enrolled patients with solid cancer, after COVID-19 vaccination, the chemotherapy group had a significantly lower median anti-S IgG titer than the nonchemotherapy group (26 v 237 U/mL, P < .001). A statistically significant difference in anti-S IgG titer was found between groups vaccinated with CoronaVac (7 v 90 U/mL, P < .001), but no difference was found in those vaccinated with ChAdOx1 nCoV-19 (818 v 1061 U/mL, P = .075). The anti-S IgG seroconversion rate was significantly lower in the chemotherapy group than that in the nonchemotherapy group (78.9% v 96.5%, P = .001). No new or serious vaccine-related adverse events were reported. CONCLUSION Patients with solid cancer receiving a COVID-19 vaccine while undergoing chemotherapy had lower immunogenicity responses to vaccination than those who were vaccinated while undergoing nonchemotherapy treatment. No statistically significant difference was observed in the COVID-19 vaccine safety profiles between groups.
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Affiliation(s)
- Walaipan Tantiyavarong
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Prakongboon Sungkasubun
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Worawit Chaiwiriyawong
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Archara Supavavej
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Piyarat Limpawittayakul
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Bowon Weerasubpong
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Jomtana Siripaibun
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Chumut Phanthunane
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Wisut Lamlertthon
- Faculty of Medicine and Public Health, Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Teerapat Ungtrakul
- Faculty of Medicine and Public Health, Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Kriangkrai Tawinprai
- Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Pichaya Tantiyavarong
- Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Chayanee Samdaengpan
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
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Limpawittayakul P, Sungkasubun P, Chaiwiriyawong W, Supavavej A, Weerasubpong B, Siripaibun J, Phanthunane C, Lamlertthon W, Ungtrakul T, Tawinprai K, Tantiyavarong W, Samdaengpan C. Immunogenicity evaluation of ChAdox1 nCov-19 (AZD1222) vaccine in solid cancer patients in Chulabhorn Hospital. Hum Vaccin Immunother 2022; 18:2104058. [PMID: 35976687 DOI: 10.1080/21645515.2022.2104058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Cancer patients are more vulnerable to coronavirus disease 2019 (COVID-19) owing to their compromised immune status. However, data regarding COVID-19 vaccine safety and immune response in cancer patients are scarce. METHOD This prospective, age- and sex-matched, single-center cohort study included 61 cancer patients and 122 healthy control participants. Seropositivity was defined as anti-S IgG titer >0.8 units/ml. Primary end point was seroconversion rate of immunoglobulin (Ig)G antibodies against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) protein (anti-S IgG) in cancer patients vs. healthy control participants following the second dose of COVID-19 vaccine ChAdOx1 nCoV-19 (AZD1222). RESULTS After the second-dose vaccination, there was no difference in seropositivity rate between groups (57 [93.44%] patients with cancer vs. 121 [99.18%] control participants; geometric mean ratio [GMR]: 0.39; 95%CI: 0.01-10.46; p-value = 0.571). In contrast, after the first-dose vaccination, the seropositivity rate was significantly lower in the cancer patients than in the control participants (50/61 [81.97%] vs. 121/122 [99.18%]; GMR: 0.07; 95%CI: 0.01-0.71; p = 0.025). The median anti-S IgG titer after the first-and second dose vaccination were not significantly different between groups. Female sex was significantly associated with a higher anti-S IgG titer. 5FU- and taxane-based chemotherapy regimens were associated with a lower IgG titer. Side effects of vaccination were tolerable. CONCLUSIONS The anti-S IgG seropositivity rate after completing the second vaccine dose did not differ between the cancer patients and control participants. However, the anti-S IgG seropositivity rate after the first-dose vaccination was lower in cancer patients.
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Affiliation(s)
- Piyarat Limpawittayakul
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Prakongboon Sungkasubun
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Worawit Chaiwiriyawong
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Archara Supavavej
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Bowon Weerasubpong
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Jomtana Siripaibun
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Chumut Phanthunane
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Wisut Lamlertthon
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Teerapat Ungtrakul
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Kriangkrai Tawinprai
- Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Walaipan Tantiyavarong
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Chayanee Samdaengpan
- Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
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Chan S, Chotipanich C, Choo S, Kwang S, Worakitsitisatorn A, Tai D, Yong W, Sundar R, Li L, Yu S, Sungkasubun P. P-19 A multicentred phase II clinical trial on yttrium 90-resin microspheres followed by gemcitabine-cisplatin for treatment of locally advanced intra-hepatic cholangiocarcinoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Siripongsakun S, Vidhyarkorn S, Charuswattanakul S, Mekraksakit P, Sungkasubun P, Yodkhunnathum N, Tangruangkiat S, Ritlumlert N, Sricharunrat T, Jaroenpatarapesaj S, Soonklang K, Kulthanmanusorn A, Auewarakul CU, Mahidol C. Ultrasound surveillance for cholangiocarcinoma in an endemic area: A prove of survival benefits. J Gastroenterol Hepatol 2018; 33:1383-1388. [PMID: 29247982 DOI: 10.1111/jgh.14074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 12/03/2017] [Accepted: 12/11/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Cholangiocarcinoma (CCA) is an aggressive malignancy with rapid progression and poor prognosis. Abdominal ultrasound surveillance may detect early-stage malignancy and improve surgical outcome. However, little data exist on the benefits of abdominal ultrasound surveillance in populations at high risk for CCA development in an endemic area. This study compared survival outcomes of CCA patients recruited through abdominal ultrasound surveillance program and those presented to the hospital independent of surveillance. METHODS The surveillance population-based cohort was 4225 villagers in Northern Thailand, aged 30-60 years, who consented to a 5-year abdominal ultrasound surveillance program, which included interval ultrasound examinations every 6 months. The non-surveillance cohort was hospital-based CCA patients diagnosed during April 2007 to November 2015. Numbers of operable tumors, percentages of R0 resection, and survival analyses were compared between the two cohorts. RESULTS There were 48 and 192 CCA patients in the surveillance and the non-surveillance cohorts, respectively. Of these, 37/48 (77.1%) and 22/192 (11.5%) were in an operable stage and R0 resections performed in 36/48 (97.3%) and 14/192 (63.6%), respectively. The median survival in each group was 31.8 and 6.7 months, respectively (with correction of lead time bias) (P < 0.0001). By multivariate analysis, abdominal ultrasound surveillance (hazard ratio [HR] = 0.41; P = 0.012), operable stage (HR = 0.11; P < 0.001), and serum albumin ≥ 3.5 g/dL (HR = 0.42; P < 0.001) were significantly associated with decreased mortality, whereas size of CCA (HR = 1.11; P < 0.001), serum alanine aminotransferase > 40 IU/L (HR = 1.71; P = 0.017), and tumor recurrence (HR = 4.86; P = 0.017) were associated with increased mortality. CONCLUSION Abdominal ultrasound surveillance provided survival benefits and should be considered in areas highly endemic for CCA to reduce mortality.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Kamonwan Soonklang
- Data Management Unit, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | | | - Chirayu U Auewarakul
- School of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand.,Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chulabhorn Mahidol
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
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Sungkasubun P, Siripongsakun S, Akkarachinorate K, Vidhyarkorn S, Worakitsitisatorn A, Sricharunrat T, Singharuksa S, Chanwat R, Bunchaliew C, Charoenphattharaphesat S, Molek R, Yimyaem M, Sornsamdang G, Soonklang K, Wittayasak K, Auewarakul CU, Mahidol C. Ultrasound screening for cholangiocarcinoma could detect premalignant lesions and early-stage diseases with survival benefits: a population-based prospective study of 4,225 subjects in an endemic area. BMC Cancer 2016; 16:346. [PMID: 27251649 PMCID: PMC4890519 DOI: 10.1186/s12885-016-2390-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 05/26/2016] [Indexed: 02/06/2023] Open
Abstract
Background Thailand has a high incidence of cholangiocarcinoma (CCA), particularly in the north and northeastern regions. Most CCA patients come at a late, unresectable stage and presently no optimal screening test for CCA has been established. We determined the prevalence of CCA in a remote northern village and explored if screening could lead to early detection and survival benefits. Methods A 5-year population-based study was started in October, 2011 for consented Thai individuals, aged 30–60 years. The screening program comprised blood testing, stool examination and serial ultrasonography every 6 months. Results During the first 3 years, 4,225 eligible individuals were enrolled. CCA was detected in 32 patients, with a mean age of 51.9 years (41–62 years), and 21/32 cases were at a curative resectable stage. The prevalence rate of CCA was 165.7 per 100,000 and one- and two-year incidence rate was 236.7/100,000 and 520.7/100,000, respectively. One- and 2-year overall survival rates of CCA patients were 90.9 and 61.5 %, respectively. Prognosis was better in resectable cases with 100 % 1-year and 77.8 % 2-year survival rates. Interestingly, premalignant pathological lesions (stage 0) were identified in 11 cases with 100 % 3-year survival rate. Serum biomarkers and alkaline phosphatase were not sufficient to detect early-stage disease. In 22 patients, stool samples were positive for Opistorchis viverrini, based on polymerase chain reaction. Conclusion Detection of premalignant lesions and early-stage resectable CCA by ultrasonography resulted in improved clinical outcome. Ultrasonography should be offered as a first screening tool for CCA in an endemic area until other useful biological markers become available.
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Affiliation(s)
| | | | | | | | | | | | - Sutida Singharuksa
- Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand
| | - Rawisak Chanwat
- National Cancer Institute of Thailand, 268/1 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Chairat Bunchaliew
- National Cancer Institute of Thailand, 268/1 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
| | | | - Ruechuta Molek
- Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand
| | - Maneenop Yimyaem
- Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand
| | | | - Kamonwan Soonklang
- Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand
| | - Kasiruck Wittayasak
- Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand
| | - Chirayu U Auewarakul
- Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand.,Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Chulabhorn Mahidol
- Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. .,Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand. .,Chulabhorn Research Institute, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210, Thailand.
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Sungkasubun P, Siripongsakul S, Akkarachinorate K, Vidhyarkorn S, Worakitsitisatorn A, Leelapisut T, Sricharunrat T, Chanwat R, Bunchaliew C, Pattaranuthaporn P. Screening and 6-month surveillance interval ultrasonography in early detection of cholangiocarcinoma in an endemic area. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.4091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Parinyanitikul N, Tanakit V, Sungkasubun P, Manasnayakorn S, Raiyawa T, Sriuranpong V. The prevalence of triple-negative breast cancer in Thai patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e11541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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