Evusheld Reduced Risk of COVID-19 in Hematologic Cancer Patients

Prophylaxis with tixagevimab and cilgavimab (Evusheld) reduced the risk of breakthrough SARS-CoV-2 infections and the severity of COVID-19 among patients with hematologic cancers in an Italian study.

Researchers said these findings, published in JAMA Oncology, suggest that Evusheld prophylaxis could be “a complementary tool to vaccination boosters.”

However, Evusheld is no longer authorized for use in the United States because it was deemed unlikely to be active against newer SARS-CoV-2 variants, particularly omicron subvariants.

For the current study, researchers in Italy evaluated tixagevimab-cilgavimab prophylaxis in a cohort of 204 patients with hematologic malignancies. A total of 130 patients received tixagevimab-cilgavimab, and 74 did not.

The median age was 68.5 years in the prophylaxis group and 64.5 years in the control group. Patients had lymphoproliferative disorders and multiple myeloma (77% in the prophylaxis group and 81% in the control group), myeloproliferative neoplasms (19% and 12%, respectively), or acute leukemia (4% and 7%, respectively).

Most patients (95% in the prophylaxis group and 92% in the control group) were receiving active cancer treatment. All patients had received at least 2 doses (and up to 5 doses) of a SARS-CoV-2 vaccine.

The incidence of COVID-19 (per 10,000 person-days) was 13.8 in the tixagevimab-cilgavimab prophylaxis group and 28.0 in the control group (adjusted hazard ratio [aHR], 0.47; 95% CI, 0.27-0.81; P =.01).

The incidence of severe or critical COVID-19 (per 10,000 person-days) was 1.4 in the prophylaxis group and 4.0 in the control group (aHR, 0.18; 95% CI, 0.03-0.99; P = .0495).

The incidence of hospitalization for COVID-19 (per 10,000 person-days) was 1.3 in the prophylaxis group and 4.0 in the control group (aHR, 0.19; 95% CI, 0.04-0.91; P = .04).

The researchers also used propensity score matching to compare 52 patients in each group and found a significantly lower risk of COVID-19 in the prophylaxis group (HR, 0.44; 95% 0.20-0.97; P = .04).

There were no significant adverse events associated with tixagevimab-cilgavimab, according to the researchers.

The researchers noted that patients were enrolled in this trial between June 1, 2022, and September 1, 2022, and they were followed until March 1, 2023. From June 2022 to March 2023, omicron variants were prevalent in Italy, and the BA.5 variant became the dominant variant in July 2022.

The emergency authorization for Evusheld was withdrawn in January 2023 in the United States because the product was expected to be ineffective against the omicron subvariants BQ.1, BQ.1.1, BF.7, BF.11, BA.5.2.6, BA.4.6, BA.2.75.2, XBB, and XBB.1.5.

Research published in May 2022 had suggested that Evusheld was less effective against omicron variants in patients with hematologic malignancies.

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

This article originally appeared on Cancer Therapy Advisor