Antibody Responses to COVID-19 Vaccination in Cancer: A Systematic Review

Güven, Deniz Can; Şahin, Taha Koray; Kılıçkap, Saadettin; Uçkun, Fatih M.

doi:10.3389/fonc.2021.759108

Cited by 25 publications

(28 citation statements)

References 81 publications

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“…Further, vaccination was associated with seroconversion rates of 85% after two doses, notably lower than the general population 11,12 . These and other data suggest that patients with solid-organ cancers do broadly develop an immune response to SARS-CoV-2, although it may be slightly reduced 10,11,13 . Other studies estimate an even lower or delayed immune response in this group of patients, although studies often include patients with haematological cancers, have early antibody testing strategies and may lack long-term follow-up 13–16 .…”

Section: Introductionsupporting

confidence: 51%

“…Many early studies could be influenced by a highly diverse definition of cancer and, importantly, changes in anti-cancer treatment policies during the pandemic 5 . More recent studies have evaluated the immune response of patients with cancer following SARS-CoV-2 infection and vaccination, with a wide variation in proposed responses owing to differences in study populations 10,11,13–15 . In contrast with much of the UK, the South East Scotland Cancer Network (SCAN), which comprises both hospitals reported here, had largely normalised SACT attendance rates by June/July 2020 (vs −31.2% in England and Northern Ireland) 23,24 .…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, there was no difference in response between patients receiving chemotherapy, immunotherapy or other treatments. Others have reported that patients with cancer may have delayed seroconversion 13,15 . Previously reported cohorts targeted patients with confirmed SARS-CoV-2 infection over a discrete period of time (both in terms of recruitment and antibody testing strategy) 10,11 .…”

Section: Discussionmentioning

confidence: 99%

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Scottish COVID CAncer iMmunity Prevalence (SCCAMP) - a longitudinal study of patients with cancer receiving active anti-cancer treatment during the COVID-19 pandemic

Purshouse

Thomson

Vallet

et al. 2022

Preprint

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BackgroundCancer and systemic anti-cancer treatment (SACT) have been identified as possible risk factors for infection and related severe illness associated with SARS-CoV-2 virus as a consequence of immune suppression. The Scottish COVID CAncer iMmunity Prevalence (SCCAMP) study aims to characterise the incidence and outcomes of SARS-Cov-2 infection in patients undergoing active anti-cancer treatment during the COVID-19 pandemic and their antibody response following vaccination.Patients and MethodsEligible patients were those attending secondary care for active anti-cancer treatment for a solid tumour. Blood samples were taken for total SARS-CoV-2 antibody assay (Siemens) at baseline and after 1.5, 3, 6 and 12 months. Data on COVID-19 infection, vaccination, cancer type, treatment and outcome was obtained from routine electronic health records.ResultsThe study recruited 766 eligible participants between 28th May 2020 and 31st October 2021. The median age was 62.7 years, and 66.5% were female. Most received cytotoxic chemotherapy (79%), with the remaining 14% receiving immunotherapy and 7% receiving another form of anti-cancer therapy (radiotherapy, other systemic anti-cancer treatment). 48 (6.3%) tested positive for SARS-CoV-2 by PCR during the study period. The overall infection rate matched that of the age-matched local general population until May 2021, after which population levels appeared higher. Antibody testing detected additional evidence of infection prior to vaccination, taking the total number to 58 (7.6%). There was no significant difference in SARS-CoV-2 PCR positive test rates based on type of anti-cancer treatment. Mortality proportion was similar between those who died within 90 days of a positive SARS-CoV-2 PCR and those with no positive PCR (10.4% vs 10.6%). Death from all causes was lowest among vaccinated patients, and of the patients who had a positive SARS-CoV-2 PCR at any time, all of those who died during the study period were unvaccinated. Multivariate analysis correcting for age, gender, socioeconomic status, comorbidities and number of previous medications revealed that vaccination was associated with a significantly lower infection rate regardless of treatment with chemotherapy or immunotherapy with hazard ratios of 0.307 (95% CI 0.144-0.6548) or 0.314 (95% CI 0.041-2.367) in vaccinated patients respectively. Where antibody data was available, 96.3% of patients successfully raised SARS-CoV-2 antibodies at a time point after vaccination. This was unaffected by treatment type.ConclusionSCCAMP provides real-world evidence that patients with cancer undergoing SACT have a high antibody response and protection from SARS-CoV-2 infection following COVID-19 vaccination.Highlights-The SCCAMP dataset represents the largest longitudinal study of patients with cancer undergoing anti-cancer treatment during the COVID-19 pandemic-Rates of infection in the cancer cohort mirrored those of the local age adjusted population-Vaccination was effective in patients with cancer undergoing active treatment in terms of antibody response and SARS-CoV-2 PCR rates-Treatment type did not impact the rate of SARS-CoV-2 antibody response

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Section: Introductionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Scottish COVID CAncer iMmunity Prevalence (SCCAMP) - a longitudinal study of patients with cancer receiving active anti-cancer treatment during the COVID-19 pandemic

Purshouse

Thomson

Vallet

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…Given that the level of neutralizing antibody titers have been shown to be highly correlated with immune protection, 7 these findings support the use of booster doses, with prioritization for specific, vulnerable populations, in particular those with a history of malignancy, as other studies suggest. 32,33…”

Section: Discussionmentioning

confidence: 99%

Clinical Variables Correlate with Serum Neutralizing Antibody Titers after COVID-19 mRNA Vaccination in an Adult, US-based Population

Zhao¹,

Slotkin²,

Sheth³

et al. 2022

Preprint

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Background: We studied whether comorbid conditions impact strength and duration of immune responses after SARS-CoV-2 mRNA vaccination in a US-based, adult population. Methods: Sera (pre-and-post-BNT162b2 vaccination) were tested serially up to 6 months after two doses of vaccine for SARS-CoV-2-anti-Spike neutralizing capacity by pseudotyping assay in 91 Veterans and 33 healthcare workers; neutralizing titers were correlated to clinical variables with multivariate regression. In 36 participants, post-booster effect was measured. Results: After completion of the primary vaccine series, neutralizing antibody IC-50 titers were high at one month (14-fold increase from pre-vaccination), declined at six months (3.3-fold increase), and increased at one month post-booster (52.5-fold increase). Age >65 years (β=-0.94, p=0.001) and malignancy (β=-0.88, p=0.002) significantly reduced strength of response at 1 month. Both strength and durability of response at 6 months, respectively, were negatively impacted by end-stage renal disease [(β=-1.10, p=0.004); (β=-0.66, p=0.014)], diabetes mellitus [(β=-0.57, p=0.032); (β=-0.44, p=0.028)], and systemic steroid use [(β=-0.066, p=0.032); (β=-0.55, p=0.037)]. Interestingly, the booster neutralizing antibody titer response was unaffected by clinical factors. Conclusion: Multiple clinical factors impacted the strength and duration of post-vaccination serum neutralizing antibodies in this adult population. Response to the booster dose was universally robust, however. This suggests that the antibody response to the booster dose benefits from a sustained and effective anti-Spike memory immune response.

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“…Recent systematic reviews suggest that active cancer treatment, particularly anti-CD20 therapy, is associated with lower vaccination response. 22 , 23 We wanted to gain further insight by conducting this retrospective analysis. To our knowledge, this is the largest series with a specific focus on COVID-19 in MCL.…”

Section: Introductionmentioning

confidence: 99%

Outcome of COVID-19 in Patients With Mantle Cell Lymphoma—Report From the European MCL Registry

et al. 2022

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Data on outcome of patients with mantle cell lymphoma (MCL) and COVID-19 infection are limited. The European MCL (EMCL) registry is a centralized registry of the EMCL network, collecting real-world information about treatments and disease courses. During the COVID-19 pandemic, additional data on MCL patients with COVID-19 infection were collected, aiming to identify risk factors for mortality from COVID-19. In our retrospective, multicenter, international study, we collected data from 63 MCL patients with a median age of 64 years (range, 44–84) in 9 countries with evidence of a COVID-19 infection between February 2020 and October 2021. The overall mortality rate was high (44.4%), especially in hospitalized patients (61%) and in patients with need for intensive care unit care (94%). Patients receiving rituximab had significantly poorer survival than patients not receiving rituximab (P = 0.04). Our data highlight the importance of prevention strategies and underline the need for effective vaccination in this vulnerable cohort.

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Antibody Responses to COVID-19 Vaccination in Cancer: A Systematic Review

Cited by 25 publications

References 81 publications

Scottish COVID CAncer iMmunity Prevalence (SCCAMP) - a longitudinal study of patients with cancer receiving active anti-cancer treatment during the COVID-19 pandemic

Scottish COVID CAncer iMmunity Prevalence (SCCAMP) - a longitudinal study of patients with cancer receiving active anti-cancer treatment during the COVID-19 pandemic

Clinical Variables Correlate with Serum Neutralizing Antibody Titers after COVID-19 mRNA Vaccination in an Adult, US-based Population

Outcome of COVID-19 in Patients With Mantle Cell Lymphoma—Report From the European MCL Registry

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