Evaluation of COVID-19 vaccine response in patients with cancer: An interim analysis

Abstract

Background Efficacy and safety data of COVID-19 vaccines among cancer populations have been limited; however, preliminary data from recent studies have emerged regarding their immunogenicity and safety in this population. In this review, we examined current peer-reviewed publications containing serological and safety data following COVID-19 vaccination of patients with cancer. Methods This analysis examined 21 studies with a total of 5,012 cancer patients, of which 2,676 (53%) had hematological malignancies, 2,309 (46%) had solid cancers, and 739 were healthy controls. Serological responses by anti-SARS-CoV-2 spike protein S1/S2 IgG (anti-S IgG) antibody levels and post-vaccination patient questionnaires regarding vaccine-related side effects following the first and second dose were collected and analyzed. Results In general, a single dose of COVID-19 vaccine yields weaker and heterogeneous serological responses in both patients with hematological and solid malignancies. Upon receiving a second dose, serological response rates indicate a substantial increase in seropositivity to the SARS-CoV-2 spike protein in all cancer cohorts, but antibody titers remain reduced in comparison to healthy controls. Furthermore, seroconversion in patients with hematological malignancies was significantly lower compared to patients with solid tumors. COVID-19 vaccines are safe and well-tolerated in cancer patients based on current data of local and systemic effects. Conclusion Together, these data support the prioritization of patients with cancer to receive their first and second doses to minimize the risk of COVID-19 infection and severe complications in this vulnerable population. Additional prophylactic measures must be considered for high-risk patients where current vaccination programs may not mount sufficient protection against SARS-CoV-2 infection.

Third dose of COVID‐19 vaccine restores immune response in patients with haematological malignancies after loss of protective antibody titres

“…Our data on two‐dose BNT162b2 vaccine efficacy for the whole cohort are similar to previously published results [median: 76% (40%–86%); n = 10] 6 . Our findings in the MM group are very similar to those of van Oekelen et al 7 .…”

“…Our data on two-dose BNT162b2 vaccine efficacy for the whole cohort are similar to previously published results [median: 76% (40%-86%); n = 10]. 6 Our findings in the MM group are very similar to those of van Oekelen et al 7 and numerically better than data published so far (Shah et al 8 , 61%; Terpos et al, 48% 9 ), which is likely due to the limited number of patients in all trials along with different antibody cut-off values for a positive response. Consequently, we saw a better response in patients on anti-CD38 therapy or with immunoparesis.…”

The national COVID-19 vaccination campaign targeting the extremely vulnerable: the Florence Medical Oncology Unit experience in patients with cancer

“…Only 1 of these patients required a short-term hospitalization for monitoring. This suggests great effectiveness and protection obtained with mRNA vaccines in cancer patients, and the result is aligned with current literature 29 . In a recent phase 3 randomized trial the usefulness of the mRNA-1273 vaccine was pointed up showing 94.1% efficacy at preventing COVID-19 disease, both asymptomatic and severe one 30 .…”

Third dose of anti-SARS-CoV-2 vaccine for patients with cancer: Should humoral responses be monitored? A position article

“…From end April 2021 onwards, vaccine efficacy studies conducted among patients with cancer were published ( 6 , 7 ), these patients having been excluded from registration trials without any initial efficacy data. Around the same time, first comparative data focused on humoral and cellular vaccine responses in patients with solid cancer and HM were published ( 8 ), and many publications have recently been reviewed ( 24 , 25 , 26 ).…”