Humoral and cellular immune responses in SARS-CoV-2 mRNA-vaccinated patients with cancer

Mairhofer, Mario; Kausche, Lea; Kaltenbrunner, Sabine; Ghanem, R; Stegemann, Maike; Klein, Katharina; Pammer, Maria; Rauscher, Isabella; Salzer, H.; Doppler, Stefan; Habringer, Anna; Paar, Christian; Kimeswenger, Susanne; Hoetzenecker, Wolfram; Lamprecht, Bernd; Lee, Soyoung; Schmitt, Clemens A.

doi:10.1016/j.ccell.2021.08.001

Cited by 57 publications

(49 citation statements)

References 9 publications

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“…T cell responses to vaccination against COVID-19, defined as IFNγ release 65 , 66 , 125 , combined IFNγ and IL-2 release 102 , 110 , or flow cytometric analysis of cellular activation-induced markers 126 , are detectable in 46–79% of patients with solid tumours. In contrast to individuals without cancer, these patients often have discordant antibody and cellular responses 65 , 102 , 110 , 126 . Overall, establishing risk factors for poor T cell responses to vaccination is more challenging than for antibody responses.…”

Section: Vaccination In Patients With Cancermentioning

confidence: 99%

“…Secondly, T cell responses have often been assessed in subsets of patients, such as those with no seroconversion, thereby limiting the ability to detect less overt risk factors. Nevertheless, receiving treatment for cancer 110 , 126 , chemotherapy 102 or steroids within 15 days of vaccination 102 has been associated with reduced T cell responses to vaccination. Although reduced in patients receiving chemotherapy, T cells are detectable in the absence of antibody responses in patients receiving chemotherapy or immune checkpoint inhibitors 66 .…”

Section: Vaccination In Patients With Cancermentioning

confidence: 99%

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COVID-19 vaccines in patients with cancer: immunogenicity, efficacy and safety

et al. 2022

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Patients with cancer have a higher risk of severe coronavirus disease (COVID-19) and associated mortality than the general population. Owing to this increased risk, patients with cancer have been prioritized for COVID-19 vaccination globally, for both primary and booster vaccinations. However, given that these patients were not included in the pivotal clinical trials, considerable uncertainty remains regarding vaccine efficacy, and the extent of humoral and cellular immune responses in these patients, as well as the risks of vaccine-related adverse events. In this Review, we summarize the current knowledge generated in studies conducted since COVID-19 vaccines first became available. We also highlight critical points that might affect vaccine efficacy in patients with cancer in the future.

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Section: Vaccination In Patients With Cancermentioning

confidence: 99%

Section: Vaccination In Patients With Cancermentioning

confidence: 99%

COVID-19 vaccines in patients with cancer: immunogenicity, efficacy and safety

et al. 2022

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“…Whereas in the majority of immunocompetent patients the humoral and the T cell vaccine response correlated well, in B cell depleted patients a drastically reduced antibody response was observed, while about a third of these patients still had specific T cells. In contrast, patients after HCT showed a more pronounced reduction in T cellular response whilst preserving the antibody response [8,29,31,32,[60][61][62]. Relevant factors impacting T cell vaccine-induced immune response beyond humoral response and vice versa are yet to be determined in studies of larger sample sizes.…”

Section: Cellular Responses Induced By Nucleic Acid Vaccinesmentioning

confidence: 98%

“…The latter was shown to be impaired in many patients with solid cancer (46%) in a recent observation [31]. Although more recent studies describe higher rates (up to 89.5%) of achieved vaccine-induced cellular responses, they also describe substantially reduced magnitudes of vaccine-induced antibody and T cell responses in patients with cancer compared to healthy individuals [34,61]. Depending on the underlying disease and type of treatment, cancer patients also exhibited discordant immune responses and may have a T cell response even if failing seroconversion.…”

Section: Solid Malignanciesmentioning

confidence: 99%

“…Agammaglobulinemia patients were shown to recover from COVID-19 without adequate serological responses, suggesting a T cell response to be sufficient for recovery from disease and even for mounting protection from infection [99,100]. An undetectable B cell and reduced T cell response in many hematological patients (ranging from 34.2 to 79.0%) compared to healthy controls or solid tumor patients has so far been reported [31,61,62,101,102]. Age (>65 years), active disease, immunosuppressive treatment for GvHD, and lymphopenia were associated with impaired cellular response.…”

Section: Patients With Hematological Malignanciesmentioning

confidence: 99%

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Cellular Immune Response after Vaccination in Patients with Cancer—Review on Past and Present Experiences

et al. 2022

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Patients with cancer are at particular risk for infection but also have diminished vaccine responses, usually quantified by the level of specific antibodies. Nonetheless, vaccines are specifically recommended in this vulnerable patient group. Here, we discuss the cellular part of the vaccine response in patients with cancer. We summarize the experience with vaccines prior to and during the SARS-CoV-2 pandemic in different subgroups, and we discuss why, especially in patients with cancer, T cells may be the more reliable correlate of protection. Finally, we provide a brief outlook on options to improve the cellular response to vaccines.

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Humoral Immune Response in Hematooncological Patients and Health Care Workers Who Received SARS-CoV-2 Vaccinations

et al. 2022

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IMPORTANCETo our knowledge, little is known about antibody development after SARS-CoV-2 vaccination in immunocompromised individuals, such as patients with cancer.OBJECTIVE To determine whether hematooncological patients develop anti-SARS-CoV-2 antibodies after vaccination. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study included 2 independent cohorts of patients who were treated for hematological and solid malignant tumors between October 2020 and May 2021, comprising 901 samples from 595 patients and 58 health care workers (HCWs). Serum samples were collected from patients who were treated at an academic center and a community hospital in a rural area and a control group of HCWs, all of whom received SARS-CoV-2 vaccination. MAIN OUTCOMES AND MEASURESTotal anti-SARS-CoV-2 nucleocapsid (anti-NC) and antispike protein (anti-S) antibodies were measured retrospectively. RESULTS In total, 595 patients (320 women [53.8%] and 275 men [46.2%]; median [range] age, 67 [19-96] years) and 58 HCWs (40 women [69.0%] and 18 men [31.0%]; median [range] age, 42 [24-60] years) were included. Previous SARS-CoV-2 infection was documented in 43 of 595 (7.2%), while anti-NC antibodies that suggested previous infections were observed in 49 of 573 evaluable patients (8.6%). In both cohorts, anti-S antibody levels were higher in fully vaccinated patients compared with patients who received 1 dose. After the first vaccination, patients with hematological cancer who received B cell-targeting agents had lower anti-S levels (median, 1.6 AU/mL; range: 0-17 244 AU/mL) than patients who received other therapies (median, 191.6 AU/mL; range, 0-40 000; P < .001) or patients with solid tumors (median, 246.4 AU/mL; range, 0-40 000 AU/mL; P < .001). Anti-S levels after the first vaccination differed according to ongoing antineoplastic treatment modalities, with the lowest median levels in patients who received chemotherapy alone (157.7 AU/mL; range, 0-40 000 AU/mL) or in combination with immunotherapy (118.7 AU/mL; range, 14.1-38 727 AU/mL) and the highest levels in patients with no ongoing antineoplastic treatment (median, 634.3 AU/mL; range, 0-40 000 AU/mL; P = .01). Antibody levels after full immunization were higher in HCWs (median, 2500 U/mL; range, 485-2500 U/mL) than in patients with cancer (median, 117.0 U/mL; range, 0-2500 U/mL; P < .001). CONCLUSIONS AND RELEVANCEIn this cohort study of patients with hematooncological diseases and a control group of HCWs, anti-SARS-CoV-2 antibodies after vaccination could be detected in patients with cancer. Lower antibody levels compared with HCWs and differences in seroconversion in specific subgroups underscore the need for further studies on SARS-CoV-2 vaccination in patients with hematooncological disease.

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Humoral and cellular immune responses in SARS-CoV-2 mRNA-vaccinated patients with cancer

Cited by 57 publications

References 9 publications

COVID-19 vaccines in patients with cancer: immunogenicity, efficacy and safety

COVID-19 vaccines in patients with cancer: immunogenicity, efficacy and safety

Cellular Immune Response after Vaccination in Patients with Cancer—Review on Past and Present Experiences

Humoral Immune Response in Hematooncological Patients and Health Care Workers Who Received SARS-CoV-2 Vaccinations

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