Humoral and cellular immunity to delayed second dose of SARS-CoV-2 BNT162b2 mRNA vaccination in patients with cancer

McKenzie, Duncan R.; Muñoz-Ruiz, Miguel; Monin, Leticia; Alaguthurai, Thanussuyah; Lechmere, Thomas; Abdul-Jawad, Sultan; Graham, Carl; Pollock, Emily; Graham, Rosalind; Sychowska, Kamila; Tremain, Catherine; Gousis, Charalampos; Domingo‐Vila, Clara; Cooper, Jack; Vidler, Jennifer; Owczarczyk, K.; Swampillai, Angela; Kristeleit, Hartmut; Malim, Michael H.; Fields, Paul; Patten, Piers; Papa, Sophie; North, Bernard; Tree, Timothy; Doores, Katie J.; Hayday, Adrian; Irshad, Sheeba

doi:10.1016/j.ccell.2021.10.003

Cited by 33 publications

(45 citation statements)

References 6 publications

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“…Most studies investigating COVID-19 vaccination in patients with cancer only assessed the presence of spike-reactive or RBD-reactive antibodies, although some have additionally performed neutralizing assays, including against VOCs 65 , 66 , 99 – 102 . T cell responses have been addressed in fewer studies and often in smaller subsets, and therefore additional research is needed to validate the observed effects.…”

Section: Vaccination In Patients With Cancermentioning

confidence: 99%

“…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%

See 2 more Smart Citations

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%

Section: Vaccination In Patients With Cancermentioning

confidence: 99%

See 1 more Smart Citation

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: 99%

“…Consequently, limitations in vaccine efficacy and immunogenicity are to be expected. However, while many studies report on the humoral responses to vaccination, much less is known about individual vaccine induced cell-based responses in immunocompromised patients [29,[31][32][33][34]. Notably, recent publications suggest an important role for T cells [35][36][37][38], although the extent depends on the underlying disease and treatment.…”

Section: Overview Of Vaccines Used In Cancer Patientsmentioning

confidence: 99%

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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Impaired serological response to COVID‐19 vaccination following anticancer therapy: A systematic review and meta‐analysis

Tang

Wei

2022

Journal of Medical Virology

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Owing to the high coronavirus disease 2019 (COVID‐19)‐related morbidity and fatality rate among patients with cancer, the introduction of COVID‐19 vaccines is of profound significance in this fragile population. Accumulating data suggested that oncologic patients, especially those with anticancer therapy have an impaired immune response to COVID‐19 vaccination. However, the exact effect of anticancer treatments on postvaccination response has not been elucidated yet. We, therefore, conducted a meta‐analysis to evaluate the impact of treatments on response to COVID‐19 vaccination in patients with cancer. A total of 39 studies were finally included comprising 11 075 oncologic patients. Overall, we found the humoral response was significantly decreased in patients undergoing anticancer treatments (odds ratio [OR] = 2.55, 95% confidence interval [CI]: 2.04–3.18) compared with those without active treatment. The seroconversion rates were significantly lower in patients with chemotherapy (OR = 3.04, 95% CI: 2.28–4.05), targeted therapy (OR = 4.72, 95% CI: 3.18–7.01) and steroid usage (OR = 2.19, 95% CI: 1.57–3.07), while there was no significant association between immunotherapy or hormonal therapy and seroconversion after vaccination. Subgroup analyses showed therapies with anti‐CD20 antibody (OR = 11.28, 95% CI: 6.40–19.90), B‐cell lymphoma 2 inhibitor (OR = 5.76, 95% CI: 3.64–9.10), and Bruton tyrosine kinase inhibitor (OR = 6.86, 95% CI: 4.23–11.15) were significantly correlated with the risk of negative humoral response to vaccination. In conclusion, our results demonstrated that specific oncologic therapies may significantly affect serological response to COVID‐19 vaccines in patients with cancer. Thus, an adapted vaccination strategy taking the influence of active treatment into account is in need, and further research on the effect of the third dose of vaccine and the role of postvaccination cellular response in oncologic patients is also needed.

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Humoral and cellular immunity to delayed second dose of SARS-CoV-2 BNT162b2 mRNA vaccination in patients with cancer

Cited by 33 publications

References 6 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

Impaired serological response to COVID‐19 vaccination following anticancer therapy: A systematic review and meta‐analysis

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