Immune Response and Effects of COVID-19 Vaccination in Patients with Lung Cancer—COVID Lung Vaccine Study

Abstract

Lung cancer patients represent a subgroup of special vulnerability in whom the SARS-CoV-2 infection could attain higher rates of morbidity and mortality. Therefore, those patients were recommended to receive SARS-CoV-2 vaccines once they were approved. However, little was known at that time regarding the degree of immunity developed after vaccination or vaccine-related adverse events, and more uncertainty involved the real need for a third dose. We sought to evaluate the immune response developed after vaccination, as well as the safety and efficacy of SARS-CoV-2 vaccines in a cohort of patients with lung cancer. Patients were identified through the Oncology/Hematology Outpatient Vaccination Program. Anti-Spike IgG was measured before any vaccine and at 3–6-, 6–9- and 12–15-month time points after the 2nd dose. Detailed clinical data were also collected. In total, 126 patients with lung cancer participated and received at least one dose of the SARS-CoV-2 vaccine. At 3–6 months after 2nd dose, 99.1% of baseline seronegative patients seroconverted and anti-Spike IgG titers went from a median value of 9.45 to 720 UI/mL. At the 6–9-month time point, titers raised to a median value of 924 UI/mL, and at 12–15 months, after the boost dose, they reached a median value of 3064 UI/mL. Adverse events to the vaccine were mild, and no SARS- CoV-2 infection-related deaths were recorded. In this lung cancer cohort, COVID-19 vaccines were safe and effective irrespective of the systemic anticancer therapy. Most of the patients developed anti-Spike IgG after the second dose, and these titers were maintained over time with low infection and reinfection rates with a mild clinical course.

Serological Response to SARS-CoV-2 after COVID-19 Vaccination in Lung Cancer patients: Short Review

“…IgG titers were maintained over time with low infection and reinfection rates with a mild clinical course. None of the reports by Valanparambil et al [33], Mack et al [32], and Hernandez et al [28] observed differences in serologic responses as a result of cancer treatment in LC patients, but with significant heterogeneity in treatment modalities, were not necessarily powered to do so.…”

“…Seven studies included healthy controls (HC) in the study cohorts while two studies [4,28] did not employ controls. Overall, after primary dose vaccination, patients with lung cancer showed lower seropositivity rates compared to healthy controls, and in some cases, a suboptimal response to the vaccine was observed in a certain percentage of lung cancer patients.…”

“…It has also been shown that additional booster doses of the COVID-19 vaccination can improve on the inferior immunological effectiveness of the primary doses in patients with lung cancer. Five studies reported seroconversion rates (defined as the proportion of vaccine recipients whose blood titers for SARS-CoV-2 vaccine antibodies were higher than the test-specific lower limit cutoff value) of LC or thoracic cancer patients, at 93.7% [29], 95.2% [4,30], 98% [30], 99.1% [28], and 96.7% [31,32]. Mack et al [32] reported that LC patient Ab titers had a significantly reduced area under the curve per day compared to control antibody titers.…”

Add fuel to the fire: Inflammation and immune response in lung cancer combined with COVID-19

“…In addition, a study found that during anti-CTLA4 and anti-PD-1 combination immunotherapy, a lung cancer patient developed cytokine release syndrome due to a new crown vaccination, elevated cytokine levels (IL-6, IL-10, and IFN-g), and grade 2 liver and kidney dysfunction (93). However, Hernandez et al (94) believe that the COVID-19 vaccine is safe for patients with lung cancer, and most patients can generate immunity after the first and second doses, reducing the risk of infection.…”

“…However, Hernandez et al. ( 94 ) believe that the COVID-19 vaccine is safe for patients with lung cancer, and most patients can generate immunity after the first and second doses, reducing the risk of infection.…”