Immunogenicity and Safety of the Coronavac Vaccine in Patients with Cancer Receiving Active Systemic Therapy

Abstract

Aim: To evaluate the immunogenicity and safety of the CoronaVac vaccine in patients with cancer receiving active systemic therapy. Methods: This multicenter, prospective, observational study was conducted with 47 patients receiving active systemic therapy for cancer. CoronaVac was administered as two doses (3 μg/day) on days 0 and 28. Antibody level higher than 1 IU/ml was defined as ‘immunogenicity.’ Results: The immunogenicity rate was 63.8% (30/47) in the entire patient group, 59.5% (25/42) in those receiving at least one cytotoxic drug and 100% (five of five) in those receiving monoclonal antibody or immunotherapy alone. Age was an independent predictive factor for immunogenicity (odds ratio: 0.830; p = 0.043). Conclusion: More than half of cancer patients receiving active systemic therapy developed immunogenicity.

Immunogenicity and risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection after Coronavirus Disease 2019 (COVID-19) vaccination in patients with cancer: a systematic review and meta-analysis

“…Growing evidence suggests that among cancer patients, those with hematologic malignancies are less likely to develop robust anti-S IgG after SARS-CoV-2 vaccination due to immunosuppression induced by disease-related lineage defects and its treatments. [ 3 , 17 , 35 , 36 ] Consistently, when stratifying by type of cancer, we observed that patients with hematological malignancies had the highest risk of being non-responders after complete COVID-19 vaccination. Furthermore, oncologic regimens based on monoclonal antibodies (anti-CD20, anti-CD38), Bruton tyrosine kinase-, Bcl-2-, Janus Kinase 1/2- inhibitors, and chimeric antigen receptor T-cell therapy have been associated with lower seroconversion rates.…”

“…Following title and abstract review, 1,233 records were excluded given that they reported non-original findings, did not include cancer patients, or did not assess COVID-19 vaccines’ immunogenicity. Of the 54 articles that underwent full-text review, 35 articles[ [17] , [18] , [19] , [20] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] ] were considered eligible and were included in the meta-analysis ( Figure 1 ).

Figure 1 The PRISMA flowchart summarizing the process for the identification of eligible studies.

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“…Of the included 35 studies, 20 reported the seroconversion rate in cancer patients after partial COVID-19 immunization (2574 patients)[ 17 , 20 , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , 37 , [42] , [43] , [44] , [47] , [48] , [49] , [50] , [51] , [52] ] and 24 after complete vaccination schemes (4708 patients). [ [17] , [18] , [19] , [20] , 27 , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , 45 , 46 , 48 , 49 , 53 , 54 ] A lower seroconversion rate was achieved by those with incomplete vaccination regimens (51%; 95%CI 41-62) compared to those with fully immunized patients (73%; 95%CI 64-81) ( P =0.0009) ( Figure 2 ).

Figure 2 Rates of seroconversion in patients with cancer according to vaccination regimen.

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“…Although new evidence from the VOICE and CAPTURE trials have shown that chemotherapy was not a significant predictor for suboptimal immunogenicity in patients with solid tumors[ 58 , 59 ], numerous studies have documented the potential detrimental impact that chemotherapy could have in seroconversion rates after COVID-19 immunization in patients with cancer. [ 17 , 18 , 20 , 25 , 30 , 33 , 35 , 38 , 41 , 46 , 54 ] Further studies with sufficient statistical power to evaluate the influence of different oncologic treatments on COVID-19 vaccine immunogenicity among patients with solid and hematologic malignancies are warranted.…”

Immunological and clinical efficacy of COVID-19 vaccines in immunocompromised populations: a systematic review

“…The vast majority of included studies evaluated vaccines developed by Pfizer (BNT162b2) or Moderna (mRNA-1273). Thirteen studies included patients who received the vaccine developed by Janssen (Ad26.COV2.S) [ [25] , [26] , [27] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] ], nine included patients vaccinated with the AstraZeneca vaccine (ChAdOx1) [ [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] ], three included patients receiving the CoronaVac vaccine (Sinovac Biotech) [ [50] , [51] , [52] ], and one randomized controlled trial evaluated the vaccine developed by Novavax (NVX-CoV2373) vaccine [ 53 ]. One study included patients receiving the BBV152-Covaxin (Bharat Biotech) vaccine [ 44 ] and one included patients receiving the BBIBP-CorV (Sinopharm) vaccine [ 54 ].…”