“…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.…”
Section: Resultsmentioning
confidence: 99%
“…of cancer patients No. of controls Patients’ age (years) Type of cancer Vaccine type Vaccine scheme Reported outcomes Addeo et al[ 17 ] Switzerland/USA Multicenter, prospective, cohort 244 NA 63 (IQR 55–69) Hematologic malignancy and solid tumor mRNA (BNT162b2/mRNA1273) Incomplete and complete Anti-S IgG Ab, adverse effects, SARS-CoV-2 infection Agha et al[ 41 ] USA Single-center, prospective, cohort 67 NA 71 (IQR 65-77) Hematologic malignancy mRNA (BNT162b2/mRNA1273) Complete Anti-S IgG Ab Barrière et al[ 42 ] France Single-center, prospective, cohort 122 29 69.5 (range 44-90) Solid tumor mRNA (BNT162b2) Incomplete and complete Anti-S IgG Ab, adverse effects Benda et al[ 37 ] Austria Single-center, prospective, cohort 259 NA 65.1 (SD 12.2) Hematologic malignancy and solid tumor mRNA (BNT162b2) Incomplete and complete Anti-S IgG Ab, adverse effects, SARS-CoV-2 infection Benjamini et al[ 53 ] Israel Multi-center, prospective, cohort 373 NA 70 (range 40-89) Hematologic malignancy mRNA (BNT162b2) Complete Anti-S IgG Ab, anti-N IgG Ab, adverse effects Bird et al[ 43 ] UK Single-center, retrospective, cohort 93 NA 67 (IQR 59-73) Hematologic malignancy mRNA (BNT162b2) and viral vector (AZD1222) Incomplete Anti-S IgG Ab Chowdhury et al[ …”
Section: Resultsmentioning
confidence: 99%
“…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 ).…”
BACKGROUND
Cancer patients are considered a priority group for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination given their high risk of contracting severe coronavirus disease 2019 (COVID-19). However, limited data exists regarding the efficacy of immunization in this population. In this study we assess the immunologic response after COVID-19 vaccination of cancer versus non-cancer population.
METHODS
PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases were searched from March 01, 2020, through August 12, 2021. Primary endpoints were anti-SARS-CoV-2 spike protein (S) immunoglobulin G (IgG) seroconversion rates, T-cell response, and documented SARS-CoV-2 infection after COVID-19 immunization. Data was extracted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Overall effects were pooled using random effects models.
RESULTS
This systematic review and meta-analysis included 35 original studies. Overall, 51% (95% confidence interval [CI], 41-62) and 73% (95%CI, 64-81) of cancer patients developed anti-S IgG above the threshold level after partial and complete immunization, respectively. Patients with hematologic malignancies had a significantly lower seroconversion rate than those with solid tumors after complete immunization (65% vs 94%;
P
<0.0001). Compared to non-cancer controls, oncological patients were less likely to attain seroconversion after incomplete (RR 0.45 [95%CI 0.35-0.58]) and complete (RR 0.69 [95%CI 0.56-0.84]) COVID-19 immunization schemes. Cancer patients had a higher likelihood of having a documented SARS-CoV-2 infection after partial (RR 3.21; 95%CI 0.35-29.04) and complete (RR 2.04; 95%CI 0.38-11.10) immunization.
CONCLUSIONS
Cancer patients have an impaired immune response to COVID-19 vaccination compared to controls. Strategies that endorse the completion of vaccination schemes are warranted. Future studies should aim to evaluate different approaches that enhance oncological patients’ immune response.
“…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.…”
Section: Resultsmentioning
confidence: 99%
“…of cancer patients No. of controls Patients’ age (years) Type of cancer Vaccine type Vaccine scheme Reported outcomes Addeo et al[ 17 ] Switzerland/USA Multicenter, prospective, cohort 244 NA 63 (IQR 55–69) Hematologic malignancy and solid tumor mRNA (BNT162b2/mRNA1273) Incomplete and complete Anti-S IgG Ab, adverse effects, SARS-CoV-2 infection Agha et al[ 41 ] USA Single-center, prospective, cohort 67 NA 71 (IQR 65-77) Hematologic malignancy mRNA (BNT162b2/mRNA1273) Complete Anti-S IgG Ab Barrière et al[ 42 ] France Single-center, prospective, cohort 122 29 69.5 (range 44-90) Solid tumor mRNA (BNT162b2) Incomplete and complete Anti-S IgG Ab, adverse effects Benda et al[ 37 ] Austria Single-center, prospective, cohort 259 NA 65.1 (SD 12.2) Hematologic malignancy and solid tumor mRNA (BNT162b2) Incomplete and complete Anti-S IgG Ab, adverse effects, SARS-CoV-2 infection Benjamini et al[ 53 ] Israel Multi-center, prospective, cohort 373 NA 70 (range 40-89) Hematologic malignancy mRNA (BNT162b2) Complete Anti-S IgG Ab, anti-N IgG Ab, adverse effects Bird et al[ 43 ] UK Single-center, retrospective, cohort 93 NA 67 (IQR 59-73) Hematologic malignancy mRNA (BNT162b2) and viral vector (AZD1222) Incomplete Anti-S IgG Ab Chowdhury et al[ …”
Section: Resultsmentioning
confidence: 99%
“…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 ).…”
BACKGROUND
Cancer patients are considered a priority group for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination given their high risk of contracting severe coronavirus disease 2019 (COVID-19). However, limited data exists regarding the efficacy of immunization in this population. In this study we assess the immunologic response after COVID-19 vaccination of cancer versus non-cancer population.
METHODS
PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases were searched from March 01, 2020, through August 12, 2021. Primary endpoints were anti-SARS-CoV-2 spike protein (S) immunoglobulin G (IgG) seroconversion rates, T-cell response, and documented SARS-CoV-2 infection after COVID-19 immunization. Data was extracted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Overall effects were pooled using random effects models.
RESULTS
This systematic review and meta-analysis included 35 original studies. Overall, 51% (95% confidence interval [CI], 41-62) and 73% (95%CI, 64-81) of cancer patients developed anti-S IgG above the threshold level after partial and complete immunization, respectively. Patients with hematologic malignancies had a significantly lower seroconversion rate than those with solid tumors after complete immunization (65% vs 94%;
P
<0.0001). Compared to non-cancer controls, oncological patients were less likely to attain seroconversion after incomplete (RR 0.45 [95%CI 0.35-0.58]) and complete (RR 0.69 [95%CI 0.56-0.84]) COVID-19 immunization schemes. Cancer patients had a higher likelihood of having a documented SARS-CoV-2 infection after partial (RR 3.21; 95%CI 0.35-29.04) and complete (RR 2.04; 95%CI 0.38-11.10) immunization.
CONCLUSIONS
Cancer patients have an impaired immune response to COVID-19 vaccination compared to controls. Strategies that endorse the completion of vaccination schemes are warranted. Future studies should aim to evaluate different approaches that enhance oncological patients’ immune response.
“…Single dose-response rates of BNT162b2 (Pfizer-BioNTech) were assessed in 13 studies [ [16] , [17] , [18] , [19] , [20] , [21] , 23 , 24 , [27] , [28] , [29] , [30] , 32 ], mRNA-1273 (Moderna) in four studies [ 16 , 24 , 30 , 32 ], AZD1222 (Oxford-AstraZeneca) in three studies [ 18 , 19 , 24 ], and Ad26.COV2.S (Janssen) in one study [ 33 ]. Of these, 12 studies classified their cancer patient cohorts (11 cohorts with hematological malignancies, of which three were primarily patients with multiple myeloma [MM], two of patients with myeloproliferative neoplasms [MPN], and one study containing patients with chronic myeloid neoplasms [CMN]; and five cohorts with solid tumors) in addition to seven studies with data from healthy control subjects.…”
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.
“…In a small cohort of MPN patients, those receiving treatment with peg.interferon had the highest serological response in comparison with ruxolitinib or hydroxyurea. Notably, only two-thirds of the patients not receiving cytoreduction seroconverted [ 150 ].…”
Section: Prevention Of Sars-cov2 Infection In Mpn Patients: What Vaccines To Use When and With What Precautions?mentioning
An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) started in December 2019 in China and then become pandemic in February 2020. Several publications investigated the possible increased rate of COVID-19 infection in hematological malignancies. Based on the published data, strategies for the management of chronic Philadelphia-negative chronic myeloproliferative neoplasms (MPNs) are provided. The risk of severe COVID-19 seems high in MPN, particularly in patients with essential thrombocythemia, but not negligible in myelofibrosis. MPN patients are at high risk of both thrombotic and hemorrhagic complications and this must be accounted in the case of COVID-19 deciding on a case-by-case basis. There are currently no data to suggest that hydroxyurea or interferon may influence the risk or severity of COVID-19 infection. Conversely, while the immunosuppressive activity of ruxolitinib might pose increased risk of infection, its abrupt discontinuation during COVID-19 syndrome is associated with worse outcome. All MPN patients should receive vaccine against COVID-19; reassuring data are available on efficacy of mRNA vaccines in MPNs.
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