Predictors of Poor Seroconversion and Adverse Events to SARS-CoV-2 mRNA BNT162b2 Vaccine in Cancer Patients on Active Treatment

Webber, Tania Buttiron; Provinciali, Nicoletta; Musso, Marco; Ugolini, Martina; Boitano, Monica; Clavarezza, Matteo; D’Amico, Mauro; Defferrari, Carlotta; Gozza, Alberto; Briata, Irene Maria; Magnani, Monica; Paciolla, Fortuna; Menghini, Nadia; Marcenaro, Emanuela; Sacchi, Nicoletta; Innocenti, Leonello; Siri, Giacomo; D’Ecclesiis, Oriana; Cevasco, Isabella; Gandini, Sara; Decensi, Andrea

doi:10.2139/ssrn.3901796

Cited by 3 publications

(6 citation statements)

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“…Several studies reported that cytotoxic agents reduce the immunogenicity of COVID-19 vaccines in patients with solid cancer. 14, 25, 28-30 Consistent with the results of prior studies, in this study, the OR for seroprotection at cutoff values of ≥ 1,084 AU/mL for Architect and ≥ 150 U/mL for Elecsys after two vaccination doses was significantly decreased in lung cancer patients undergoing treatment with cytotoxic agents. Additionally, there are limited data on whether TKIs affect the immunogenicity of COVID-19 vaccines.…”

Section: Discussionsupporting

confidence: 89%

Immunogenicity and safety of COVID-19 vaccine in lung cancer patients receiving anticancer treatment: A prospective multicenter cohort study

Nakashima¹,

Ishida

Matsui

et al. 2022

Preprint

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Introduction: This study assessed the immunogenicity and safety of BNT162b2 mRNA vaccine in lung cancer patients receiving anticancer treatment using two immunoassays. Methods: We enrolled lung cancer patients receiving anticancer treatment and non-cancer patients with chronic diseases; all participants were fully vaccinated with the BNT162b2 vaccine. Blood samples were collected before the first and second vaccinations and 4 ± 1 weeks after the second vaccination. Anti-acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spike protein S1 subunit receptor-binding domain antibody titers were measured using the Architect SARS-CoV-2 IgG II Quant (Abbott Laboratory) and Elecsys Anti-SARS-CoV-2 S (Roche Diagnostics). Results: Fifty-five lung cancer patients and 38 non-cancer patients were included in the immunogenicity analysis. Lung cancer patients showed significant increase in the geometric mean antibody titer, which was significantly lower than that in the non-cancer patients after the first (30 vs. 121 AU/mL, p<0.001 on Architect; 4.0 vs 1.2 U/mL, p<0.001, on Elecsys) and second vaccinations (1632 vs. 3472 AU/mL, p=0.005, on Architect; 213 vs 573 A/mL, p=0.002, on Elecsys). The adjusted odds ratio (OR) for seroprotection was significantly lower in the lung cancer patients. Analysis of the anticancer treatment types showed that the adjusted OR for seroprotection was significantly lower in lung cancer patients receiving cytotoxic agents. Lung cancer patients showed no increase in the number of adverse reactions. Conclusions: BNT162b2 vaccination in lung cancer patients undergoing anticancer treatment significantly increased antibody titers and showed acceptable safety. However, the immunogenicity in these patients could be inadequate compared with that in non-cancer patients.

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Section: Discussionsupporting

confidence: 89%

Immunogenicity and safety of COVID-19 vaccine in lung cancer patients receiving anticancer treatment: A prospective multicenter cohort study

Nakashima¹,

Ishida

Matsui

et al. 2022

Preprint

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“…Patients with solid tumours Metastatic disease 124 Advanced age 65 , 99 , 103 , 127 , 224 Male sex 99 , 103 …”

Section: Covid-19 Vaccinesmentioning

confidence: 99%

“…Relevant reduction in antibody response possible (<50% of patients, probably dependent on dosing) Chemotherapy b, 99 , 100 , 105 , 106 , 121 , 154 , 224 , 231 , 246 Steroids 122 , 124 , 125 , 131 , 160 , 228 CDK4/6 inhibitors associated with lower binding antibody levels (not a risk factor in ref. 247 , a risk factor in ref.…”

Section: Vaccination In Patients With Cancermentioning

confidence: 99%

“…Relevant reduction in antibody response uncommon c Endocrine therapy 100 , 120 , 129 , 248 Tyrosine kinase inhibitors 69 , 106 , 231 Immune checkpoint inhibitors (reduced immune response may occur in approximately 10% of patients) 66 , 100 , 105 , 106 , 120 , 224 , 249 Immunomodulatory drugs 163 , 231 , 239 Proteasome inhibitors 163 , 231 …”

Section: Vaccination In Patients With Cancermentioning

confidence: 99%

“…Immune checkpoint inhibitors (reduced immune response may occur in approximately 10% of patients) 66 , 100 , 105 , 106 , 120 , 224 , 249 …”

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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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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Predictors of Poor Seroconversion and Adverse Events to SARS-CoV-2 mRNA BNT162b2 Vaccine in Cancer Patients on Active Treatment

Cited by 3 publications

References 0 publications

Immunogenicity and safety of COVID-19 vaccine in lung cancer patients receiving anticancer treatment: A prospective multicenter cohort study

Immunogenicity and safety of COVID-19 vaccine in lung cancer patients receiving anticancer treatment: A prospective multicenter cohort study

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

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

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