SARS-CoV-2 Neutralizing Antibodies Kinetics Postvaccination in Cancer Patients under Treatment with Immune Checkpoint Inhibition

Abstract

Considering that COVID-19 could adversely affect cancer patients, several countries have prioritized this highly susceptible population for vaccination. Thus, rapidly generating evidence on the efficacy of SARS-CoV-2 vaccination in the subset of patients with cancer under active therapy is of paramount importance. From this perspective, we launched the present prospective observational study to comprehensively address the longitudinal dynamics of immunogenicity of both messenger RNA (mRNA) and viral vector-based vaccines in 85 patients treated with immune checkpoint inhibitors (ICIs) for a broad range of solid tumors. Despite the relatively poor humoral responses following the priming vaccine inoculum, the seroconversion rates significantly increased after the second dose. Waning vaccine-based immunity was observed over the following six months, yet the administration of a third booster dose remarkably optimized antibody responses. Larger cohort studies providing real-world data with regard to vaccines effectiveness and durability of their protection among cancer patients receiving immunotherapy are an increasing priority.

Adult Patients with Cancer Have Impaired Humoral Responses to Complete and Booster COVID-19 Vaccination, Especially Those with Hematologic Cancer on Active Treatment: A Systematic Review and Meta-Analysis

“…In total, 60 studies were included for data analysis on booster COVID-19 vaccination, 43 studies reported on the immune response of a total of 4754 patients with a diagnosis of hematological malignancy, and 22 studies determined immune seroconversion in 2440 patients with solid tumors [ 78 , 79 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 ,…”

“… Pooled EffectSize (ES) for the immune seroconversion rates of patients with solid tumors after the second dose of COVID-19 vaccine. [ 7 , 15 , 17 , 18 , 20 , 22 , 23 , 24 , 25 , 28 , 35 , 36 , 37 , 38 , 39 , 40 , 40 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 52 , 53 , 54 , 55 , 57 , 58 , 59 , 60 , 61 , 63 , 66 , 67 , 68 , 69 , 71 , 72 , 74 , 80 , 81 , 82 , 85 , 86 ]. …”

BNT162b2 COVID-19 vaccination elicited protective robust immune responses in pediatric patients with inborn errors of metabolism

“…It has been suggested that this decline is related to decreased neutralizing antibody levels and may predict the need for booster vaccinations ( 28 ). Adult patients with concomitant diseases including chronic renal failure (hemodialysis and renal transplant), rheumatoid arthritis and solid malignancies have been found to have different neutralizing antibody levels other than healthy individuals, but no data are available for children ( 29 – 32 ). Best of our knowledge, assessment of humoral immune response by evaluating SARS-CoV-2 neutralizing antibodies in IEM patients has not been studied.…”

COVID-19 Vaccination Campaign in Cancer Patients and Healthcare Workers-Results from a French Prospective Multicenter Cohort (PAPESCO-19)

“…In a Greek experience, in CP treated with checkpoint inhibitors and vaccinated with the BNT162b2 or AZD1222 vaccines, despite a poor humoral response after the first injection, the seroconversion rate increased after full vaccination up to 73.5%. A steady decline in neutralizing antibodies was then noted over 6 months, corrected by a third booster dose [ 29 ]. In another series of 112 CPs, 44 receiving immune checkpoint inhibitors, levels of anti-SARS-CoV-2 antibodies decreased significantly, and this decrease was more pronounced in patients receiving immune check point inhibitors [ 30 ].…”