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REDUCED HUMORAL IMMUNE RESPONSE AFTER BNT162B2 COVID-19 MRNA VACCINATION IN CANCER PATIENTS UNDER ANTI-NEOPLASTIC TREATMENT
- Source :
- ESMO Open
- Publication Year :
- 2021
- Publisher :
- Published by Elsevier Ltd on behalf of European Society for Medical Oncology., 2021.
-
Abstract
- Background: Cancer patients are at a higher risk of developing severe coronavirus disease 2019 (COVID-19). However, the safety and efficacy of COVID-19 vaccination in cancer patients undergoing treatment remain unclear. Patients and methods: In this interventional prospective multicohort study, priming and booster doses of the BNT162b2 COVID-19 vaccine were administered 21 days apart to solid tumor patients receiving chemotherapy, immunotherapy, targeted or hormonal therapy, and patients with a hematologic malignancy receiving rituximab or after allogeneic hematopoietic stem cell transplantation. Vaccine safety and efficacy (until 3 months post-booster) were assessed. Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor-binding domain (RBD) antibody levels were followed over time (until 28 days after the booster) and in vitro SARS-CoV-2 50% neutralization titers (NT50) toward the wild-type Wuhan strain were analyzed 28 days after the booster. Results: Local and systemic adverse events (AEs) were mostly mild to moderate (only 1%-3% of patients experienced severe AEs). Local, but not systemic, AEs occurred more frequently after the booster dose. Twenty-eight days after the booster vaccination of 197 cancer patients, RBD-binding antibody titers and NT50 were lower in the chemotherapy group {234.05 IU/ml [95% confidence interval (CI) 122.10-448.66] and 24.54 (95% CI 14.50-41.52), respectively} compared with healthy individuals [1844.93 IU/ml (95% CI 1383.57-2460.14) and 122.63 (95% CI 76.85-195.67), respectively], irrespective of timing of vaccination during chemotherapy cycles. Extremely low antibody responses were seen in hematology patients receiving rituximab; only two patients had RBD-binding antibody titers necessary for 50% protection against symptomatic SARS-CoV-2 infection (
- Subjects :
- safety
Cancer Research
medicine.medical_specialty
COVID-19 Vaccines
medicine.medical_treatment
Antineoplastic Agents
Hematopoietic stem cell transplantation
Booster dose
Gastroenterology
Internal medicine
Neoplasms
medicine
Humans
cancer
Prospective Studies
RNA, Messenger
Adverse effect
BNT162 Vaccine
Original Research
Chemotherapy
anti-RBD IgG antibody response
business.industry
SARS-CoV-2
Vaccination
Antibody titer
Cancer
COVID-19
medicine.disease
Immunity, Humoral
BNT162b2 COVID-19 vaccination
Oncology
Rituximab
Human medicine
business
Anti-neoplastic treatment
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 20597029
- Database :
- OpenAIRE
- Journal :
- ESMO Open
- Accession number :
- edsair.doi.dedup.....c1cb951a408750e52aac9f6e2d13cad7