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. 2021 Aug 9;39(8):1091-1098.e2.
doi: 10.1016/j.ccell.2021.06.009. Epub 2021 Jun 18.

Immunogenicity of SARS-CoV-2 messenger RNA vaccines in patients with cancer

Alfredo Addeo  1 , Pankil K Shah  2 , Natacha Bordry  3 , Robert D Hudson  2 , Brenna Albracht  2 , Mariagrazia Di Marco  3 , Virginia Kaklamani  2 , Pierre-Yves Dietrich  3 , Barbara S Taylor  4 , Pierre-Francois Simand  3 , Darpan Patel  2 , Jing Wang  2 , Intidhar Labidi-Galy  5 , Sara Fertani  3 , Robin J Leach  2 , Jose Sandoval  3 , Ruben Mesa  2 , Kate Lathrop  2 , Nicolas Mach  3 , Dimpy P Shah  6
Affiliations

Immunogenicity of SARS-CoV-2 messenger RNA vaccines in patients with cancer

Alfredo Addeo et al. Cancer Cell. .

Abstract

Patients with cancer experience a higher burden of SARS-CoV-2 infection, disease severity, complications, and mortality, than the general population. SARS-CoV-2 mRNA vaccines are highly effective in the general population; however, few data are available on their efficacy in patients with cancer. Using a prospective cohort, we assessed the seroconversion rates and anti-SARS-CoV-2 spike protein antibody titers following the first and second dose of BNT162b2 and mRNA-1273 SARS-CoV-2 vaccines in patients with cancer in US and Europe from January to April 2021. Among 131 patients, most (94%) achieved seroconversion after receipt of two vaccine doses. Seroconversion rates and antibody titers in patients with hematological malignancy were significantly lower than those with solid tumors. None of the patients with history of anti-CD-20 antibody in the 6 months before vaccination developed antibody response. Antibody titers were highest for clinical surveillance or endocrine therapy groups and lowest for cytotoxic chemotherapy or monoclonal antibody groups.

Keywords: COVID-19; anti-cancer treatment; antibody; immune response; malignancy; oncology; pandemic; seroconversion; tumor; vaccine.

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Conflict of interest statement

Declaration of interests A.A. reported receiving personal fees for attending advisory from Bristol-Myers Squibb, AstraZeneca, Roche, Pfizer, Merck Sharp and Dohme, Astella, Eli Lilly, and Boehringer Ingelheim and receiving fees for speaking bureau for Eli Lilly, AstraZeneca, Merck Sharp and Dohme for work performed outside of this study. P.S. reported receiving a grant from the Biomedical Advanced Research and Development Authority outside of this work. I.L.-G. reported receiving personal fees for attending advisory from AstraZeneca. N.M. is a founder and minority shareholder of MaxiVAX SA, a private biotech company based in Geneva, Switzerland, working on personalized cancer immunotherapy and infectious disease vaccines, with no impact on the current manuscript. R.M. reported receiving research support from Celgene, Incyte, Abbvie, Samus, Genotech, Promedior, and CTI; and consulting fees from Novartis, Sierra Onc, LaJolla, and Pharma. D.S. reported receiving a grant from the Biomedical Advanced Research and Development Authority outside of this work. All other co-authors reported no competing interests.

Figures

None
Graphical abstract
Figure 1
Figure 1
Differences in anti-SARS-CoV-2 S (anti-S) IgG titers following partial and complete vaccination Anti-S antibody titers (U/mL) were significantly lower at time point 1 (post first vaccination dose) compared with time point 2 (post second vaccination dose). Number of patient samples assessed at time point 1 (121) and time point 2 (123). Boxplot showing median (horizontal bar), the 25th and 75th quartiles, and the error bars depicting largest and smallest values. Differences were assessed by Kruskal-Wallis test.
Figure 2
Figure 2
Differences in anti-SARS-CoV-2 S (anti-S) IgG titers following partial and complete vaccination, stratified by type of cancer Anti-S antibody titers (U/mL) were significantly lower in patients with hematological malignancy compared with those with solid tumor, at time point 1 (post first vaccination dose) and at time point 2 (post second vaccination dose). Boxplot showing median (horizontal bar), the 25th and 75th quartiles, and the error bars depicting largest and smallest values. Differences assessed by Kruskal-Wallis test.
Figure 3
Figure 3
Differences in anti-SARS-CoV-2 S (anti-S) IgG titers following complete vaccination, stratified by anti-cancer treatment modality Anti-S antibody titers (U/mL) after complete vaccination were significantly different among anti-cancer treatment groups. Significantly lower levels of antibody titers were observed for those on cytotoxic chemotherapy within 6 months before vaccination compared with those on clinical surveillance or endocrine therapy. Patients receiving monoclonal antibody treatment had the lowest antibody titers, and the difference was statistically significant when compared with antibody titers in those receiving endocrine therapy. Boxplots are shown and differences measured by Kruskal-Wallis test with Dunn's post-hoc test, corrected by the Benjamini-Hochberg method.
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