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. 2021 Aug 26;13(17):4312.
doi: 10.3390/cancers13174312.

Evaluation of Antibody Responses to COVID-19 Vaccines among Solid Tumor and Hematologic Patients

Josef Singer  1   2 , Nguyen-Son Le  1   2 , Daniel Mattes  1   2 , Valerie Klamminger  1   3 , Klaus Hackner  1   3 , Nicole Kolinsky  2 , Michaela Scherb  2 , Peter Errhalt  1   3 , Gudrun Kreye  1   2 , Martin Pecherstorfer  1   2 , Sonia Vallet  1   2   4 , Klaus Podar  1   2   4
Affiliations

Evaluation of Antibody Responses to COVID-19 Vaccines among Solid Tumor and Hematologic Patients

Josef Singer et al. Cancers (Basel). .

Abstract

Vaccination is the primary public health strategy to cope with the COVID-19 pandemic. Although solid tumor and hematologic patients are at higher risk of serious COVID-19-related complications, data on immune responses to COVID-19 vaccines in this patient cohort are particularly scarce. The present study, therefore, aimed at the standardized determination of anti-SARS-CoV-2 spike protein antibody titers among non-vaccinated versus vaccinated solid tumor and hematologic patients who are under clinical observation or under treatment at the University Hospital Krems. Standardized anti-SARS-CoV-2 S antibody titers of a total of 441 patients were retrospectively analyzed. Our results show that antibody titers against the SARS-CoV-2 spike protein are significantly higher in solid tumor versus hematologic patients. While SARS-CoV-2 antibody titers were equal among sexes, an age-dependent decrease was observed. Of note, our studies additionally show that complete vaccination represents a valuable predictor for high anti-SARS-CoV-2 antibody responses in solid tumor and hematologic patients. In summary, to date, this is one of the largest studies to comprehensively evaluate the impact of various COVID-19 vaccines on anti-SARS-CoV-2 S antibody production in solid tumor and hematologic patients. Our findings aim to support future vaccination strategies in these highly vulnerable patients, including vaccination booster programs and alternative protective approaches.

Keywords: COVID-19; SARS-CoV-2; SARS-CoV-2 S vaccine; antibody response; cancer patients.

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Conflict of interest statement

J.S. declares honorarium payments from Abbvie, Amgen, Gilead, Janssen, Merck, Merck Sharp & Dohme, Novartis, Pfizer, Roche and Servier as an invited speaker or expert consulting on other topics than SARS-CoV-2 and vaccination. K.H. declares honorarium from Amgen, Boehringer Ingelheim and Roche as an expert consulting on other topics than SARS-CoV-2 and vaccination. M.P. declares financial support from Roche for research projects other than SARS-CoV-2 and vaccination. S.V. received speaker’s honoraria from Bristol Myers Squibb, MSD, Pfizer and consultancy fees from Roche, Eusa, MSD and Merck on other topics than SARS-CoV-2 and vaccination. K.P. has received speaker’s honoraria from Celgene, Amgen Inc. and Janssen Pharmaceuticals, consultancy fees from Celgene, Takeda and Janssen Pharmaceuticals and research support from Roche Pharmaceuticals on other topics than SARS-CoV-2 and vaccination. All other authors have no conflict of interest with regard to this work.

Figures

Figure 1
Figure 1
Comparison of antibody levels of included patients: not vaccinated control group, groups with documented prior COVID-19 infections and vaccinated (indexed by thick lines in the description of the x-axis) solid tumor or hematologic patients. Threshold (lower dotted line) indicates ≥15 BAU/mL; the upper dotted line shows the upper limit of the assay (250.01). Displayed are median values and 95% CI of BAU/mL values (upper and lower ends of error bars). BAU: Binding Antibody Units. **** p < 0.0001.
Figure 2
Figure 2
Comparison of antibody levels based on gender or age. (A) Comparison of antibody levels after COVID-19 vaccination in solid tumor patients stratified by gender. (B) Comparison of different age groups of solid tumor patients with respect to antibody formation upon COVID-19 vaccination. (C) Comparison of antibody levels after COVID-19 vaccination in hematologic patients stratified by gender. (D) Comparison of different age groups of hematologic therapies with respect to antibody formation upon COVID-19 vaccination. Threshold (lower dotted line) indicates ≥15 BAU/mL; the upper dotted line shows the upper limit of the assay (250.01). Displayed are median values and 95% CI of BAU/mL values (upper and lower ends of error bars). BAU: Binding Antibody Units, ns: not significant; ** p < 0.01.
Figure 3
Figure 3
Comparison of antibody levels based on oncological treatment. (A) Comparison of antibody levels after COVID-19 vaccination in solid tumor patients that were observed only with patients receiving any type of oncologic therapy. (B) Comparison of different oncologic therapies with respect to antibody formation upon COVID-19 vaccination. (C) Comparison of antibody levels after COVID-19 vaccination in hematologic patients that were observed only with patients receiving any type of hematologic therapy. (D) Comparison of different hematologic therapies with respect to antibody formation upon COVID-19 vaccination. Here, only selected therapies were analyzed. Threshold (lower dotted line) indicates ≥15 BAU/mL; the upper dotted line shows the upper limit of the assay (250.01). Displayed are median values and 95% CI of BAU/mL values (upper and lower ends of error bars). ns: not significant, * p < 0.05, *** p < 0.001, **** p < 0.0001. BAU: Binding Antibody Units; ICI: Immune Checkpoint Inhibitor; TKI:Tyrosine Kinase Inhibitor; IMID: Immunomodulatory Imide Drug; BTKi: Bruton’s Tyrosine Kinase Inhibitor.
Figure 4
Figure 4
Comparison of antibody levels stratified by type of solid tumor type (A) or type of hematologic disease (B). (C) Comparison of antibody levels after COVID-19 vaccination in hematologic patients with lymphoid diseases grouped by cell of origin of the disease. Threshold (lower dotted line) indicates ≥15 BAU/mL; the upper dotted line shows the upper limit of the assay (250.01). Displayed are median values and 95% CI of BAU/mL values (upper and lower ends of error bars). BAU: Binding Antibody Units, SCLC: Small Cell Lung Cancer, NSCLC: Non-Small Cell Lung Cancer, ENT: Ear-Nose-Throat. ns: not significant, * p < 0.05, ** p < 0.01, *** p < 0.001.
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