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. 2022 Jan:166:88-91.
doi: 10.1016/j.radonc.2021.11.012. Epub 2021 Nov 25.

Heterogeneous immunogenicity of SARS-CoV-2 vaccines in cancer patients receiving radiotherapy

Cynthia L Bowes  1 , Vivek Naranbhai  2 , Kerri J St Denis  3 , Evan C Lam  3 , Brittany Bertaux  2 , Florence K Keane  1 , Melin J Khandekar  1 , Alejandro B Balazs  3 , John A Iafrate  4 , Justin F Gainor  2 , Henning Willers  5
Affiliations

Heterogeneous immunogenicity of SARS-CoV-2 vaccines in cancer patients receiving radiotherapy

Cynthia L Bowes et al. Radiother Oncol. 2022 Jan.

Abstract

The immunogenicity of SARS-CoV-2 vaccines in cancer patients receiving radiotherapy is unknown. This prospective cohort study demonstrates that anti-SARS-CoV-2 spike antibody and neutralization titers are reduced in a subset of thoracic radiotherapy patients, possibly due to immunosuppressive conditions. Antibody testing may be useful to identify candidates for additional vaccine doses.

Keywords: COVID-19; Immunogenicity; Lung cancer; Radiotherapy; SARS-CoV-2; mRNA vaccine.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Gainor has served as a compensated consultant or received honoraria from Bristol-Myers Squibb, Genentech, Ariad/Takeda, Loxo/Lilly, Blueprint, Oncorus, Regeneron, Gilead, Moderna, AstraZeneca, Pfizer, Novartis, Merck, and GlydeBio; research support from Novartis, Genentech/Roche, and Ariad/Takeda; institutional research support from Bristol-Myers Squibb, Tesaro, Moderna, Blueprint, Jounce, Array Biopharma, Merck, Adaptimmune, Novartis, and Alexo; and has an immediate family member who is an employee with equity at Ironwood Pharmaceuticals. None of the other authors has declared a competing interest.

Figures

Fig. 1
Fig. 1
Measures of SARS-Cov-2 vaccine immunogenicity in cancer patients who received thoracic radiotherapy. (A) Left bar, Quantitative SARS-CoV-2 spike IgG/A/M antibody concentrations (Roche Elecsys Anti-SARS-CoV-2 assay) in U/ml of serum at a median interval of 12 weeks after complete vaccination in participants who received thoracic radiotherapy (RT). Dots indicate individual concentrations (n = 33). Middle bar, geometric mean antibody concentration in patients with thoracic malignancies who did not receive radiotherapy (n = 181). Right bar, healthy controls vaccinated (HC Vax) for COVID (n = 187). Error bars indicate 95% CI around the geometric mean. (B) Correlation of spike antibody concentrations with pseudovirus neutralization titer 50 (pNT50), which was defined as the titer at which the serum achieves 50% neutralization of SARS-CoV-2 wild-type pseudovirus entry into ACE2 expressing 293T cells (in 20/33 thoracic radiotherapy patients for whom neutralization titers were available). Solid line represents linear regression. Dotted vertical line corresponds to a pNT50 titer of 27.6 equivalent to 20% of the convalescent titer that is predicted to be associated with 50% protection. (C) Data from thoracic radiotherapy patients in Panel (A) grouped according to immunosuppressive condition listed in Table 1. Statistical comparisons by Mann Whitney Test on log transformed values, two-sided.
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