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Hua T, Fan R, Fan Y, Chen F. Immune response of COVID-19 vaccines in solid cancer patients: A meta-analysis. Hum Vaccin Immunother 2024; 20:2357424. [PMID: 38785118 DOI: 10.1080/21645515.2024.2357424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
Solid cancer patients, compared to their healthy counterparts, are at a greater risk of contracting and suffering from severe complications and poorer prognosis after COVID-19 infections. They also have different immune responses after doses of COVID-19 vaccination, but limited evidence is available to reveal the effectiveness and help to guide immunization programs for this subpopulation; MEDLINE, Embase, Web of Science, Cochrane Library databases, and clinicaltrials.gov were used to search literature. The pooled seroconversion rate was calculated using a random-effects model and reported with a 95% confidence interval (CI); The review includes 66 studies containing serological responses after COVID-19 vaccination in 13,050 solid cancer patients and 8550 healthy controls. The pooled seropositive rates after the first dose in patients with solid cancer and healthy controls are 55.2% (95% CI 45.9%-64.5% N = 18) and 90.2% (95% CI 80.9%-96.6% N = 13), respectively. The seropositive rates after the second dose in patients with solid cancer and healthy controls are 87.6% (95% CI 84.1%-90.7% N = 50) and 98.9% (95% CI 97.6%-99.7% N = 35), respectively. The seropositive rates after the third dose in patients with solid cancer and healthy controls are 91.4% (95% CI 85.4%-95.9% N = 21) and 99.8% (95% CI 98.1%-100.0% N = 4), respectively. Subgroup analysis finds that study sample size, timing of antibody testing, and vaccine type have influence on the results; Seroconversion rates after COVID-19 vaccination are significantly lower in patients with solid malignancies, especially after the first dose, then shrinking gradually after the following two vaccinations, indicating that subsequent doses or a booster dose should be considered for the effectiveness of this subpopulation.
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Affiliation(s)
- Tiantian Hua
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Ru Fan
- Medical Statistics and Analysis Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yang Fan
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Feng Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
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Geinitz H, Silberberger E, Spiegl K, Feichtinger J, Wagner H, Hermann P, Bräutigam E, Track C, Weis EM, Venhoda C, Huppert R, Spindelbalker-Renner B, Zauner-Babor G, Nyiri DV, Karasek N, Erdei M, Gheju R, Gruber G, Egger M, Dieplinger B. SARS-CoV-2 vaccination willingness and humoral vaccination response in radiation oncology patients. Vaccine 2024; 42:945-959. [PMID: 38246842 DOI: 10.1016/j.vaccine.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/27/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND SARS-CoV-2 infection has been and, in some parts, still is a threat to oncologic patients, making it crucial to understand perception of vaccination and immunologic responses in this vulnerable patient segment. SARS-CoV-2 vaccines in relation to malignant disease characteristics and therapies have so far not been studied consecutively in larger oncologic patient populations. This study captures SARS-CoV-2 vaccination willingness and humoral immune response in a large consecutive oncologic patient collective at the beginning of 2021. METHODS 1142 patients were consecutively recruited over 5.5 months at a tertiary department for radiation oncology and were assessed for vaccination willingness via a standardized interview. In already vaccinated patients total SARS-CoV-2 S antibody titres against the spike protein (Anti-SARS-CoV-2 S) and were evaluated 35 days or later after the first dose of SARS-CoV-2 vaccine. RESULTS Vaccination willingness was high with a rate of 90 %. The most frequent reasons for rejection were: undecided/potential vaccination after therapy, distrust in the vaccine and fear of interaction with comorbidities. Factors associated with lower vaccination willingness were: worse general condition, lower age and female sex. 80 % of the participants had been previously vaccinated, 8 % reported previous infection and 16 % received vaccination during antineoplastic therapy. In 97.5 % of the vaccinated patients Anti-SARS-CoV-2 S was detected. In a univariable analysis parameters associated with non-conversion were: lower performance status, spread to the local lymphatics (N + ), hematologic disease and diffuse metastases. All patients with oligometastatic disease achieved positive Anti-SARS-CoV-2 S titres. For patients with two vaccinations several risk factors were identified, that were associated with low antibody concentrations. CONCLUSIONS SARS-CoV-2 vaccination willingness among oncologic patients was high in the first months after its availability, and most patients had already received one or two doses. Over 97 % of vaccinated patients had measurable anti-SARS-CoV-2 S titres. Our data supports early identification of low humoral responders after vaccination and could facilitate the design of future oncologic vaccine trials (clinicaltrials.gov Identifier: NCT04918888).
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Affiliation(s)
- Hans Geinitz
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria; Johannes Kepler Universität Linz, Medizinische Fakultät, Krankenhausstraße 5, A-4020 Linz, Austria.
| | - Elisabeth Silberberger
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Kurt Spiegl
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Johann Feichtinger
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Helga Wagner
- Kompetenzzentrum für Klinische Studien (KKS Linz) am Zentrum für Klinische Forschung (ZKF), Johannes Kepler Universität Linz, Medizinische Fakultät, Med Campus I, Gebäude ADM, 8.OG, Krankenhausstraße 5, A-4020 Linz, Austria
| | - Philipp Hermann
- Kompetenzzentrum für Klinische Studien (KKS Linz) am Zentrum für Klinische Forschung (ZKF), Johannes Kepler Universität Linz, Medizinische Fakultät, Med Campus I, Gebäude ADM, 8.OG, Krankenhausstraße 5, A-4020 Linz, Austria
| | - Elisabeth Bräutigam
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Christine Track
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Eva Maria Weis
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Clemens Venhoda
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Roswitha Huppert
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Barbara Spindelbalker-Renner
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Georgine Zauner-Babor
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Dalma Viktoria Nyiri
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Nicola Karasek
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Mercedesz Erdei
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Ruben Gheju
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Georg Gruber
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Margot Egger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz and Ordensklinikum Linz, Linz, Austria
| | - Benjamin Dieplinger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz and Ordensklinikum Linz, Linz, Austria
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Pietroluongo E, De Placido P, Tortora M, Martinelli C, Viggiano A, Saponaro MR, Caltavituro A, Buonaiuto R, Morra R, Ottaviano M, Del Deo V, Cernera G, Gelzo M, Malfitano AM, Di Tolla MF, De Angelis C, Arpino G, Terracciano D, Bianco R, Veneziani BM, Formisano P, Castaldo G, Palmieri G, De Placido S, Giuliano M. Impaired Seroconversion After Severe Acute Respiratory Syndrome Coronavirus 2 mRNA Vaccine in Patients With Thymic Epithelial Tumors. J Thorac Oncol 2023; 18:1399-1407. [PMID: 37390981 PMCID: PMC10303630 DOI: 10.1016/j.jtho.2023.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 05/29/2023] [Accepted: 06/10/2023] [Indexed: 07/02/2023]
Abstract
INTRODUCTION Thymic epithelial tumors (TETs) are rare malignancies associated with dysregulation of the immune system and humoral- and cell-mediated immunity abnormalities. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine is effective in preventing coronavirus disease 2019 morbidity and mortality. The aim of this study was to evaluate the seroconversion in patients with TET after two doses of mRNA vaccine. METHODS This is a prospective study in which consecutive patients with TET were enrolled before receiving the first dose of SARS-CoV-2 mRNA vaccine (BNT162b2 by Pfizer-BioNTech). SARS-CoV-2 spike-binding immunoglobulin (Ig)G antibody serologic levels were analyzed at different time points, including before first vaccine dose (T0), 1 month after the second dose (T2), and 3 months after the second dose (T3). RESULTS Overall, 39 patients were included in the analysis. All patients had negative antibody titer results at T0. There were 19 patients (48.7%) in the follow-up with no residual tumor lesion/s (referred as no evidence of disease), and 20 (51.3%) had evidence of disease (ED) and were receiving systemic treatment. Dysregulations of the immune system were diagnosed in 29 patients (74.4%) with Good syndrome (GS) being the most frequent immune disorder (48.7%). At univariate analysis, lack of seroconversion at T2 was significantly associated with ED (p < 0.001) and with GS (p = 0.043). A significant association with impaired seroconversion was confirmed at multivariate analysis for ED (p = 0.00101) but not for GS (p = 0.625). CONCLUSIONS Our data revealed that patients with TET with ED had substantially higher probability of impaired seroconversion after SARS-CoV-2 mRNA vaccine as compared with patients with no evidence of disease.
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Affiliation(s)
- Erica Pietroluongo
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Pietro De Placido
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Marianna Tortora
- Rare Tumors Coordinating Center of Campania Region (CRCTR), Naples, Italy
| | - Claudia Martinelli
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Angela Viggiano
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | | | - Aldo Caltavituro
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Roberto Buonaiuto
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Rocco Morra
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Margaret Ottaviano
- Rare Tumors Coordinating Center of Campania Region (CRCTR), Naples, Italy; Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Italian National Cancer Institute- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Pascale Foundation, Naples, Italy
| | - Vitantonio Del Deo
- Rare Tumors Coordinating Center of Campania Region (CRCTR), Naples, Italy
| | - Gustavo Cernera
- CEINGE, Biotecnologie Avanzate, Naples, Italy; Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Monica Gelzo
- CEINGE, Biotecnologie Avanzate, Naples, Italy; Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Anna Maria Malfitano
- Department of Translational Medical Sciences, University "Federico II," Naples, Italy
| | | | - Carmine De Angelis
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Grazia Arpino
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University "Federico II," Naples, Italy
| | - Roberto Bianco
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Bianca Maria Veneziani
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II," Naples, Italy
| | - Pietro Formisano
- Department of Translational Medical Sciences, University "Federico II," Naples, Italy
| | - Giuseppe Castaldo
- CEINGE, Biotecnologie Avanzate, Naples, Italy; Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | | | - Sabino De Placido
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy; Rare Tumors Coordinating Center of Campania Region (CRCTR), Naples, Italy
| | - Mario Giuliano
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy; Rare Tumors Coordinating Center of Campania Region (CRCTR), Naples, Italy
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Chehelgerdi M, Chehelgerdi M. The use of RNA-based treatments in the field of cancer immunotherapy. Mol Cancer 2023; 22:106. [PMID: 37420174 PMCID: PMC10401791 DOI: 10.1186/s12943-023-01807-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/13/2023] [Indexed: 07/09/2023] Open
Abstract
Over the past several decades, mRNA vaccines have evolved from a theoretical concept to a clinical reality. These vaccines offer several advantages over traditional vaccine techniques, including their high potency, rapid development, low-cost manufacturing, and safe administration. However, until recently, concerns over the instability and inefficient distribution of mRNA in vivo have limited their utility. Fortunately, recent technological advancements have mostly resolved these concerns, resulting in the development of numerous mRNA vaccination platforms for infectious diseases and various types of cancer. These platforms have shown promising outcomes in both animal models and humans. This study highlights the potential of mRNA vaccines as a promising alternative approach to conventional vaccine techniques and cancer treatment. This review article aims to provide a thorough and detailed examination of mRNA vaccines, including their mechanisms of action and potential applications in cancer immunotherapy. Additionally, the article will analyze the current state of mRNA vaccine technology and highlight future directions for the development and implementation of this promising vaccine platform as a mainstream therapeutic option. The review will also discuss potential challenges and limitations of mRNA vaccines, such as their stability and in vivo distribution, and suggest ways to overcome these issues. By providing a comprehensive overview and critical analysis of mRNA vaccines, this review aims to contribute to the advancement of this innovative approach to cancer treatment.
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Affiliation(s)
- Mohammad Chehelgerdi
- Novin Genome (NG) Lab, Research and Development Center for Biotechnology, Shahrekord, Iran.
- Young Researchers and Elite Club, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran.
| | - Matin Chehelgerdi
- Novin Genome (NG) Lab, Research and Development Center for Biotechnology, Shahrekord, Iran
- Young Researchers and Elite Club, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
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5
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Rodilla AM, Tavolacci S, Cagan J, Shah T, Mittan S, Mack PC, Hirsch FR. Serological Response to SARS-CoV-2 after COVID-19 Vaccination in Lung Cancer Patients: Short Review. Vaccines (Basel) 2023; 11:vaccines11050969. [PMID: 37243073 DOI: 10.3390/vaccines11050969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/30/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Abstract
In comparison to the general population, lung cancer patients are more likely to suffer from severe Coronavirus disease (COVID-19) and associated mortality. Considering this increased risk, and in order to prevent symptoms and severe disease, patients with lung cancer have been prioritized for COVID-19 vaccination primary and booster doses. Despite this, the pivotal clinical trials did not include these patients, which leaves open questions regarding vaccine efficacy and humoral immune response. This review outlines the findings of recent investigations into the humoral responses of lung cancer patients to COVID-19 vaccination, particularly the primary doses and first boost.
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Affiliation(s)
- Ananda M Rodilla
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Sooyun Tavolacci
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jazz Cagan
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Tanay Shah
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Sandeep Mittan
- Department of Obstetrics, Gynecology and Medical Oncology, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Philip C Mack
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Fred R Hirsch
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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6
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Yin J, Chen Y, Li Y, Zhang X, Wang C. Seroconversion rate after COVID-19 vaccination in patients with solid cancer: A systematic review and meta-analysis. Hum Vaccin Immunother 2022; 18:2119763. [PMID: 36161976 DOI: 10.1080/21645515.2022.2119763] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Patients with solid cancer have an increased risk of severe coronavirus disease 2019 (COVID-19) and associated mortality than the general population. This meta-analysis aimed to investigate the currently available evidence about the efficacy of COVID-19 vaccines in patients with solid cancer. We included prospective studies comparing the immunogenicity and efficacy of COVID-19 vaccines between patients with solid cancer and healthy individuals. Relative risks of seroconversion after the first and second dose of a COVID-19 vaccine were separately pooled with the use of random effects meta-analysis. Thirty studies with 11,245 subjects met the inclusion criteria. After first vaccine dose, the pooled RR of seroconversion in patients with solid cancer vs healthy individuals was 0.54 (95% CI 0.38-0.78, I2 = 94%). After a second dose, the pooled RR of seroconversion in patients with solid cancer vs healthy controls was 0.87 (0.86-0.88, I2 = 87%). Our review suggests that, compared with healthy individuals, COVID-19 vaccines show favorable immunogenicity and efficacy in patients with solid cancer. A second dose is associated with significantly improved seroconversion, although it is slightly lower in patients with solid cancer compared with healthy individuals.
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Affiliation(s)
- Juntao Yin
- Department of Pharmacy, Huaihe Hospital, Henan University, Kaifeng, Henan, China
| | - Yangyang Chen
- Cardiology, Huaihe Hospital, Henan University, Kaifeng, Henan, China
| | - Yang Li
- Department of Pharmacy, Huaihe Hospital, Henan University, Kaifeng, Henan, China
| | - Xingwang Zhang
- Department of Pharmaceutics, School of Pharmacy, Jinan University, Guangzhou, Guangdong, China
| | - Chaoyang Wang
- Evidence-Based Medicine Center, Department of Medicine, Henan University, Zhengzhou, Henan, China
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Song R, Liu L, Pan Q, Liu J, Tan J, Deng J, Deng Q, Lin Z, Chen M, Peng M, Ren H, Ming J. Short-term safety and immunogenicity of inactivated and peptide-based SARS-CoV-2 vaccines in patients with endocrine-related cancer. Front Immunol 2022; 13:1028246. [DOI: 10.3389/fimmu.2022.1028246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe aim of this study was to explore the short-term safety and immunogenicity of inactivated and peptide-based SARS-CoV-2 vaccines in patients with endocrine-related cancer (ER).MethodsEighty-eight patients with ER cancer and 82 healthy controls who had completed a full course of inactivated or peptide-based SARS-CoV-2 vaccines were recruited. Adverse events (AEs) were recorded. Responses to receptor-binding domain IgG antibody (anti-RBD-IgG), neutralizing antibodies (NAbs) and RBD+ memory B cells (MBCs) were evaluated.ResultsApproximately 26.14% (23/88) of patients with ER cancer reported AEs within 7 days, which was comparable to that reported by healthy controls (24.39%, 20/82). Both the overall seroprevalence of anti-RBD-IgG and NAbs was obviously lower in the cancer group (70.45% vs. 86.59%, P < 0.05; 69.32% vs. 82.93%, P < 0.05, respectively). Anti-RBD-IgG and NAbs titers exhibited similar results, and dropped gradually over time. Patients with ongoing treatment had an attenuated immune response, especially in patients receiving active chemotherapy. The frequency of overall RBD+ MBCs was similar between the two groups, but the percentage of active MBCs was remarkably reduced in patients with ER cancer. Unlike antibody titers, MBCs responses were relatively constant over time.ConclusionInactivated and peptide-based COVID-19 vaccines were well tolerated, but with lower immunogenicity for ER cancer patients. More intensive antibody monitoring and timely booster immunization is recommended for patients with ER cancer presenting disordered subpopulations of RBD+ MBCs.
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La Verde N, Riva A, Cona MS, Gabrieli A, Cattaneo M, Fasola C, Lipari G, De Stradis C, Favorito V, Lombardi Stocchetti B, Chizzoniti D, Covizzi A, Rulli E, Galli F, Ruggieri L, Gambaro A, Ferrario S, Dalu D, Tarkowski MS. Immunogenicity of two doses of BNT162b2 and mRNA-1273 vaccines for solid cancer patients on treatment with or without a previous SARS-CoV-2 infection. Int J Cancer 2022; 152:661-671. [PMID: 36056571 PMCID: PMC9538813 DOI: 10.1002/ijc.34273] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/19/2022] [Accepted: 08/18/2022] [Indexed: 02/01/2023]
Abstract
Previous studies on the immunogenicity of SARS-CoV-2 mRNA vaccines showed a reduced seroconversion in cancer patients. The aim of our study is to evaluate the immunogenicity of two doses of mRNA vaccines in solid cancer patients with or without a previous exposure to the virus. This is a single-institution, prospective, nonrandomized study. Patients in active treatment and a control cohort of healthy people received two doses of BNT162b2 (Comirnaty, BioNTech/Pfizer, The United States) or mRNA-1273 (Spikevax, Moderna). Vaccine was administered before starting anticancer therapy or on the first day of the treatment cycle. SARS-CoV-2 antibody levels against S1, RBD (to evaluate vaccine response) and N proteins (to evaluate previous infection) were measured in plasma before the first dose and 30 days after the second one. From January to June 2021, 195 consecutive cancer patients and 20 healthy controls were enrolled. Thirty-one cancer patients had a previous exposure to SARS-CoV-2. Cancer patients previously exposed to the virus had significantly higher median levels of anti-S1 and anti-RBD IgG, compared to healthy controls (P = .0349) and to cancer patients without a previous infection (P < .001). Vaccine type (anti-S1: P < .0001; anti-RBD: P = .0045), comorbidities (anti-S1: P = .0274; anti-RBD: P = .0048) and the use of G-CSF (anti-S1: P = .0151) negatively affected the antibody response. Conversely, previous exposure to SARS-CoV-2 significantly enhanced the response to vaccination (anti-S1: P < .0001; anti-RBD: P = .0026). Vaccine immunogenicity in cancer patients with a previous exposure to SARS-CoV-2 seems comparable to that of healthy subjects. On the other hand, clinical variables of immune frailty negatively affect humoral immune response to vaccination.
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Affiliation(s)
- Nicla La Verde
- Department of OncologySacco Hospital, ASST Fatebenefratelli SaccoMilanItaly
| | - Agostino Riva
- Department of Infectious DiseasesSacco Hospital, ASST Fatebenefratelli SaccoMilanItaly,Luigi Sacco Department of Biomedical and Clinical Sciences DIBICUniversity of MilanMilanItaly
| | - Maria Silvia Cona
- Department of OncologySacco Hospital, ASST Fatebenefratelli SaccoMilanItaly
| | - Arianna Gabrieli
- Luigi Sacco Department of Biomedical and Clinical Sciences DIBICUniversity of MilanMilanItaly
| | - Monica Cattaneo
- Department of OncologySacco Hospital, ASST Fatebenefratelli SaccoMilanItaly
| | - Cinzia Fasola
- Department of OncologySacco Hospital, ASST Fatebenefratelli SaccoMilanItaly
| | - Giuseppe Lipari
- Luigi Sacco Department of Biomedical and Clinical Sciences DIBICUniversity of MilanMilanItaly
| | - Claudia De Stradis
- Luigi Sacco Department of Biomedical and Clinical Sciences DIBICUniversity of MilanMilanItaly
| | - Valentina Favorito
- Department of OncologySacco Hospital, ASST Fatebenefratelli SaccoMilanItaly
| | | | - Davide Chizzoniti
- Department of OncologySacco Hospital, ASST Fatebenefratelli SaccoMilanItaly
| | - Alice Covizzi
- Department of Infectious DiseasesSacco Hospital, ASST Fatebenefratelli SaccoMilanItaly
| | - Eliana Rulli
- Laboratory of Methodology for Clinical ResearchIstituto di Ricerche Farmacologiche Mario Negri IRCCSMilanItaly
| | - Francesca Galli
- Laboratory of Methodology for Clinical ResearchIstituto di Ricerche Farmacologiche Mario Negri IRCCSMilanItaly
| | - Lorenzo Ruggieri
- Department of OncologySacco Hospital, ASST Fatebenefratelli SaccoMilanItaly
| | - Anna Gambaro
- Department of OncologySacco Hospital, ASST Fatebenefratelli SaccoMilanItaly
| | - Sabrina Ferrario
- Department of OncologySacco Hospital, ASST Fatebenefratelli SaccoMilanItaly
| | - Davide Dalu
- Department of OncologySacco Hospital, ASST Fatebenefratelli SaccoMilanItaly
| | - Maciej S. Tarkowski
- Luigi Sacco Department of Biomedical and Clinical Sciences DIBICUniversity of MilanMilanItaly
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Li T, Song R, Wang J, Zhang J, Cai H, He H, Hu W, Yu D, Wang C, Pan Q, Peng M, Ren H, Zhu P. Safety and immunogenicity of inactivated SARS-CoV-2 vaccines in people with gastrointestinal cancer. Int J Infect Dis 2022; 122:874-884. [PMID: 35905950 PMCID: PMC9316719 DOI: 10.1016/j.ijid.2022.07.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the safety and immunogenicity of inactivated COVID-19 vaccines in patients with gastrointestinal cancer (GI) cancer. The role of memory B cells (MBCs) in the humoral response to COVID-19 vaccination was also investigated. METHODS In this prospective observational study, GI cancer patients and healthy individuals who had received 2 doses of inactivated COVID-19 vaccines were included. The data regarding adverse effects, serum anti-receptor binding domain (RBD)-IgG, neutralizing antibodies (NAbs), and frequencies of MBCs were collected prospectively. RESULTS The inactivated COVID-19 vaccines were safe and well tolerated. Serum anti-RBG-IgG and NAbs were lower for cancer patients. Old age, high ASA score, and receiving active chemotherapy were risk factors for lower antibody titers. The frequencies of activated and resting MBCs decreased in (17.45% vs 38.11%, P = 0.002; 16.98% vs 34.13%, P = 0.023), while the frequencies of intermediate and atypical MBCs increased in cancer patients (40.06% vs 19.87%, P = 0.010; 25.47% vs 16.61%, P = 0.025). The serum antibody titer decreased gradually during follow-up but increased when a booster vaccine was given. CONCLUSION The inactivated COVID-19 vaccines were well tolerated in patients with GI cancer but with lower immunogenicity. The subpopulations of MBCs were disordered in cancer patients, and a booster vaccine may be prioritized for them.
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Affiliation(s)
- Tong Li
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rui Song
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jingjie Wang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jianbo Zhang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongxing Cai
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongmei He
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Hu
- Department of General Surgery, The Renmin Hospital of Wushan country, Chongqing, China
| | - Dajun Yu
- Department of General Surgery, The Renmin Hospital of Wushan country, Chongqing, China
| | - Chuanhu Wang
- Department of General Surgery, The Renmin Hospital of Wushan country, Chongqing, China
| | - Qingbo Pan
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingli Peng
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hong Ren
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China,Hong Ren, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing 400010, China, Tel.: +86-023-63829629
| | - Peng Zhu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China,Corresponding author: Peng Zhu, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing 400010, China. Tel: +86-023-63693840
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10
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Di Giacomo AM, Giacobini G, Anichini G, Gandolfo C, D'alonzo V, Calabrò L, Lofiego MF, Cusi MG, Maio M. SARS-CoV-2 infection in cancer patients on active therapy after the booster dose of mRNA vaccines. Eur J Cancer 2022; 171:143-149. [PMID: 35717822 PMCID: PMC9130712 DOI: 10.1016/j.ejca.2022.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/04/2022] [Accepted: 05/13/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The protective role against SARS-CoV-2 infection by the third booster dose of mRNA vaccines in cancer patients with solid malignancies is presently unknown. We prospectively investigated the occurrence of COVID-19 in cancer patients on active therapy after the booster vaccine dose. METHODS Cancer patients on treatment at the Center for Immuno-Oncology (CIO) of the University Hospital of Siena, Italy, and health care workers at CIO who had received a booster third dose of mRNA vaccine entered a systematic follow-up monitoring period to prospectively assess their potential risk of SARS-CoV-2 infection. Serological and microneutralization assay were utilized to assess levels of anti-spike IgG, and of neutralizing antibodies to the SARS-CoV-2 Wild Type, Delta and Omicron variants, respectively, after the booster dose and after negativization of the nasopharyngeal swab for those who had developed COVID-19. RESULTS Ninety cancer patients with solid tumors on active treatment (Cohort 1) and 30 health care workers (Cohort 2) underwent a booster third dose of mRNA vaccine. After the booster dose, the median value of anti-spike IgG was higher (p = 0.009) in patients than in healthy subjects. Remarkably, 11/90 (12%) patients and 11/30 (37%) healthy subjects tested positive to SARS-CoV-2 infection during the monitoring period. Similar levels of anti-spike IgG and of neutralizing antibodies against all the investigated variants, with geometric mean titers of neutralizing antibodies against the Omicron being the lowest were detected after the booster dose and after COVID-19 in both Cohorts. CONCLUSIONS The occurrence of SARS-CoV-2 infection we observed in a sizable proportion of booster-dosed cancer patients and in healthy subjects during the Omicron outbreak indicates that highly specific vaccines against SARS-CoV-2 variants are urgently required.
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Affiliation(s)
- Anna M Di Giacomo
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, Siena, Italy; University of Siena, Siena, Italy; Italian Network for Tumor Bio-Immunotherapy Foundation Onlus, Italy
| | - Gianluca Giacobini
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, Siena, Italy
| | - Gabriele Anichini
- Virology Unit, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Claudia Gandolfo
- Virology Unit, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Vincenzo D'alonzo
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, Siena, Italy; University of Siena, Siena, Italy
| | - Luana Calabrò
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, Siena, Italy
| | - Maria F Lofiego
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, Siena, Italy
| | - Maria G Cusi
- Virology Unit, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Michele Maio
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, Siena, Italy; University of Siena, Siena, Italy; Italian Network for Tumor Bio-Immunotherapy Foundation Onlus, Italy.
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11
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Sisteré-Oró M, Wortmann DDJ, Andrade N, Aguilar A, Mayo de las Casas C, Casabal FG, Torres S, Bona Salinas E, Raventos Soler L, Arcas A, Esparre C, Garcia B, Valarezo J, Rosell R, Güerri-Fernandez R, Gonzalez-Cao M, Meyerhans A. Brief Research Report: Anti-SARS-CoV-2 Immunity in Long Lasting Responders to Cancer Immunotherapy Through mRNA-Based COVID-19 Vaccination. Front Immunol 2022; 13:908108. [PMID: 35911701 PMCID: PMC9330498 DOI: 10.3389/fimmu.2022.908108] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/01/2022] [Indexed: 01/14/2023] Open
Abstract
Cancer patients (CPs) have been identified as particularly vulnerable to SARS-CoV-2 infection, and therefore are a priority group for receiving COVID-19 vaccination. From the patients with advanced solid tumors, about 20% respond very efficiently to immunotherapy with anti-PD1/PD-L1 antibodies and achieve long lasting cancer responses. It is unclear whether an efficient cancer-specific immune response may also correlate with an efficient response upon COVID-19 vaccination. Here, we explored the antiviral immune response to the mRNA-based COVID-19 vaccine BNT162b2 in a group of 11 long-lasting cancer immunotherapy responders. We analysed the development of SARS-CoV-2-specific IgG serum antibodies, virus neutralizing capacities and T cell responses. Control groups included patients treated with adjuvant cancer immunotherapy (IMT, cohort B), CPs not treated with immunotherapy (no-IMT, cohort C) and healthy controls (cohort A). The median ELISA IgG titers significantly increased after the prime-boost COVID vaccine regimen in all cohorts (Cohort A: pre-vaccine = 900 (100-2700), 3 weeks (w) post-boost = 24300 (2700-72900); Cohort B: pre-vaccine = 300 (100-2700), 3 w post-boost = 8100 (300-72900); Cohort C: pre-vaccine = 500 (100-2700), 3 w post-boost = 24300 (300-72900)). However, at the 3 w post-prime time-point, only the healthy control group showed a statistically significant increase in antibody levels (Cohort A = 8100 (900-8100); Cohort B = 900 (300-8100); Cohort C = 900 (300-8100)) (P < 0.05). Strikingly, while all healthy controls generated high-level antibody responses after the complete prime-boost regimen (Cohort A = 15/15 (100%), not all CPs behaved alike [Cohort B= 12/14 (84'6%); Cohort C= 5/6 (83%)]. Their responses, including those of the long-lasting immunotherapy responders, were more variable (Cohort A: 3 w post-boost (median nAb titers = 95.32 (84.09-96.93), median Spike-specific IFN-γ response = 64 (24-150); Cohort B: 3 w post-boost (median nAb titers = 85.62 (8.22-97.19), median Spike-specific IFN-γ response (28 (1-372); Cohort C: 3 w post-boost (median nAb titers = 95.87 (11.8-97.3), median Spike-specific IFN-γ response = 67 (20-84)). Two long-lasting cancer responders did not respond properly to the prime-boost vaccination and did not generate S-specific IgGs, neutralizing antibodies or virus-specific T cells, although their cancer immune control persisted for years. Thus, although mRNA-based vaccines can induce both antibody and T cell responses in CPs, the immune response to COVID vaccination is independent of the capacity to develop an efficient anti-cancer immune response to anti PD-1/PD-L1 antibodies.
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Affiliation(s)
- Marta Sisteré-Oró
- Infection Biology Laboratory, Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Diana D. J. Wortmann
- Infection Biology Laboratory, Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Naína Andrade
- Infection Biology Laboratory, Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Andres Aguilar
- Instituto Oncologico Dr Rosell, Hospital Quiron-Dexeus Barcelona, Barcelona, Spain
| | - Clara Mayo de las Casas
- Instituto Oncologico Dr Rosell, Hospital Quiron-Dexeus Barcelona, Barcelona, Spain
- Laboratorio Oncología, Hospital Universitario Dexeus, Pangaea Oncology Lab, Barcelona, Spain
| | | | - Susana Torres
- Instituto Oncologico Dr Rosell, Hospital Quiron-Dexeus Barcelona, Barcelona, Spain
| | - Eduardo Bona Salinas
- Instituto Oncologico Dr Rosell, Hospital Quiron-Dexeus Barcelona, Barcelona, Spain
| | - Laura Raventos Soler
- Instituto Oncologico Dr Rosell, Hospital Quiron-Dexeus Barcelona, Barcelona, Spain
| | - Andrea Arcas
- Instituto Oncologico Dr Rosell, Hospital Quiron-Dexeus Barcelona, Barcelona, Spain
| | - Carlos Esparre
- Instituto Oncologico Dr Rosell, Hospital Quiron-Dexeus Barcelona, Barcelona, Spain
| | - Beatriz Garcia
- Instituto Oncologico Dr Rosell, Hospital Quiron-Dexeus Barcelona, Barcelona, Spain
- Laboratorio Oncología, Hospital Universitario Dexeus, Pangaea Oncology Lab, Barcelona, Spain
| | - Joselyn Valarezo
- Instituto Oncologico Dr Rosell, Hospital Quiron-Dexeus Barcelona, Barcelona, Spain
- Laboratorio Oncología, Hospital Universitario Dexeus, Pangaea Oncology Lab, Barcelona, Spain
| | - Rafael Rosell
- Instituto Oncologico Dr Rosell, Hospital Quiron-Dexeus Barcelona, Barcelona, Spain
- Laboratorio Oncología, Hospital Universitario Dexeus, Pangaea Oncology Lab, Barcelona, Spain
- Laboratorio Oncología, Germans Trias i Pujol Health Science Insitute and Hospital (IGTP), Badalona, Spain
| | | | - Maria Gonzalez-Cao
- Instituto Oncologico Dr Rosell, Hospital Quiron-Dexeus Barcelona, Barcelona, Spain
- *Correspondence: Maria Gonzalez-Cao, ; Andreas Meyerhans,
| | - Andreas Meyerhans
- Infection Biology Laboratory, Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA) Pg. Lluiís Companys 23, Barcelona, Spain
- *Correspondence: Maria Gonzalez-Cao, ; Andreas Meyerhans,
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12
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Pino MS, Cheli S, Perna M, Fabbroni V, Giordano C, Martella F, Lanini F, Ribecco AS, Scoccianti S, Bacci C, Baldazzi V, Bertolini I, Di Leonardo G, Fulignati C, Grifoni R, Molinara E, Rangan S, Tassi R, Furlan F, Goldzweig G, Bassetti A, Fioretto L. The national COVID-19 vaccination campaign targeting the extremely vulnerable: the Florence Medical Oncology Unit experience in patients with cancer. Eur J Cancer 2022; 170:149-157. [PMID: 35635936 PMCID: PMC9020512 DOI: 10.1016/j.ejca.2022.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/19/2022] [Accepted: 04/01/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND International and national oncology societies had released recommendations in favor of COVID-19 vaccination in cancer patients. In the context of the national vaccination campaign targeting the so called extremely vulnerable, we aimed to assess the safety and efficacy of the mRNA vaccines in a cohort of 623 patients. METHODS Between March 26 and April 04, 2021, the Pfizer and BioNTech BNT162b2 mRNA and the Moderna mRNA-1273 vaccines were given as a two-dose prime-boost regimen. Starting on September 25th 2021 a third dose was offered to patients in whom a suboptimal immunogenicity with COVID-19 vaccination could be expected. Safety assessments were performed by phone call 7 days after each dose. Electronic health records were accessed to review demographic information, disease history, treatment detail, and outcome events of participants patients'. FINDINGS No toxicities were reported in 63.7%, 54%, and in 48.7% patients with cancer after each dose. Mild-to-moderate pain at the injection site was the most commonly adverse event. After the second dose, 46% of the 610 patients reported toxicity, with more systemic side-effects observed. Fever was reported in 45% of patients, with a temperature ≥ 38 °C in 21.4% of them. Of the 335 patients receiving a third vaccine dose, 51% reported toxicity, with 13% of patients reporting more than one effect. Logistic regression analysis reported mixed results, with limited variables or categories reporting a significant odd ratio. The type of vaccine reported a significant value at first dose (OR = 0.12; CI 0.52, 0.26; p = 0.00). Thirty-four cases of COVID-19 infection were reported with only one patient requiring a short-term hospitalization for monitoring. INTERPRETATION The safety profile of the mRNA vaccines does not raise any specific concerns and support prioritization of vaccination for cancer patients.
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Affiliation(s)
- Maria S Pino
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy.
| | - Simone Cheli
- School of Human Health Sciences, University of Florence, Italy
| | - Marco Perna
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Valentina Fabbroni
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Clara Giordano
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Francesca Martella
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Fabio Lanini
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Angela S Ribecco
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Silvia Scoccianti
- Radiation Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Carlotta Bacci
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Valentina Baldazzi
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Ilaria Bertolini
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Greta Di Leonardo
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Chiara Fulignati
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Raffaella Grifoni
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Elena Molinara
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Sheila Rangan
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Renato Tassi
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
| | - Federica Furlan
- Direzione Sanitaria, Santa Maria Annunziata Hospital, Azienda USL Toscana Centro, Italy
| | - Gil Goldzweig
- The Academic College of Tel Aviv - Yaffo, Tel Aviv, Israel
| | - Andrea Bassetti
- Direzione Sanitaria, Santa Maria Annunziata Hospital, Azienda USL Toscana Centro, Italy
| | - Luisa Fioretto
- Medical Oncology Unit - Florence, Department of Oncology, Azienda USL Toscana Centro, Italy
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13
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Yang W, Zhang D, Li Z, Zhang K. Predictors of poor serologic response to COVID-19 vaccine in patients with cancer: a systematic review and meta-analysis. Eur J Cancer 2022; 172:41-50. [PMID: 35752155 PMCID: PMC9160160 DOI: 10.1016/j.ejca.2022.05.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/14/2022] [Accepted: 05/24/2022] [Indexed: 02/08/2023]
Abstract
Backgrounds Patients with cancer presented a lower probability to obtain seroconversion after a complete course of COVID-19 vaccination. However, little was known on the factors that predict poor seroconversion in this frail population. Methods We searched the PubMed, EMBASE, and China National Knowledge Infrastructure databases for all articles within a range of published years from 2019 to 2022 on the predictors of response to COVID-19 vaccine in patients with cancer (last search was updated on 2st March 2022). The odds ratio corresponding to the 95% confidence interval was used to assess the outcome. The statistical heterogeneity among studies was assessed with the Q-test and I2 statistics. The review was registered with PROSPERO (CRD42022315687) and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Twenty cohort studies met the inclusion criteria for this study, with 5,499 patients with cancer. We found that advanced age, male patients, and metastatic disease increased negative seropositivity to COVID-19 vaccine. Immunoglobulin heavy chain variable mutation status, high concentration of Ig G, Ig M, and Ig A were correlated with seropositivity. Relating to cancer treatment strategy, anti-CD20 therapy within recent 12 months and chemotherapy were negatively correlated with seroconversion. Meta-analysis found no significant difference associated with targeted treatment, immunotherapy, and endocrine treatment. Conclusions Our meta-analysis assessed the factors that predict poor seroconversion in order to plan better prevention strategies in this frail population. The results proposed that enhanced vaccination strategies would be beneficial for the special patients such as advanced male, or patients receiving active chemotherapy, and carefully prevention should be emphasised even after a complete course of vaccination.
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Affiliation(s)
- Wenxing Yang
- Department of Physiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Dongxue Zhang
- Equipment and Material Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Zhuo Li
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Kui Zhang
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China.
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14
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Margalit O, Shacham-Shmueli E, Itay A, Berger R, Halperin S, Jurkowicz M, Levin EG, Olmer L, Regev-Yochay G, Lustig Y, Rahav G. Seropositivity and neutralising antibodies at six months after BNT162b2 vaccination in patients with solid tumours. Eur J Cancer 2022; 168:51-55. [PMID: 35439660 PMCID: PMC9013177 DOI: 10.1016/j.ejca.2022.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/07/2022] [Accepted: 03/16/2022] [Indexed: 02/06/2023]
Abstract
Aim Patients with cancer are at an increased risk for severe coronavirus disease of 2019. We previously reported initial findings from a single centre prospective study evaluating antibody response after BNT162b2 vaccine, showing that adequate antibody response was achieved after two doses, but not after one, in patients with cancer vaccinated during anticancer therapy. Herein, we report a follow-up study, evaluating antibody response six months after the second vaccine dose. Methods The study included patients with solid tumours undergoing anticancer treatment, and immunocompetent health-care workers serving as controls. Serum titres of the receptor-binding domain (RBD) IgG and neutralising antibodies (Nabs) were measured approximately six months after the second vaccine dose. Complete blood count values were collected and evaluated as predictors for antibody response. Results The analysis included 93 patients with cancer (66.7% metastatic). Six months after the second vaccine dose (mean 176 ± 20 days), seropositivity rate among patients and controls was 83.9% versus 96.3% (p = 0.0001), respectively. Median RBD-IgG titre was lower among patients compared with controls (2.3 versus 3.2, p = 0.0002). Among seropositive individuals, median Nabs titre was similar between patients with cancer and controls (p = 0.566). Among patients with cancer, lymphocyte and neutrophil counts were not correlated with either RBD-IgG or Nabs titres. Conclusions Seropositivity rates and RBD-IgG titre at six months after second BNT162b2 vaccine dose are lower among patients with cancer compared with healthy controls. However, Nabs titre is similar, suggesting a comparable protection among seropositive individuals. Lymphocyte count is not predictive of antibody response.
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Affiliation(s)
- Ofer Margalit
- Department of Oncology, Sheba Medical Center, Derech Sheba 2, Tel-Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel-Aviv University, P.O.B 39040, Ramat Aviv, Tel Aviv, Israel
| | - Einat Shacham-Shmueli
- Department of Oncology, Sheba Medical Center, Derech Sheba 2, Tel-Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel-Aviv University, P.O.B 39040, Ramat Aviv, Tel Aviv, Israel.
| | - Amit Itay
- Department of Oncology, Sheba Medical Center, Derech Sheba 2, Tel-Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel-Aviv University, P.O.B 39040, Ramat Aviv, Tel Aviv, Israel
| | - Raanan Berger
- Department of Oncology, Sheba Medical Center, Derech Sheba 2, Tel-Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel-Aviv University, P.O.B 39040, Ramat Aviv, Tel Aviv, Israel
| | - Sharon Halperin
- Department of Oncology, Sheba Medical Center, Derech Sheba 2, Tel-Hashomer, Ramat Gan, Israel
| | - Menucha Jurkowicz
- Department of Oncology, Sheba Medical Center, Derech Sheba 2, Tel-Hashomer, Ramat Gan, Israel
| | - Einav G Levin
- Sackler Faculty of Medicine, Tel-Aviv University, P.O.B 39040, Ramat Aviv, Tel Aviv, Israel; The Infectious Diseases Unit, Sheba Medical Center, Derech Sheba 2, Tel-Hashomer, Ramat Gan, Israel
| | - Liraz Olmer
- Bio-statistical and Bio-mathematical Unit, The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Derech Sheba 2, Tel-Hashomer, Ramat Gan, Israel
| | - Gili Regev-Yochay
- Sackler Faculty of Medicine, Tel-Aviv University, P.O.B 39040, Ramat Aviv, Tel Aviv, Israel; The Infectious Diseases Unit, Sheba Medical Center, Derech Sheba 2, Tel-Hashomer, Ramat Gan, Israel
| | - Yaniv Lustig
- Sackler Faculty of Medicine, Tel-Aviv University, P.O.B 39040, Ramat Aviv, Tel Aviv, Israel; The Infectious Diseases Unit, Sheba Medical Center, Derech Sheba 2, Tel-Hashomer, Ramat Gan, Israel
| | - Galia Rahav
- Sackler Faculty of Medicine, Tel-Aviv University, P.O.B 39040, Ramat Aviv, Tel Aviv, Israel; The Infectious Diseases Unit, Sheba Medical Center, Derech Sheba 2, Tel-Hashomer, Ramat Gan, Israel
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15
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Mencoboni M, Fontana V, Damiani A, Spitaleri A, Raso A, Bottaro LC, Rossi G, Canobbio L, La Camera A, Filiberti RA, Taveggia P, Cavo A. Antibody Response to COVID-19 mRNA Vaccines in Oncologic and Hematologic Patients Undergoing Chemotherapy. Curr Oncol 2022; 29:3364-3374. [PMID: 35621663 PMCID: PMC9139308 DOI: 10.3390/curroncol29050273] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/01/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Information on immune responses in cancer patients following mRNA COVID-19 vaccines is still insufficient, but generally, patients had impaired serological responses, especially those with hematological malignancies. We evaluated serological response to COVID-19 mRNA vaccine in cancer patients receiving chemotherapy compared with healthy controls. METHODS In total, 195 cancer patients and 400 randomly selected controls who had been administered a Pfizer-BioNTech or Moderna COVID-19 vaccines in two doses were compared. The threshold of positivity was 4.33 BAU/mL. Patients were receiving anticancer treatment after the first and second dose of the vaccines. RESULTS a TOTAL OF 169 patients (87%) had solid tumors and 26 hemolymphopoietic diseases. Seropositivity rate was lower in patients than controls (91% vs. 96%), with an age/gender-adjusted rate ratio (RR) of 0.95 (95% CL = 0.89-1.02). Positivity was found in 97% of solid cancers and in 50% of hemolymphopoietic tumors. Both advanced and adjuvant therapy seemed to slightly reduce seropositivity rates in patients when compared to controls (RR = 0.97, 95% CL = 0.89-1.06; RR = 0.94, 95% CL = 0.87-1.01). CONCLUSIONS the response to vaccination is similar in patients affected by solid tumors to controls. On the contrary, hemolymphopietic patients show a much lower response than controls.
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Affiliation(s)
- Manlio Mencoboni
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
| | - Vincenzo Fontana
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 12, 16100 Genoa, Italy;
| | - Azzurra Damiani
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
| | - Antonino Spitaleri
- Analysis Laboratory, ASL 3, Via Bertani 4, 16125 Genoa, Italy; (A.S.); (A.R.)
| | - Alessandro Raso
- Analysis Laboratory, ASL 3, Via Bertani 4, 16125 Genoa, Italy; (A.S.); (A.R.)
| | | | - Giovanni Rossi
- Oncology Unit, Antero Micone Hospital, Largo Nevio Rosso 2, 16100 Genoa, Italy; (G.R.); (L.C.)
| | - Luciano Canobbio
- Oncology Unit, Antero Micone Hospital, Largo Nevio Rosso 2, 16100 Genoa, Italy; (G.R.); (L.C.)
| | - Antonella La Camera
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
| | - Rosa Angela Filiberti
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 12, 16100 Genoa, Italy;
| | - Paola Taveggia
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
| | - Alessia Cavo
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
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Kobayashi T. Editorial Comment from Dr Kobayashi to Effect of active anticancer therapy on serologic response to SARS-CoV-2 BNT162b2 vaccine in patients with urothelial and renal cell carcinoma. Int J Urol 2022; 29:739. [PMID: 35478200 PMCID: PMC9111718 DOI: 10.1111/iju.14919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Takashi Kobayashi
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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17
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Seroconversion after SARS-CoV-2 mRNA booster vaccine in cancer patients. Eur J Cancer 2022; 167:175-176. [PMID: 35370047 PMCID: PMC8920783 DOI: 10.1016/j.ejca.2022.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 11/22/2022]
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