Antibody response to SARS-CoV-2 mRNA vaccine in lung cancer patients: Reactivity to vaccine antigen and variants of concern

Abstract

Purpose: We investigated SARS-CoV-2 mRNA vaccine-induced binding and live-virus neutralizing antibody response in NSCLC patients to the SARS-CoV-2 wild type strain and the emerging Delta and Omicron variants. Methods: 82 NSCLC patients and 53 healthy adult volunteers who received SARS-CoV-2 mRNA vaccines were included in the study. Blood was collected longitudinally, and SARS-CoV-2-specific binding and live-virus neutralization response to 614D (WT), B.1.617.2 (Delta), B.1.351 (Beta) and B.1.1.529 (Omicron) variants were evaluated by Meso Scale Discovery (MSD) assay and Focus Reduction Neutralization Assay (FRNT) respectively. We determined the longevity and persistence of vaccine-induced antibody response in NSCLC patients. The effect of vaccine-type, age, gender, race and cancer therapy on the antibody response was evaluated. Results: Binding antibody titer to the mRNA vaccines were lower in the NSCLC patients compared to the healthy volunteers (P=<0.0001). More importantly, NSCLC patients had reduced live-virus neutralizing activity compared to the healthy vaccinees (P=<0.0001). Spike and RBD-specific binding IgG titers peaked after a week following the second vaccine dose and declined after six months (P=<0.001). While patients >70 years had lower IgG titers (P=<0.01), patients receiving either PD-1 monotherapy, chemotherapy or a combination of both did not have a significant impact on the antibody response. Binding antibody titers to the Delta and Beta variants were lower compared to the WT strain (P=<0.0001). Importantly, we observed significantly lower FRNT50 titers to Delta (6-fold), and Omicron (79-fold) variants (P=<0.0001) in NSCLC patients. Conclusions: Binding and live-virus neutralizing antibody titers to SARS-CoV-2 mRNA vaccines in NSCLC patients were lower than the healthy vaccinees, with significantly lower live-virus neutralization of B.1.617.2 (Delta), and more importantly, the B.1.1.529 (Omicron) variant compared to the wild-type strain. These data highlight the concern for cancer patients given the rapid spread of SARS-CoV-2 Omicron variant.

COVID-19 vaccines in patients with cancer: immunogenicity, efficacy and safety

“…Initial data on Omicron neutralization in patients with cancer confirm the expected findings deduced from the general population 116 : the percentage of patients with solid tumours with neutralizing responses against Omicron increased from 47.8% to 88.9% following a third vaccine dose 117 . In particular, patients with non-small-cell lung cancer have a 79-fold lower neutralizing response to Omicron compared with individuals without cancer after two doses of an mRNA vaccine 118 . In patients with haematological malignancies, neutralizing antibodies against Omicron are rarely detected after two vaccine doses, although approximately 50% have detectable neutralizing antibodies after a third dose 119 .…”

Emerging evidence on Omicron (B.1.1.529) SARS‐CoV‐2 variant

“…Pfizer claims in a recent press release that three doses provide significant protection, but there is no evidence to back up this claim 77 . The spread of SARS‐CoV‐2 Omicron variant has caused concern among cancer patients, according to Valanparambil et al Non‐small cell lung cancer patients had lower binding and live‐virus‐neutralizing antibody titers to SARS‐CoV‐2 mRNA vaccines than healthy vaccines, with significantly decreased live‐virus neutralization of the Delta and Omicron variants than the wild‐type strain 78 . The neutralizing potential of vaccine‐induced and hybrid immunity‐induced antibodies is significantly reduced in the Omicron variant.…”

“…77 The spread of SARS-CoV-2 Omicron variant has caused concern among cancer patients, according to Valanparambil et al Nonsmall cell lung cancer patients had lower binding and live-virusneutralizing antibody titers to SARS-CoV-2 mRNA vaccines than healthy vaccines, with significantly decreased live-virus neutralization of the Delta and Omicron variants than the wild-type strain. 78 The neutralizing potential of vaccine-induced and hybrid immunity-induced antibodies is significantly reduced in the Omicron variant. This could justify immune escape and high transmission despite extensive vaccination coverage.…”

Prospective Medicinal Plants and Their Phytochemicals Shielding Autoimmune and Cancer Patients Against the SARS-CoV-2 Pandemic: A Special Focus on Matcha

“…Focusing on cancer patients and patients with autoimmune diseases, there are several studies that showed impaired antibody responses following dual COVID-19 vaccination in patients with chronic lymphocytic leukemia ( 81 ) and lung cancer ( 82 ). Furthermore, it was proved that humoral protection against the delta variant is markedly impaired among chronic lymphocytic leukemia patients, indicating the urgent need for further optimization of immune protection in this patient cohort ( 81 ).…”