Immunogenicity and early clinical outcome after two or three doses of SARS-CoV-2 mRNA-BNT162b2 vaccine in actively treated cancer patients: results from the prospective observational Vax-On-Third study

Nelli, Fabrizio; Giannarelli, Diana; Fabbri, Agnese; Silvestri, Maria Assunta; Berrìos, Julio Rodrigo Giròn; Virtuoso, Antonella; Marrucci, Eleonora; Schirripa, Marta; Mazzotta, Marco; Onorato, Angelo; Panichi, Valentina; Topini, Giuseppe; Pessina, G; Natoni, Federica; Signorelli, Carlo; Chilelli, Mario Giovanni; Primi, Francesca; Ruggeri, Enzo Maria

doi:10.1016/j.annonc.2022.04.002

Cited by 8 publications

(9 citation statements)

References 5 publications

(5 reference statements)

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“…The rate of new SARS-CoV-2 infections after three doses of mRNA-BNT162b2 vaccine in actively treated cancer patients has been reported in 6.3% of cases, which is very similar to that reported in our series. None of the SARS-CoV-2 infection in cancer patients was clinically severe 26 as we observed in LTs. Since the median anti-SARS-CoV-2 antibody titres between LTs who experienced or not symptomatic infection was not statistically different, further well-conducted studies must be performed to detect, if possible, the minimum post-vaccination anti-SARS-CoV-2 antibody titre protecting LTs from new SARS-CoV-2 infection.…”

Section: Mmf (T + E T + a T + P C + Psupporting

confidence: 49%

Immunogenicity and safety of a third dose of anti‐SARS‐CoV‐2 BNT16b2 vaccine in liver transplant recipients

Toniutto

Cussigh

Cmet

et al. 2022

Liver International

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Background & Aims A strategy to improve the low rate of anti‐SARS‐CoV‐2 mRNA vaccine‐induced immunogenicity in liver transplant recipients (LTs) is urgently needed. Methods We analyzed the rate of positive (≥0.8 U/ml) anti‐SARS‐CoV‐2 receptor domain binding protein (RBD) antibody response two months after a third dose of the BNT16b2 vaccine in 107 LTs who completed the second vaccine dose seven months earlier. Results A positive anti‐SARS‐CoV‐2‐s‐RBD antibody response after the third vaccine dose was detected in 98 (91.6%) LTs compared to 82 (76.6%) after the second vaccine dose (p=0.003). The median of anti‐SARS‐CoV‐2 RBD antibody titers increased from 22.9 U/ml six months after the second to 3500 U/ml two months after the third vaccine dose (p<0.001). Fourteen (14.3%) responder patients presented antibody titers <100 U/ml, 57 (58.2%) between 100 and 9999 U/ml and 27 (27.6%) ≥10000 U/ml. Seropositivity after the second dose was maintained after the third dose. Independent predictors of antibody response failure after the third vaccine dose were taking a higher daily dose of mycophenolate mofetil (MMF, p<0.001) and had a lower (<60 ml/min/1.73m 2 ) estimated glomerular filtration rate (p=0.007). Nine (9.1%) LTs experienced symptomatic SARS‐CoV‐2 infection after the third vaccine dose. Median antibody titers were not statistically different between infected and not infected LTs (1325 vs 3515 U/ml, p=0.678). Conclusions The third dose of the BNT16b2 vaccine increased the number of LTs who developed a positive anti‐SARS‐CoV‐2 s‐RBD antibody response. A proportion of patients remained unresponsive, mainly for modifiable factors, such the use of MMF or multiple immunosuppressants.

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Section: Mmf (T + E T + a T + P C + Psupporting

confidence: 49%

Immunogenicity and safety of a third dose of anti‐SARS‐CoV‐2 BNT16b2 vaccine in liver transplant recipients

Toniutto

Cussigh

Cmet

et al. 2022

Liver International

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“…In total, 10 studies [ 14 , 16 , 19 , 24 , 34 , 64 , 73 , 76 , 77 , 78 ] provided immune response information for patients with solid tumors, whereas 48 studies reported immune seroconversion results from patients with hematological malignancies [ 7 , 17 , 20 , 21 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 32 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 45 , 46 , 47 , 48 , 49 , 51 , 53 , 54 , 55 , 56 , 57 , 59 , 60 , 61 , 62 , 63 , 66 , 68 , 69 , 70 , 74 , 75 ,…”

Section: Resultsmentioning

confidence: 99%

“…Studies were also stratified according to the type of vaccine that patients received. Of the 70 included studies, 30 studies reported vaccination results after vaccination with BN162b2 only [ 14 , 16 , 18 , 20 , 22 , 23 , 24 , 27 , 28 , 30 , 34 , 35 , 37 , 38 , 39 , 40 , 43 , 45 , 47 , 53 , 57 , 58 , 63 , 66 , 77 , 78 , 80 , 81 , 82 , 83 ], 20 studies reported results from vaccination with either BNT162b2 or mRNA-1273 vaccine [ 7 , 17 , 25 , 36 , 40 , 44 , 46 , 48 , 52 , 54 , 59 , 60 , 62 , 67 , 68 , 70 , 72 , 73 , 74 , 76 ], 11 studies reported results from vaccination with either BNT162b2 or AZD1222 vaccine [ 21 , ...…”

Section: Resultsmentioning

confidence: 99%

“…In total, 60 studies were included for data analysis on booster COVID-19 vaccination, 43 studies reported on the immune response of a total of 4754 patients with a diagnosis of hematological malignancy, and 22 studies determined immune seroconversion in 2440 patients with solid tumors [ 78 , 79 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 ,…”

Section: Resultsmentioning

confidence: 99%

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Adult Patients with Cancer Have Impaired Humoral Responses to Complete and Booster COVID-19 Vaccination, Especially Those with Hematologic Cancer on Active Treatment: A Systematic Review and Meta-Analysis

Liatsou

Ntanasis‐Stathopoulos

Lykos

et al. 2023

Cancers

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The exclusion of patients with cancer in clinical trials evaluating COVID-19 vaccine efficacy and safety, in combination with the high rate of severe infections, highlights the need for optimizing vaccination strategies. The aim of this study was to perform a systematic review and meta-analysis of the published available data from prospective and retrospective cohort studies that included patients with either solid or hematological malignancies according to the PRISMA Guidelines. A literature search was performed in the following databases: Medline (Pubmed), Scopus, Clinicaltrials.gov, EMBASE, CENTRAL and Google Scholar. Overall, 70 studies were included for the first and second vaccine dose and 60 studies for the third dose. The Effect Size (ES) of the seroconversion rate after the first dose was 0.41 (95%CI: 0.33–0.50) for hematological malignancies and 0.56 (95%CI: 0.47–0.64) for solid tumors. The seroconversion rates after the second dose were 0.62 (95%CI: 0.57–0.67) for hematological malignancies and 0.88 (95%CI: 0.82–0.93) for solid tumors. After the third dose, the ES for seroconversion was estimated at 0.63 (95%CI: 0.54–0.72) for hematological cancer and 0.88 (95%CI: 0.75–0.97) for solid tumors. A subgroup analysis was performed to evaluate potential factors affecting immune response. Production of anti-SARS-CoV-2 antibodies was found to be more affected in patients with hematological malignancies, which was attributed to the type of malignancy and treatment with monoclonal antibodies according to the subgroup analyses. Overall, this study highlights that patients with cancer present suboptimal humoral responses after COVID-19 vaccination. Several factors including timing of vaccination in relevance with active therapy, type of therapy, and type of cancer should be considered throughout the immunization process.

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“…It is well documented that SARS-CoV-2 infection and related COVID-19 conditions will negatively impact the clinical outcomes of cancer patients, including hospital admission and death, as compared to the corresponding uninfected patients. Since their availability, the immunogenicity of SARS-CoV-2 vaccines has been demonstrated in the general population and in patients with several cancer sites/types [10] , [11] , [12] . Such efficacy includes the recent vaccines against the Omicron variant [13] , an observation that has a specific significance in cancer patients, given their potential weakened vaccine-induced immunity [14] .…”

Section: Discussionmentioning

confidence: 99%

Vaccination against SARS-CoV-2 and risk of hospital admission and death among infected cancer patients: A population-based study in northern Italy

Gobbato¹,

Clagnan²,

Toffolutti³

et al. 2023

Cancer Epidemiology

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Immunogenicity and early clinical outcome after two or three doses of SARS-CoV-2 mRNA-BNT162b2 vaccine in actively treated cancer patients: results from the prospective observational Vax-On-Third study

Cited by 8 publications

References 5 publications

Immunogenicity and safety of a third dose of anti‐SARS‐CoV‐2 BNT16b2 vaccine in liver transplant recipients

Immunogenicity and safety of a third dose of anti‐SARS‐CoV‐2 BNT16b2 vaccine in liver transplant recipients

Adult Patients with Cancer Have Impaired Humoral Responses to Complete and Booster COVID-19 Vaccination, Especially Those with Hematologic Cancer on Active Treatment: A Systematic Review and Meta-Analysis

Vaccination against SARS-CoV-2 and risk of hospital admission and death among infected cancer patients: A population-based study in northern Italy

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