Immunogenicity and Optimal Timing of 13-Valent Pneumococcal Conjugate Vaccination during Adjuvant Chemotherapy in Gastric and Colorectal Cancer: A Randomized Controlled Trial

Abstract

Pneumococcal vaccination (13-valent pneumococcal conjugate vaccine [PCV13]) is recommended to cancer patients undergoing systemic chemotherapy. However, the optimal time interval between vaccine administration and initiation of chemotherapy has been little studied in adult patients with solid malignancies. Materials and MethodsWe conducted a prospective randomized controlled trial to evaluate whether administering PCV13 on the first day of chemotherapy is non-inferior to vaccinating 2 weeks prior to chemotherapy initiation. Patients were randomly assigned to two study arms, and serum samples were collected at baseline and 4 weeks after vaccination to analyze the serologic response against Streptococcus pneumoniae using a multiplexed opsonophagocytic killing assay. ResultsOf the 92 patients who underwent randomization, 43 patients in arm A (vaccination 2 weeks before chemotherapy) and 44 patients in arm B (vaccination on the first day of chemotherapy) were analyzed. Immunogenicity was assessed by geometric mean and fold-increase of post-vaccination titers, seroprotection rates (percentage of patients with post-vaccination titers > 1:64), and seroconversion rates (percentage of patients with > 4-fold increase in post-vaccination titers). Serologic responses to PCV13 did not differ significantly between the two study arms according to all three types of assessments. ConclusionThe overall antibody response to PCV13 is adequate in patients with gastric and colorectal cancer during adjuvant chemotherapy, and no significant difference was found when patients were vaccinated two weeks before or on the day of chemotherapy initiation.

Can Cancer Survivors Donate Convalescent Plasma for the Treatment of COVID-19?

“…Hence, the degree of immunosuppression is expected to be minimal. Consistent with this, no deficiency in serologic response was noted in patients with solid tumors, such as gastric and colorectal cancers, vaccinated with pneumococcal vaccine, 34 or influenza vaccine. 35 They have responded with adequate antibody titers.…”

Reduced humoral immune response after BNT162b2 coronavirus disease 2019 messenger RNA vaccination in cancer patients under antineoplastic treatment

“…Although in contradiction with recommendations for vaccine administration between chemotherapy cycles 32 , this is in line with non-mRNA vaccines such as influenza 33 and pneumococcal vaccins. 34 As a beneficial effect of booster vaccination against influenza has been demonstrated 30 , this supports further studies to investigate the role of additional booster vaccination BNT162b2 in improving vaccine efficacy.…”

Invasive pneumococcal disease among adults with hematological and solid organ malignancies: A population-based cohort study

“…This is comparable to vaccine efficacy of one single dose of PPSV23 (vaccine efficacy 27%) or PCV13 (vaccine efficacy 31%) against pneumococcal CAP in healthy elderly persons (Bonten et al, 2015;Suzuki et al, 2017). Immunogenicity studies report serological response rates of >50% for MM, CLL, gastric cancer, and colon cancer, and post HSCT (Choi et al, 2020;Cordonnier et al, 2010;Pasiarski et al, 2014;Renaud et al, 2019).…”

“…Hypothetical vaccine efficacy values (Ve) of 40% and 60% were applied. The Ve values were based on several studies investigating the effectiveness and immunogenicity of pneumococcal vaccines (Chiou et al, 2015;Choi et al, 2020;Pasiarski et al, 2014;Renaud et al, 2019). NNV was calculated as follows:…”