Immunogenicity and risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection after Coronavirus Disease 2019 (COVID-19) vaccination in patients with cancer: a systematic review and meta-analysis

Becerril-Gaitan, Andrea; Vaca-Cartagena, B.F.; Ferrigno, Ana S.; Mesa-Chavez, Fernanda; Barrientos‐Gutiérrez, Tonatiuh; Tagliamento, Marco; Lambertini, Matteo; Villarreal‐Garza, Cynthia

doi:10.1016/j.ejca.2021.10.014

Cited by 104 publications

(116 citation statements)

References 69 publications

Supporting

Mentioning

101

Contrasting

Unclassified

Order By: Relevance

“…We observed that 96.3% of patients in our cohort who were vaccinated had seroconverted when considering any positive result post first vaccination, and all results >14 days post second vaccination as the denominator. This is higher than reported in some studies 11,14,15 . Importantly, there was no difference in response between patients receiving chemotherapy, immunotherapy or other treatments.…”

Section: Discussioncontrasting

confidence: 68%

Scottish COVID CAncer iMmunity Prevalence (SCCAMP) - a longitudinal study of patients with cancer receiving active anti-cancer treatment during the COVID-19 pandemic

Purshouse

Thomson

Vallet

et al. 2022

Preprint

View full text Add to dashboard Cite

BackgroundCancer and systemic anti-cancer treatment (SACT) have been identified as possible risk factors for infection and related severe illness associated with SARS-CoV-2 virus as a consequence of immune suppression. The Scottish COVID CAncer iMmunity Prevalence (SCCAMP) study aims to characterise the incidence and outcomes of SARS-Cov-2 infection in patients undergoing active anti-cancer treatment during the COVID-19 pandemic and their antibody response following vaccination.Patients and MethodsEligible patients were those attending secondary care for active anti-cancer treatment for a solid tumour. Blood samples were taken for total SARS-CoV-2 antibody assay (Siemens) at baseline and after 1.5, 3, 6 and 12 months. Data on COVID-19 infection, vaccination, cancer type, treatment and outcome was obtained from routine electronic health records.ResultsThe study recruited 766 eligible participants between 28th May 2020 and 31st October 2021. The median age was 62.7 years, and 66.5% were female. Most received cytotoxic chemotherapy (79%), with the remaining 14% receiving immunotherapy and 7% receiving another form of anti-cancer therapy (radiotherapy, other systemic anti-cancer treatment). 48 (6.3%) tested positive for SARS-CoV-2 by PCR during the study period. The overall infection rate matched that of the age-matched local general population until May 2021, after which population levels appeared higher. Antibody testing detected additional evidence of infection prior to vaccination, taking the total number to 58 (7.6%). There was no significant difference in SARS-CoV-2 PCR positive test rates based on type of anti-cancer treatment. Mortality proportion was similar between those who died within 90 days of a positive SARS-CoV-2 PCR and those with no positive PCR (10.4% vs 10.6%). Death from all causes was lowest among vaccinated patients, and of the patients who had a positive SARS-CoV-2 PCR at any time, all of those who died during the study period were unvaccinated. Multivariate analysis correcting for age, gender, socioeconomic status, comorbidities and number of previous medications revealed that vaccination was associated with a significantly lower infection rate regardless of treatment with chemotherapy or immunotherapy with hazard ratios of 0.307 (95% CI 0.144-0.6548) or 0.314 (95% CI 0.041-2.367) in vaccinated patients respectively. Where antibody data was available, 96.3% of patients successfully raised SARS-CoV-2 antibodies at a time point after vaccination. This was unaffected by treatment type.ConclusionSCCAMP provides real-world evidence that patients with cancer undergoing SACT have a high antibody response and protection from SARS-CoV-2 infection following COVID-19 vaccination.Highlights-The SCCAMP dataset represents the largest longitudinal study of patients with cancer undergoing anti-cancer treatment during the COVID-19 pandemic-Rates of infection in the cancer cohort mirrored those of the local age adjusted population-Vaccination was effective in patients with cancer undergoing active treatment in terms of antibody response and SARS-CoV-2 PCR rates-Treatment type did not impact the rate of SARS-CoV-2 antibody response

show abstract

Section: Discussioncontrasting

confidence: 68%

Scottish COVID CAncer iMmunity Prevalence (SCCAMP) - a longitudinal study of patients with cancer receiving active anti-cancer treatment during the COVID-19 pandemic

Purshouse

Thomson

Vallet

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Patients in need of ongoing lymphoma treatment are prime candidates for passive immunization with monoclonal anti-SARS-CoV-2 antibodies, although vaccination should still be attempted as vaccine benefits may extend beyond neutralizing antibodies. Emerging evidence suggests that vaccinated patients with hematologic malignancies have greater risk of infection, hospitalization, and death compared to vaccinated controls (23,24). While rates of poor outcomes are much lower than seen in unvaccinated patients with hematologic malignancies, signaling the benefit of vaccination, layering of additional mitigation strategies is clearly needed.…”

Section: Discussionmentioning

confidence: 99%

CD20-Targeted Therapy Ablates De Novo Antibody Response to Vaccination but Spares Preestablished Immunity

Shree

Shankar

Lohmeyer

et al. 2022

Blood Cancer Discovery

View full text Add to dashboard Cite

To obtain a deeper understanding of poor responses to COVID-19 vaccination in patients with lymphoma, we assessed blocking antibodies, total anti-spike IgG, and spike-specific memory B cells in the peripheral blood of 126 patients with lymphoma and 20 age-matched healthy controls 1 and 4 months after COVID-19 vaccination. Fifty-five percent of patients developed blocking antibodies postvaccination, compared with 100% of controls. When evaluating patients last treated from days to nearly 18 years prior to vaccination, time since last anti-CD20 was a significant independent predictor of vaccine response. None of 31 patients who had received anti-CD20 treatment within 6 months prior to vaccination developed blocking antibodies. In contrast, patients who initiated anti-CD20 treatment shortly after achieving a vaccine-induced antibody response tended to retain that response during treatment, suggesting a policy of immunizing prior to treatment whenever possible. Significance: In a large cohort of patients with B-cell lymphoma, time since anti-CD20 treatment was an independent predictor of neutralizing antibody response to COVID-19 vaccination. Comparing patients who received anti-CD20 treatment before or after vaccination, we demonstrate that vaccinating first can generate an antibody response that endures through anti-CD20–containing treatment. This article is highlighted in the In This Issue feature, p. 85

show abstract

“…From end April 2021 onwards, vaccine efficacy studies conducted among patients with cancer were published ( 6 , 7 ), these patients having been excluded from registration trials without any initial efficacy data. Around the same time, first comparative data focused on humoral and cellular vaccine responses in patients with solid cancer and HM were published ( 8 ), and many publications have recently been reviewed ( 24 , 25 , 26 ).…”

Section: Introductionmentioning

confidence: 99%

Third dose of anti-SARS-CoV-2 vaccine for patients with cancer: Should humoral responses be monitored? A position article

Barrière

Carlès

Audigier-Valette

et al. 2022

European Journal of Cancer

View full text Add to dashboard Cite

Taking into account higher risk of severe coronavirus disease 2019 (COVID-19) or death among patients with cancer, as well as impaired immunogenicity following anti-SARS-CoV-2 vaccines, in addition to waning immunity, booster dosing appears mandatory in this patient population. This review sought to provide reasonable evidence so as to assist oncologists in their daily practice, helping them decide when an anti-SARS-Cov2 antibodies (Abs) dosage should be scheduled following a full two-dose vaccination and if necessary, propose an early third dose (D3). Such D3 could apply to non-responder patients with anti-Spike (S) Abs titers < 40 binding antibody units (BAU)/mL. For low-responder patients with anti-S Abs titers between 40 BAU/mL and 100/260 BAU/mL (suggested area of uncertainty), an early D3 may similarly be proposed. Nevertheless, this D3 could be administered in a less urgent manner, taking into account associated co-morbidities and regional epidemic incidence rates. This latter strategy may comprise a monthly dosage of anti-S titers so as to better assess the kinetics of waning immunity. For responder patients with anti-S titers above 260 BAU/mL, we suggest to follow the recommendations outlined for the general population. Given this context, patients with anti-S titers above 1000 BAU/mL should be given the possibility to undergo anti-S titer control after 3 months, designed to assess rapid humoral waning immunity. We strongly recommend that patients with cancer be included into observational serological monitoring studies or clinical trials that are dedicated to severe immunocompromised patients without any humoral seroconversion after D3.

show abstract

Immunogenicity and risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection after Coronavirus Disease 2019 (COVID-19) vaccination in patients with cancer: a systematic review and meta-analysis

Cited by 104 publications

References 69 publications

Scottish COVID CAncer iMmunity Prevalence (SCCAMP) - a longitudinal study of patients with cancer receiving active anti-cancer treatment during the COVID-19 pandemic

Scottish COVID CAncer iMmunity Prevalence (SCCAMP) - a longitudinal study of patients with cancer receiving active anti-cancer treatment during the COVID-19 pandemic

CD20-Targeted Therapy Ablates De Novo Antibody Response to Vaccination but Spares Preestablished Immunity

Third dose of anti-SARS-CoV-2 vaccine for patients with cancer: Should humoral responses be monitored? A position article

Contact Info

Product

Resources

About