Immunogenicity and safety of COVID-19 vaccine in lung cancer patients receiving anticancer treatment: A prospective multicenter cohort study

Abstract

This study assessed the immunogenicity and safety of the BNT162b2 mRNA vaccine in lung cancer patients receiving anticancer treatment. We enrolled lung cancer patients receiving anticancer treatment and non-cancer patients; all participants were fully vaccinated with the BNT162b2 vaccine. Blood samples were collected before the first and second vaccinations and 4 ± 1 weeks after the second vaccination. Anti-severe respiratory syndrome coronavirus-2 (SARS-CoV-2) spike protein S1 subunit receptor-binding domain antibody titers were measured using the Architect SARS-CoV-2 IgG II Quant and Elecsys Anti-SARS-CoV-2 S assays. Fifty-five lung cancer patients and 38 non-cancer patients were included in the immunogenicity analysis. Lung cancer patients showed significant increase in the geometric mean antibody concentration, which was significantly lower than that in the non-cancer patients after the first (30 vs. 121 AU/mL, p < .001 on Architect; 4.0 vs 1.2 U/mL, p < .001 on Elecsys) and second vaccinations (1632 vs. 3472 AU/mL, p = .005 on Architect; 213 vs 573 A/mL, p = .002 on Elecsys). The adjusted odds ratio (aOR) for seroprotection was significantly lower ( p < .05) in lung cancer patients than that in non-cancer patients. Analysis of the anticancer treatment types showed that the aOR for seroprotection was significantly lower ( p < .05) in lung cancer patients receiving cytotoxic agents. They showed no increase in adverse reactions. BNT162b2 vaccination in lung cancer patients undergoing anticancer treatment significantly increased ( p < .05) antibody titers and showed acceptable safety. Immunogenicity in these patients could be inadequate compared with that in non-cancer patients.

Outcomes of Thoracoscopic Lobectomy after Recent COVID-19 Infection

“…Oncological patients suffered many consequences of the COVID-19 pandemic. In the initial phases of the pandemic, the accessibility to diagnostic and therapeutic pathways was impaired due to the conversion of several departments into COVID-19 units, causing disruptions to oncological screening, treatment, and surveillance [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. Additionally, COVID-19 infection can cause serious complications in oncological patients undergoing chemotherapy or recovering from recent surgery [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ].…”

Serological Response to SARS-CoV-2 after COVID-19 Vaccination in Lung Cancer patients: Short Review

“…Articles that focused only on LC patients showed that COVID-19 mRNA and viral vectorbased vaccines can safely generate humoral immune responses in these patients, albeit at somewhat diminished levels compared to those in the general population. Out of the nine articles that specifically examine vaccine immunogenicity in LC patients, six demonstrate significant differences in median titers following the primary vaccination series when compared to HC data [29][30][31][33][34][35]. The variety of emerging and still-evolving Omicron variants of SARS-CoV-2, with the ability to overcome primary vaccination-induced immunity, present significant new threats to LC patients.…”

“…It has also been shown that additional booster doses of the COVID-19 vaccination can improve on the inferior immunological effectiveness of the primary doses in patients with lung cancer. Five studies reported seroconversion rates (defined as the proportion of vaccine recipients whose blood titers for SARS-CoV-2 vaccine antibodies were higher than the test-specific lower limit cutoff value) of LC or thoracic cancer patients, at 93.7% [29], 95.2% [4,30], 98% [30], 99.1% [28], and 96.7% [31,32]. Mack et al [32] reported that LC patient Ab titers had a significantly reduced area under the curve per day compared to control antibody titers.…”

“…In another study, Nakashima et al [30], investigated the immunogenicity of BNT162b2 mRNA vaccine in a cohort of 55 LC patients, with a mean age of 73.1, the oldest mean age among all our eligible studies. This was one of two studies that showed no difference in seropositivity rate between LC patients and healthy control, at 98% and 100% respectively.…”

Serological Response to SARS-CoV-2 after COVID-19 Vaccination in Lung Cancer Patients: Short Review

“…Seven studies included healthy controls (HC) in the study cohorts, while two studies [ 4 , 28 ] did not employ controls. All studies accounted for the confounding factors of age, anticancer treatment, and steroid use, while most also included performance status and comorbidities [ 4 , 30 , 31 , 32 , 34 , 35 ]. Overall, after primary dose vaccination, patients with lung cancer showed lower seropositivity rates compared to healthy controls.…”