Immunological Response to COVID-19 Vaccination in Ovarian Cancer Patients Receiving PARP Inhibitors

Liontos, Michalis; Terpos, Evangelos; Markellos, Christos; Zagouri, Flora; Briasoulis, Αlexandros; Katsiana, Ioanna; Skafida, Efthymia; Fiste, Oraianthi; Kunadis, Elena; Andrikopoulou, Αngeliki; Kaparelou, Maria; Koutsoukos, Konstantinos; Gavriatopoulou, Maria; Kastritis, Efstathios; Trougakos, Ioannis P.; Dimopoulos, Meletios-Athanasios

doi:10.3390/vaccines9101148

Cited by 12 publications

(9 citation statements)

References 21 publications

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“…Overall, 82 studies were included for meta-analysis ( table 1 , supplementary table 2). 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 …”

Section: Resultsmentioning

confidence: 99%

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Efficacy of covid-19 vaccines in immunocompromised patients: systematic review and meta-analysis

Lee

Wong

Chai

et al. 2022

BMJ

312

313

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Objective To compare the efficacy of covid-19 vaccines between immunocompromised and immunocompetent people. Design Systematic review and meta-analysis. Data sources PubMed, Embase, Central Register of Controlled Trials, COVID-19 Open Research Dataset Challenge (CORD-19), and WHO covid-19 databases for studies published between 1 December 2020 and 5 November 2021. ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform were searched in November 2021 to identify registered but as yet unpublished or ongoing studies. Study selection Prospective observational studies comparing the efficacy of covid-19 vaccination in immunocompromised and immunocompetent participants. Methods A frequentist random effects meta-analysis was used to separately pool relative and absolute risks of seroconversion after the first and second doses of a covid-19 vaccine. Systematic review without meta-analysis of SARS-CoV-2 antibody titre levels was performed after first, second, and third vaccine doses and the seroconversion rate after a third dose. Risk of bias and certainty of evidence were assessed. Results 82 studies were included in the meta-analysis. Of these studies, 77 (94%) used mRNA vaccines, 16 (20%) viral vector vaccines, and 4 (5%) inactivated whole virus vaccines. 63 studies were assessed to be at low risk of bias and 19 at moderate risk of bias. After one vaccine dose, seroconversion was about half as likely in patients with haematological cancers (risk ratio 0.40, 95% confidence interval 0.32 to 0.50, I 2 =80%; absolute risk 0.29, 95% confidence interval 0.20 to 0.40, I 2 =89%), immune mediated inflammatory disorders (0.53, 0.39 to 0.71, I 2 =89%; 0.29, 0.11 to 0.58, I 2 =97%), and solid cancers (0.55, 0.46 to 0.65, I 2 =78%; 0.44, 0.36 to 0.53, I 2 =84%) compared with immunocompetent controls, whereas organ transplant recipients were 16 times less likely to seroconvert (0.06, 0.04 to 0.09, I 2 =0%; 0.06, 0.04 to 0.08, I 2 =0%). After a second dose, seroconversion remained least likely in transplant recipients (0.39, 0.32 to 0.46, I 2 =92%; 0.35, 0.26 to 0.46), with only a third achieving seroconversion. Seroconversion was increasingly likely in patients with haematological cancers (0.63, 0.57 to 0.69, I 2 =88%; 0.62, 0.54 to 0.70, I 2 =90%), immune mediated inflammatory disorders (0.75, 0.69 to 0.82, I 2 =92%; 0.77, 0.66 to 0.85, I 2 =93%), and solid cancers (0.90, 0.88 to 0.93, I 2 =51%; 0.89, 0.86 to 0.91, I 2 =49%). Seroconversion was similar between people with HIV and immunocompetent controls (1.00, 0.98 to 1.01, I 2 =0%; 0.97, 0.83 to 1.00, I 2 =89%). Systematic review of 11 studies showed that a third dose of a covid-19 mRNA vaccine was associated with seroconversion among vaccine non-responders with solid cancers, haematological cancers, and immune mediated inflammatory disorders, although response was variable in transplant recipients and inadequately studied in people with HIV and those receiving non-mRNA vaccines. Conclusion Seroconversion rates after covid-19 vaccination were significantly lower in immunocompromised patients, especially organ transplant recipients. A second dose was associated with consistently improved seroconversion across all patient groups, albeit at a lower magnitude for organ transplant recipients. Targeted interventions for immunocompromised patients, including a third (booster) dose, should be performed. Systematic review registration PROSPERO CRD42021272088.

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Section: Resultsmentioning

confidence: 99%

“… 108 Liontos et al, however, found comparable neutralising antibody titres among patients with breast and prostate cancer compared with immunocompetent controls. 37 38 …”

Section: Resultsmentioning

confidence: 99%

Efficacy of covid-19 vaccines in immunocompromised patients: systematic review and meta-analysis

Lee

Wong

Chai

et al. 2022

BMJ

312

313

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“…No indications exist that endocrine therapy or small molecules generally are associated with reduced seroconversion. Poly(ADP-ribose) polymerase inhibitors have been associated with reduced seroconversion in women with ovarian cancer 123 , and CDK4/6 inhibitors with reduced but not absent antibody responses 120 . Besides cancer-specific therapies, chronic steroid use is also a risk factor for reduced seroconversion 124 .…”

Section: Vaccination In Patients With Cancermentioning

confidence: 99%

“… 247 , a risk factor in ref. 120 ) Poly(ADP-ribose) polymerase inhibition associated with lower binding antibody levels 123 …”

Section: Vaccination In Patients With Cancermentioning

confidence: 99%

“…247 , a risk factor in ref. 120 ) • Poly(ADP-ribose) polymerase inhibition associated with lower binding antibody levels 123 Relevant reduction in antibody response uncommon c • Endocrine therapy 100,120,129,248 • Tyrosine kinase inhibitors 69,106,231 • Immune checkpoint inhibitors (reduced immune response may occur in approximately 10% of patients) 66,100,105,106,120,224,249 • Immunomodulatory drugs 163,231,239 • Proteasome inhibitors 163,231 Cellular therapy • Chimeric antigen receptor (CAR) T cell therapy is associated with a reduced immune response 120 , although the duration of this effect is unknown. • Uncomplicated stem cell transplantation (SCT) with stable engraftment is not associated with long-term impairment of the antibody response.…”

Section: Box 2 | Risks Of Reduced Antibody Responses After Covid-19 V...mentioning

confidence: 99%

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

et al. 2022

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Patients with cancer have a higher risk of severe coronavirus disease (COVID-19) and associated mortality than the general population. Owing to this increased risk, patients with cancer have been prioritized for COVID-19 vaccination globally, for both primary and booster vaccinations. However, given that these patients were not included in the pivotal clinical trials, considerable uncertainty remains regarding vaccine efficacy, and the extent of humoral and cellular immune responses in these patients, as well as the risks of vaccine-related adverse events. In this Review, we summarize the current knowledge generated in studies conducted since COVID-19 vaccines first became available. We also highlight critical points that might affect vaccine efficacy in patients with cancer in the future.

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Immunogenicity after vaccination of COVID-19 vaccines in patients with cancer: a prospective, single center, observational study

Katsuya,

Yoshida,

Takashima

et al. 2024

Int J Clin Oncol

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Background Patients with cancer, particularly those undergoing chemotherapy, are at risk from the low immunogenicity of Coronavirus Disease 19 (COVID-19) vaccines. Methods This prospective study assessed the seroconversion rate of COVID-19 vaccines among patients with cancer and hospital staff. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein-specific IgG (S-IgG) concentrations were evaluated before the first vaccination, and 1–3 and 4–6 months after the second vaccination. The primary endpoint was the seroconversion rate measured 1–3 months after the second vaccine. Results In total, 590 patients and 183 healthy hospital staff were analyzed. At 1–3 months after the second vaccination, the S-IgG antibody concentration exceeded the cut-off value (20 BAU/mL) in 96.1% (567/590) of the patients with cancer and 100% (183/183) of the healthy controls (p = 0.0024). At 4–6 months after the second vaccination, the S-IgG antibody concentration exceeded the cut-off value (20 BAU/ml for S-IgG) in 93.1% (461/495) of the patients with cancer and 100% (170/170) of the healthy controls (p < 0.0001). Old age, being male, and low lymphocyte count were related to low SARS-CoV-2 S-IgG levels 1–3 months after the second vaccination among patients, while body mass index, smoking history, and serum albumin level were not. Patients undergoing platinum combination therapy and alkylating agent among cytotoxic drugs, and PARP inhibitor, mTOR inhibitor, and BCR-ABL inhibitor exhibited a low S-IgG antibody concentration compared to the no treatment group. Conclusions COVID-19 vaccine immunogenicity was reduced among patients with cancer, especially under several treatment regimens.

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Immunological Response to COVID-19 Vaccination in Ovarian Cancer Patients Receiving PARP Inhibitors

Cited by 12 publications

References 21 publications

Efficacy of covid-19 vaccines in immunocompromised patients: systematic review and meta-analysis

Efficacy of covid-19 vaccines in immunocompromised patients: systematic review and meta-analysis

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

Immunogenicity after vaccination of COVID-19 vaccines in patients with cancer: a prospective, single center, observational study

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