SARS-CoV-2 infection in cancer patients on active therapy after the booster dose of mRNA vaccines

Giacomo, Anna Maria Di; Giacobini, Gianluca; Anichini, Gabriele; D’alonzo, Vincenzo; Calabrò, Luana; Lofiego, Maria Fortunata; Cusi, Maria Grazia; Maio, Michele

doi:10.1016/j.ejca.2022.05.018

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…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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Section: Resultsmentioning

confidence: 99%

“… Pooled EffectSize (ES) for the immune seroconversion rates of patients with solid tumors after the third dose of COVID-19 vaccine. [ 33 , 67 , 77 , 78 , 79 , 87 , 90 , 92 , 99 , 102 , 106 , 109 , 112 , 114 , 115 , 119 , 120 , 127 , 129 , 132 , 133 , 135 ]. …”

Section: Figurementioning

confidence: 99%

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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“…Most studies evaluating immune responses among cancer patients have included a wide range of patients, incorporating hematological patients who are known to be exposed to deeper immunosuppressive treatments or solid tumor patients treated with immunotherapy [ 24 , 25 ]. Not all cancer treatments have the same effect on the immune response.…”

Section: Discussionmentioning

confidence: 99%

Influence of SARS-CoV-2 mRNA Vaccine Booster among Cancer Patients on Active Treatment Previously Immunized with Inactivated versus mRNA Vaccines: A Prospective Cohort Study

et al. 2023

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Cancer patients on chemotherapy have a lower immune response to SARS-CoV-2 vaccines. Therefore, through a prospective cohort study of patients with solid tumors receiving chemotherapy, we aimed to determine the immunogenicity of an mRNA vaccine booster (BNT162b2) among patients previously immunized with an inactivated (CoronaVac) or homologous (BNT162b2) SARS-CoV-2 vaccine. The primary outcome was the proportion of patients with anti-SARS-CoV-2 neutralizing antibody (NAb) seropositivity at 8–12 weeks post-booster. The secondary end points included IgG antibody (TAb) seropositivity and specific T-cell responses. A total of 109 patients were included. Eighty-four (77%) had heterologous vaccine schedules (two doses of CoronaVac followed by the BNT162b2 booster) and twenty-five had (23%) homologous vaccine schedules (three doses of BNT162b2). IgG antibody positivity for the homologous and heterologous regimen were 100% and 96% (p = 0.338), whereas NAb positivity reached 100% and 92% (p = 0.13), respectively. Absolute NAb positivity and Tab levels were associated with the homologous schedule (with a beta coefficient of 0.26 with p = 0.027 and a geometric mean ratio 1.41 with p = 0.044, respectively). Both the homologous and heterologous vaccine regimens elicited a strong humoral and cellular response after the BNT162b2 booster. The homologous regimen was associated with higher NAb positivity and Tab levels after adjusting for relevant covariates.

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“…A third or fourth dose of an mRNA vaccine enhanced and sustained the antibody response against the Omicron variant in a high proportion of immunocompromised groups [46][47][48][49][50][51][52][53][54][55][56][57][58][59]. Nonetheless, lower levels of neutralising antibodies against Omicron after three doses of an mRNA vaccine and subsequent breakthrough infections in both immunocompromised and healthy groups were observed compared to the levels against the wild-type and Delta variant [50].…”

Section: Immunocompromised Groupsmentioning

confidence: 95%

Long-term levels of protection of different types of immunity against the Omicron variant: a rapid literature review

Rodriguez Velásquez,

Biru,

Hakiza

et al. 2024

Swiss Med Wkly

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INTRODUCTION: With the emergence of newer SARS-CoV-2 variants and their substantial effects on the levels and duration of protection against infection, an understanding of these characteristics of the protection conferred by humoral and cellular immunity can aid in the proper development and implementation of vaccine and safety guidelines. METHODS: We conducted a rapid literature review and searched five electronic databases weekly from 1 November 2021 to 30 September 2022. Studies that assessed the humoral or cellular immunity conferred by infection, vaccination or a hybrid (combination of both) in adults and risk groups (immunocompromised and older populations) were identified. Studies were eligible when they reported data on immunological assays of COVID-19 (related to vaccination and/or infection) or the effectiveness of protection (related to the effectiveness of vaccination and/or infection). RESULTS: We screened 5103 studies and included 205 studies, of which 70 provided data on the duration of protection against SARS-CoV-2 infection. The duration of protection of adaptive immunity was greatly impacted by Omicron and its subvariants: levels of protection were low by 3–6 months from exposure to infection/vaccination. Although more durable, cellular immunity also showed signs of waning by 6 months. First and second mRNA vaccine booster doses increased the levels of protection against infection and severe disease from Omicron and its subvariants but continued to demonstrate a high degree of waning over time. CONCLUSION: All humoral immunities (infection-acquired, vaccine-acquired and hybrid) waned by 3–6 months. Cellular immunity was more durable but showed signs of waning by 6 months. Hybrid immunity had the highest magnitude of protection against SARS-CoV-2 infection. Boosting may be recommended as early as 3–4 months after the last dose, especially in risk groups.

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SARS-CoV-2 infection in cancer patients on active therapy after the booster dose of mRNA vaccines

Cited by 4 publications

References 24 publications

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

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

Influence of SARS-CoV-2 mRNA Vaccine Booster among Cancer Patients on Active Treatment Previously Immunized with Inactivated versus mRNA Vaccines: A Prospective Cohort Study

Long-term levels of protection of different types of immunity against the Omicron variant: a rapid literature review

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