TY - JOUR
TI - Responses to SARS-CoV-2 Vaccination in Patients with Cancer (ReCOVer
Study): A Prospective Cohort Study of the Hellenic Cooperative Oncology
Group
AU - Linardou, Helena
AU - Spanakis, Nikolaos
AU - Koliou, Georgia-Angeliki and
AU - Christopoulou, Athina
AU - Karageorgopoulou, Sofia
AU - Alevra, Nephely
AU - and Vagionas, Anastasios
AU - Tsoukalas, Nikolaos
AU - Sgourou, Stavroula
AU - and Fountzilas, Elena
AU - Sgouros, Joseph
AU - Razis, Evangelia and
AU - Chatzokou, Dimitra
AU - Lampaki, Sofia
AU - Res, Eleni
AU - Saridaki,
AU - Zacharenia
AU - Mountzios, Giannis
AU - Saroglou, George
AU - Fountzilas,
AU - George
JO - Blood cancer journal
PY - 2021
VL - 13
TODO - 18
SP - null
PB - MDPI
SN - null
TODO - 10.3390/cancers13184621
TODO - SARS-CoV-2 vaccine; cancer patient; antibody response; neutralizing IgG;
anti-spike
TODO - Simple Summary There is limited information on the safety and efficacy
of approved SARS-CoV-2 vaccines in cancer patients, as they were
excluded from registration vaccine trials. We investigated the humoral
immunity post SARS-CoV-2 vaccination in cancer patients compared to
healthy volunteers. In this prospective cohort study, the seropositivity
rate after two doses of vaccine was high in cancer patients despite
active antineoplastic treatment, but their antibody titers were
significantly lower than in healthy control subjects. Factors affecting
immunogenicity in cancer patients, included older age, poor PS, active
treatment, certain cancer types, i.e., pancreatic cancer and SCLC, male
gender, and, interestingly, smoking status. Our results suggest that,
given the lower immunogenicity, adjustments in vaccination strategies
for more vulnerable subgroups of cancer patients may be required.
Monitoring of antibody responses and elucidation of the clinical factors
that influence immunity could guide future vaccination policies. Data on
the effectiveness and safety of approved SARS-CoV-2 vaccines in cancer
patients are limited. This observational, prospective cohort study
investigated the humoral immune response to SARS-CoV-2 vaccination in
232 cancer patients from 12 HeCOG-affiliated oncology departments
compared to 100 healthcare volunteers without known active cancer. The
seropositivity rate was measured 2-4 weeks after two vaccine doses, by
evaluating neutralising antibodies against the SARS-CoV-2 spike protein
using a commercially available immunoassay. Seropositivity was defined
as >= 33.8 Binding-Antibody-Units (BAU)/mL. A total of 189 patients and
99 controls were eligible for this analysis. Among patients, 171
(90.5%) were seropositive after two vaccine doses, compared to 98% of
controls (p = 0.015). Most seronegative patients were males (66.7%),
>70-years-old (55.5%), with comorbidities (61.1%), and on active
treatment (88.9%). The median antibody titers among patients were
significantly lower than those of the controls (523 vs. 2050 BAU/mL; p <
0.001). The rate of protective titers was 54.5% in patients vs. 97% in
controls (p < 0.001). Seropositivity rates and IgG titers in controls
did not differ for any studied factor. In cancer patients, higher
antibody titers were observed in never-smokers (p = 0.006), women (p =
0.022), <50-year-olds (p = 0.004), PS 0 (p = 0.029), and in breast or
ovarian vs. other cancers. Adverse events were comparable to
registration trials. In this cohort study, although the seropositivity
rate after two vaccine doses in cancer patients seemed satisfactory,
their antibody titers were significantly lower than in controls.
Monitoring of responses and further elucidation of the clinical factors
that affect immunity could guide adaptations of vaccine strategies for
vulnerable subgroups.
ER -