1. REDUCED HUMORAL IMMUNE RESPONSE AFTER BNT162B2 COVID-19 MRNA VACCINATION IN CANCER PATIENTS UNDER ANTI-NEOPLASTIC TREATMENT
- Author
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Kristof Y. Neven, S. Vande Kerckhove, Laure-Anne Teuwen, Manon T. Huizing, Ella Roelant, P. van Dam, Pieter Pannus, S. De Keersmaecker, I. Van der Massen, Marc Peeters, Isabelle Desombere, Bart Peeters, Timon Vandamme, Kevin K. Ariën, Y. Debie, Greetje Vanhoutte, Sébastien Anguille, Maria E Goossens, L. Verbruggen, M. Van Den Bulcke, Geert A. Martens, and S. Raats
- Subjects
safety ,Cancer Research ,medicine.medical_specialty ,COVID-19 Vaccines ,medicine.medical_treatment ,Antineoplastic Agents ,Hematopoietic stem cell transplantation ,Booster dose ,Gastroenterology ,Internal medicine ,Neoplasms ,medicine ,Humans ,cancer ,Prospective Studies ,RNA, Messenger ,Adverse effect ,BNT162 Vaccine ,Original Research ,Chemotherapy ,anti-RBD IgG antibody response ,business.industry ,SARS-CoV-2 ,Vaccination ,Antibody titer ,Cancer ,COVID-19 ,medicine.disease ,Immunity, Humoral ,BNT162b2 COVID-19 vaccination ,Oncology ,Rituximab ,Human medicine ,business ,Anti-neoplastic treatment ,medicine.drug - Abstract
Background: Cancer patients are at a higher risk of developing severe coronavirus disease 2019 (COVID-19). However, the safety and efficacy of COVID-19 vaccination in cancer patients undergoing treatment remain unclear. Patients and methods: In this interventional prospective multicohort study, priming and booster doses of the BNT162b2 COVID-19 vaccine were administered 21 days apart to solid tumor patients receiving chemotherapy, immunotherapy, targeted or hormonal therapy, and patients with a hematologic malignancy receiving rituximab or after allogeneic hematopoietic stem cell transplantation. Vaccine safety and efficacy (until 3 months post-booster) were assessed. Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor-binding domain (RBD) antibody levels were followed over time (until 28 days after the booster) and in vitro SARS-CoV-2 50% neutralization titers (NT50) toward the wild-type Wuhan strain were analyzed 28 days after the booster. Results: Local and systemic adverse events (AEs) were mostly mild to moderate (only 1%-3% of patients experienced severe AEs). Local, but not systemic, AEs occurred more frequently after the booster dose. Twenty-eight days after the booster vaccination of 197 cancer patients, RBD-binding antibody titers and NT50 were lower in the chemotherapy group {234.05 IU/ml [95% confidence interval (CI) 122.10-448.66] and 24.54 (95% CI 14.50-41.52), respectively} compared with healthy individuals [1844.93 IU/ml (95% CI 1383.57-2460.14) and 122.63 (95% CI 76.85-195.67), respectively], irrespective of timing of vaccination during chemotherapy cycles. Extremely low antibody responses were seen in hematology patients receiving rituximab; only two patients had RBD-binding antibody titers necessary for 50% protection against symptomatic SARS-CoV-2 infection (
- Published
- 2021