Abstract
Longitudinal studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine-induced immune responses in patients with cancer are needed to optimize clinical care. In a prospective cohort study of 366 (291 vaccinated) patients, we measured antibody levels [anti-spike (IgG-(S-RBD) and anti-nucleocapsid immunoglobulin] at three time points. Antibody level trajectories and frequency of breakthrough infections were evaluated by tumor type and timing of treatment relative to vaccination. IgG-(S-RBD) at peak response (median = 42 days after dose 2) was higher ( P = 0.002) and remained higher after 4 to 6 months ( P = 0.003) in patients receiving mRNA-1273 compared with BNT162b2. Patients with solid tumors attained higher peak levels ( P = 0.001) and sustained levels after 4 to 6 months ( P < 0.001) compared with those with hematologic malignancies. B-cell targeted treatment reduced peak ( P = 0.001) and sustained antibody responses ( P = 0.003). Solid tumor patients receiving immune checkpoint inhibitors before vaccination had lower sustained antibody levels than those who received treatment after vaccination ( P = 0.043). Two (0.69%) vaccinated and one (1.9%) unvaccinated patient had severe COVID-19 illness during follow-up. Our study shows variation in sustained antibody responses across cancer populations receiving various therapeutic modalities, with important implications for vaccine booster timing and patient selection. SIGNIFICANCE: Long-term studies of immunogenicity of SARS-CoV-2 vaccines in patients with cancer are needed to inform evidence-based guidelines for booster vaccinations and to tailor sequence and timing of vaccinations to elicit improved humoral responses.
【초록키워드】 Treatment, SARS-CoV-2, Tumor, Vaccine, coronavirus, vaccination, immunogenicity, antibody, mRNA-1273, Cancer, Antibody Response, Variation, SARS-CoV-2 vaccines, prospective cohort study, severe acute respiratory syndrome Coronavirus, SARS-CoV-2 vaccine, Population, BNT162b2, Immunoglobulin, mRNA, immune responses, therapeutic, Longitudinal studies, Patient, Immune checkpoint inhibitor, breakthrough infections, trajectory, antibody levels, Breakthrough infection, Follow-up, humoral responses, clinical care, respiratory, longitudinal, patients, booster, Anti-spike, booster vaccination, B-cell, Frequency, Vaccinations, dose, solid tumors, Immune checkpoint inhibitors, tumors, peak levels, Patients with cancer, acute respiratory syndrome, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, sequence, COVID-19 illness, solid tumor, malignancies, hematologic, vaccine-induced immune response, patient selection, severe COVID-19 illness, booster vaccinations, implication, remained, evaluated, receiving, reduced, median, elicit, sustained, Solid, 【제목키워드】 SARS-CoV-2, response, longitudinal,