Abstract
Background: The role and the durability of the immunogenicity of the third dose of vaccine against COVID-19 variants of concern in cancer patients have to be elucidated.
Patients and methods: We have prospectively evaluated the immunogenicity of the third dose of the SARS-CoV-2 BNT162b2 messenger RNA vaccine in triggering both humoral and cell-mediated immune response in patients with solid tumors undergoing active treatment 6 months after the booster. Neutralizing antibody (NT Ab) titers and total anti-spike immunoglobulin G concentrations were measured in serum. Heparinized whole blood samples were used for the SARS-CoV-2 interferon-γ release assay (IGRA).
Results: Six months after the third dose only two patients (2.4%) showed negative spike-specific immunoglobulin G antibody levels (<33.8 BAU/ml). The median level of SARS-CoV-2 NT Abs decreased and only 39/83 (47%) subjects showed maximum levels of NT Abs. T-cellular positive response was observed in 38/61 (62.3%) patients; the highest median level of response was observed 21 days after the third dose (354 mIU/ml, interquartile range 83.3-846.3 mIU/ml). The lowest median level of NT Ab response was observed against the Omicron variant (1 : 10, interquartile range 1 : 10-1 : 40) with a significant reduced rate of responder subjects with respect to the wild-type strain (77.5% versus 95%; P = 0.0022) and Delta variant (77.5% versus 93.7%; P = 0.0053). During the follow-up period, seven patients (8%) had a confirmed post-vaccination infection, but none of them required hospitalization or oxygen therapy.
Conclusions: Our work highlights a significant humoral and cellular immune response among patients with solid tumors 6 months after the third BNT162b2 vaccine dose, although a reduction in neutralizing activity against Omicron was observed.
Keywords: BNT162b2 anti-SARS-CoV-2 vaccine; VOCs; cancer; neutralizing antibody; third dose.
【저자키워드】 neutralizing antibody, Cancer, BNT162b2 anti-SARS-CoV-2 vaccine, third dose., VOCs, 【초록키워드】 COVID-19, Treatment, SARS-CoV-2, Vaccine, BNT162b2 vaccine, Hospitalization, antibody, Cellular immune response, variant, Infection, variants of concern, omicron, delta variant, anti-SARS-CoV-2, BNT162b2, serum, Neutralizing activity, Immunoglobulin, Patient, Oxygen therapy, Neutralizing, booster, Anti-spike, Concentration, dose, humoral, cancer patient, interquartile range, Messenger RNA, interferon-γ, follow-up period, subject, solid tumor, wild-type strain, positive response, triggering, whole blood sample, highlight, Seven, lowest, highest, evaluated, required, reduced, median, were used, reduction in, were measured, cell-mediated immune, the SARS-CoV-2, 【제목키워드】 Vaccine, Cellular immune response, variants of concern, anti-SARS-CoV-2, Patient, dose, humoral, longitudinal cohort study, of BNT162b2,