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Curated Papers > Recent research on high-impact "mRNA vaccines" (IF≥30, past 5 years)

Immunogenicity of SARS-CoV-2 messenger RNA vaccines in patients with cancer. ​

Literature Information ​

DOI10.1016/j.ccell.2021.06.009
PMID34214473
JournalCancer cell
Impact Factor44.5
JCR QuartileQ1
Publication Year2021
Times Cited156
KeywordsCOVID-19, anti-cancer treatment, antibody, immune response, malignancy
Literature TypeJournal Article
ISSN1535-6108
Pages1091-1098.e2
Issue39(8)
AuthorsAlfredo Addeo, Pankil K Shah, Natacha Bordry, Robert D Hudson, Brenna Albracht, Mariagrazia Di Marco, Virginia Kaklamani, Pierre-Yves Dietrich, Barbara S Taylor, Pierre-Francois Simand, Darpan Patel, Jing Wang, Intidhar Labidi-Galy, Sara Fertani, Robin J Leach, Jose Sandoval, Ruben Mesa, Kate Lathrop, Nicolas Mach, Dimpy P Shah

TL;DR ​

This study investigates the efficacy of SARS-CoV-2 mRNA vaccines in cancer patients, revealing that 94% of the 131 participants achieved seroconversion after two doses, though those with hematological malignancies had significantly lower rates and antibody responses. The findings underscore the need for tailored vaccination strategies in cancer patients, particularly for those receiving certain treatments, to enhance their immune response against SARS-CoV-2.

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COVID-19 · anti-cancer treatment · antibody · immune response · malignancy

Abstract ​

Patients with cancer experience a higher burden of SARS-CoV-2 infection, disease severity, complications, and mortality, than the general population. SARS-CoV-2 mRNA vaccines are highly effective in the general population; however, few data are available on their efficacy in patients with cancer. Using a prospective cohort, we assessed the seroconversion rates and anti-SARS-CoV-2 spike protein antibody titers following the first and second dose of BNT162b2 and mRNA-1273 SARS-CoV-2 vaccines in patients with cancer in US and Europe from January to April 2021. Among 131 patients, most (94%) achieved seroconversion after receipt of two vaccine doses. Seroconversion rates and antibody titers in patients with hematological malignancy were significantly lower than those with solid tumors. None of the patients with history of anti-CD-20 antibody in the 6 months before vaccination developed antibody response. Antibody titers were highest for clinical surveillance or endocrine therapy groups and lowest for cytotoxic chemotherapy or monoclonal antibody groups.

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Primary Questions Addressed ​

  1. What specific factors contribute to the lower seroconversion rates observed in patients with hematological malignancies compared to those with solid tumors?
  2. How do different cancer treatments, such as cytotoxic chemotherapy and monoclonal antibodies, impact the immunogenic response to SARS-CoV-2 mRNA vaccines?
  3. What are the long-term implications of lower antibody titers in cancer patients post-vaccination for their overall health and COVID-19 risk?
  4. Are there any specific recommendations for vaccination strategies in cancer patients to enhance immunogenicity and protect against SARS-CoV-2?
  5. How does the timing of vaccination in relation to cancer treatment affect the immune response to mRNA vaccines in patients with cancer?

Key Findings ​

Research Background and Objectives ​

Patients with cancer are at a higher risk of severe outcomes from COVID-19. This study aimed to assess the immunogenicity of SARS-CoV-2 mRNA vaccines (BNT162b2 and mRNA-1273) in cancer patients, focusing on seroconversion rates and antibody titers after vaccination. The goal was to determine how effective these vaccines are in generating an immune response in this vulnerable population.

Main Methods/Materials/Experimental Design ​

A prospective cohort study was conducted involving 140 cancer patients from the US and Switzerland who received either BNT162b2 or mRNA-1273 vaccines between January and April 2021. The study assessed seroconversion rates and anti-SARS-CoV-2 spike protein IgG antibody titers at two time points: after the first and second vaccine doses.

Experimental Design Overview ​

Mermaid diagram

Key Results and Findings ​

  • Seroconversion Rates: 94% of patients achieved seroconversion after the second dose, compared to 81% after the first dose.
  • Antibody Titers: Patients with solid tumors had significantly higher antibody titers than those with hematological malignancies.
  • Non-responders: 6% of patients (mostly with hematological malignancies) did not develop antibodies post-vaccination, particularly those treated with anti-CD-20 therapies.
  • Impact of Treatment: Patients undergoing cytotoxic chemotherapy had lower antibody titers compared to those on clinical surveillance or endocrine therapy.

Main Conclusions/Significance/Innovation ​

The study confirms that most cancer patients develop a robust antibody response to mRNA COVID-19 vaccines, particularly after the second dose. However, it highlights the concern for specific subgroups, such as those with hematological malignancies or those receiving immunosuppressive treatments, who may not respond adequately to vaccination. This underscores the need for tailored vaccination strategies and potential booster doses for immunocompromised patients.

Research Limitations and Future Directions ​

  • Limitations: The study did not assess cellular immunity, which is critical for understanding overall vaccine efficacy. Additionally, the sample size for certain demographics was small, limiting generalizability.
  • Future Directions: Further research is needed to evaluate the cellular immune response in this population and to explore the effectiveness of additional vaccine doses or alternative vaccination strategies for high-risk groups.
AspectDetails
Study DesignProspective cohort study, assessing mRNA vaccine response in cancer patients
Population140 cancer patients (131 analyzed for immunogenicity)
Key Findings94% seroconversion after second dose; lower response in hematological malignancies and certain therapies
LimitationsLack of cellular immunity data; small sample size for some demographics
Future Research NeedsExplore cellular immunity and optimal vaccination strategies for immunocompromised patients

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Literatures Citing This Work ​

  1. Immunogenicity of a heterologous COVID-19 vaccine after failed vaccination in a lymphoma patient. - Joshua A Hill;Chaitra S Ujjani;Alexander L Greninger;Mazyar Shadman;Ajay K Gopal - Cancer cell (2021)
  2. Highly variable SARS-CoV-2 spike antibody responses to two doses of COVID-19 RNA vaccination in patients with multiple myeloma. - Oliver Van Oekelen;Charles R Gleason;Sarita Agte;Komal Srivastava;Katherine F Beach;Adolfo Aleman;Katerina Kappes; ;Tarek H Mouhieddine;Bo Wang;Ajai Chari;Carlos Cordon-Cardo;Florian Krammer;Sundar Jagannath;Viviana Simon;Ania Wajnberg;Samir Parekh - Cancer cell (2021)
  3. Immune responses to COVID-19 vaccines in patients with cancer: Promising results and a note of caution. - Elizabeth A Griffiths;Brahm H Segal - Cancer cell (2021)
  4. A Quantitative ELISA Protocol for Detection of Specific Human IgG against the SARS-CoV-2 Spike Protein. - Rémi Vernet;Emily Charrier;Julien Grogg;Nicolas Mach - Vaccines (2021)
  5. COVID-19 Vaccine Among Actively-Treated People With Cancer: A Glimpse Into the Known Unknowns? - Astha Thakkar;Sanjay Mishra;Jeremy L Warner - Journal of the National Cancer Institute (2022)
  6. Evaluation of Antibody Responses to COVID-19 Vaccines among Solid Tumor and Hematologic Patients. - Josef Singer;Nguyen-Son Le;Daniel Mattes;Valerie Klamminger;Klaus Hackner;Nicole Kolinsky;Michaela Scherb;Peter Errhalt;Gudrun Kreye;Martin Pecherstorfer;Sonia Vallet;Klaus Podar - Cancers (2021)
  7. SARS-CoV-2 vaccination in patients with solid tumors or hematological malignancies: Is the pandemic over for fully vaccinated patients? - Niklas Zojer - Memo (2021)
  8. Responses to SARS-CoV-2 Vaccination in Patients with Cancer (ReCOVer Study): A Prospective Cohort Study of the Hellenic Cooperative Oncology Group. - Helena Linardou;Nikolaos Spanakis;Georgia-Angeliki Koliou;Athina Christopoulou;Sofia Karageorgopoulou;Nephely Alevra;Anastasios Vagionas;Nikolaos Tsoukalas;Stavroula Sgourou;Elena Fountzilas;Joseph Sgouros;Evangelia Razis;Dimitra Chatzokou;Sofia Lampaki;Eleni Res;Zacharenia Saridaki;Giannis Mountzios;George Saroglou;George Fountzilas - Cancers (2021)
  9. Influence of Health Beliefs on COVID-19 Vaccination among Individuals with Cancer and Other Comorbidities in Puerto Rico. - McClaren Rodriguez;Andrea López-Cepero;Ana P Ortiz-Martínez;Emma Fernández-Repollet;Cynthia M Pérez - Vaccines (2021)
  10. Serologic response to COVID-19 infection and/or vaccine in cancer patients on active treatment. - A Grinshpun;Y Rottenberg;I Z Ben-Dov;E Djian;D G Wolf;L Kadouri - ESMO open (2021)

... (146 more literatures)

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