Longitudinal SARS-CoV-2 mRNA vaccine-induced humoral immune responses in cancer patients

• Published in: Cancer research (Chicago, Ill.) Vol. 81; no. 24; pp. 6273 - 6280
• Main Authors: Figueiredo, Jane C., Merin, Noah M., Hamid, Omid, Choi, So Yung, Lemos, Tucker, Cozen, Wendy, Nguyen, Nathalie, Finster, Laurel J., Foley, Joslyn, Darrah, Justin, Gong, Jun, Paquette, Ronald, Mita, Alain C., Vescio, Robert, Mehmi, Inderjit, Basho, Reva, Tourtellotte, Warren G., Huynh, Carissa A., Melmed, Gil Y., Braun, Jonathan, McGovern, Dermot P.B., Mengesha, Emebet, Botwin, Greg, Prostko, John C., Frias, Edwin C, Stewart, James L., Joung, Sandy, Van Eyk, Jennifer, Ebinger, Joseph E., Cheng, Susan, Sobhani, Kimia, Reckamp, Karen L., Merchant, Akil
• Format: Journal Article
• Language: English
• Published: 10.11.2021
• ISSN: 0008-5472; 1538-7445
• DOI: 10.1158/0008-5472.CAN-21-3554

Longitudinal studies of SARS-CoV-2 vaccine-induced immune responses in cancer patients 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 timepoints. 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 4–6 months (p=0.003) in patients receiving mRNA-1273 compared to BNT162b2. Patients with solid tumors attained higher peak levels (p=0.001) and sustained levels after 4–6 months (p<0.001) compared to 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.