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ESMO Open . Immunogenicity and safety after the third dose of BNT162b2 anti-SARS-CoV-2 vaccine in patients with solid tumors on active treatment: a

tetano

Editor, Senior Moderator
ESMO Open


. 2022 Mar 11;7(2):100458.
doi: 10.1016/j.esmoop.2022.100458. Online ahead of print.
Immunogenicity and safety after the third dose of BNT162b2 anti-SARS-CoV-2 vaccine in patients with solid tumors on active treatment: a prospective cohort study


A Lasagna[SUP] 1 [/SUP], F Bergami[SUP] 2 [/SUP], D Lilleri[SUP] 2 [/SUP], E Percivalle[SUP] 2 [/SUP], M Quaccini[SUP] 1 [/SUP], N Alessio[SUP] 1 [/SUP], G Comolli[SUP] 2 [/SUP], A Sarasini[SUP] 2 [/SUP], J C Sammartino[SUP] 2 [/SUP], A Ferrari[SUP] 2 [/SUP], F Arena[SUP] 2 [/SUP], S Secondino[SUP] 1 [/SUP], D Cicognini[SUP] 1 [/SUP], R Schiavo[SUP] 3 [/SUP], G Lo Cascio[SUP] 3 [/SUP], L Cavanna[SUP] 4 [/SUP], F Baldanti[SUP] 5 [/SUP], P Pedrazzoli[SUP] 6 [/SUP], I Cassaniti[SUP] 2 [/SUP]



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Free article

Abstract

Background: Although a full course of coronavirus disease 2019 (COVID-19) vaccine is effective in cancer patients, the duration of the protection and the efficacy of a booster dose against the new variants remain unknown. We prospectively evaluated the immunogenicity of the third dose of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) BNT162b2 messenger RNA vaccine in cancer patients undergoing active treatment.
Patients and methods: Patients with solid cancer, vaccinated with a booster dose during active treatment, were enrolled in this study. Patients were classified into SARS-CoV-2 naïve (without previous COVID-19 infection) and SARS-CoV-2 experienced (with previous COVID-19 infection). Neutralizing antibody (NT Ab) titer and total anti-Spike immunoglobulin G (IgG) concentration were quantified in serum. Heparinized whole blood samples were used for SARS-CoV-2 Interferon Gamma Release Assay (IGRA). The primary endpoint was to assess the increase of IgG antibody level between baseline and 3 weeks after the booster.
Results: One hundred and forty-two consecutive patients were recruited. In SARS-CoV-2-naïve subjects, the median level of IgG was 157 BAU/ml [interquartile range (IQR) 62-423 BAU/ml] at T0 and reached a median of 2080 BAU/ml (IQR 2080-2080 BAU/ml) at 3 weeks after booster administration (T1; P < 0.0001). A median 16-fold increase of SARS-CoV-2 NT Ab titer (IQR 4-32) was observed in naïve subjects (from median 20, IQR 10-40, to median 640, IQR 160-640; P < 0.0001). Median interferon-γ level at T1 was significantly higher than that measured at T0 in SARS-CoV-2-naïve subjects (P = 0.0049) but not in SARS-CoV-2-experienced patients. The median level of SARS-CoV-2 NT Abs was 32-fold lower against Omicron compared to the wild-type strain (P = 0.0004) and 12-fold lower compared to the Delta strain (P = 0.0110).
Conclusions: The third dose is able to trigger both the humoral and the cell-mediated immune response in cancer patients on active treatment. Our preliminary data about the neutralization of the SARS-CoV-2 vaccine against variants of concern seem to confirm the lower vaccine activity.

Keywords: BNT162b2 anti-SARS-CoV-2 vaccine; VOCs; cancer; neutralizing antibody; third dose.
 
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