tetano
Editor, Senior Moderator
JCI Insight
. 2023 Feb 7;e163434.
doi: 10.1172/jci.insight.163434. Online ahead of print.
Selective suppression of de novo SARS-CoV2 vaccine antibody responses in cancer patients on B cell-targeted therapy
Joseph H Azar[SUP] 1 [/SUP], John P Evans[SUP] 2 [/SUP], Madison H Sikorski[SUP] 1 [/SUP], Karthik B Chakravarthy[SUP] 3 [/SUP], Selah McKenney[SUP] 1 [/SUP], Ian Carmody[SUP] 1 [/SUP], Cong Zeng[SUP] 2 [/SUP], Rachael Teodorescu[SUP] 1 [/SUP], No-Joon Song[SUP] 1 [/SUP], Jamie L Hamon[SUP] 4 [/SUP], Donna Bucci[SUP] 3 [/SUP], Maria Velegraki[SUP] 3 [/SUP], Chelsea Bolyard[SUP] 5 [/SUP], Kevin P Weller[SUP] 5 [/SUP], Sarah A Reisinger[SUP] 1 [/SUP], Seema A Bhat[SUP] 1 [/SUP], Kami J Maddocks[SUP] 1 [/SUP], Nathan Denlinger[SUP] 1 [/SUP], Narendranath Epperla[SUP] 1 [/SUP], Richard Gumina[SUP] 1 [/SUP], Anastasia N Vlasova[SUP] 6 [/SUP], Eugene Oltz[SUP] 7 [/SUP], Linda Saif[SUP] 6 [/SUP], Dongjun Chung[SUP] 8 [/SUP], Jennifer A Woyach[SUP] 1 [/SUP], Peter G Shields[SUP] 1 [/SUP], Shan-Lu Liu[SUP] 2 [/SUP], Zihai Li[SUP] 4 [/SUP], Mark P Rubinstein[SUP] 1 [/SUP]
Affiliations
Abstract
We assessed vaccine-induced antibody responses to the SARS-CoV2 ancestral virus and Omicron variant before and after booster immunization in 57 patients with B-cell malignancies. Over one third of vaccinated patients at the pre-booster timepoint were seronegative, and these patients were predominantly on active cancer therapies such as anti-CD20 monoclonal antibody. While booster immunization was able to induce detectable antibodies in a small fraction of seronegative patients, the overall booster benefit was disproportionately evident in patients already seropositive and not receiving active therapy. While ancestral and Omicron-reactive antibody levels among individual patients were largely concordant, neutralizing antibodies against Omicron tended to be reduced. Interestingly, in all patients, including those unable to generate detectable antibodies against SARS-CoV2 spike, we observed comparable levels of EBV and influenza reactive antibodies demonstrating that B cell-targeting therapies primarily impair de novo but not pre-existing antibody levels. These findings support rationale for vaccination prior to cancer treatment.
Keywords: COVID-19; Cancer; Immunoglobulins; Oncology.
. 2023 Feb 7;e163434.
doi: 10.1172/jci.insight.163434. Online ahead of print.
Selective suppression of de novo SARS-CoV2 vaccine antibody responses in cancer patients on B cell-targeted therapy
Joseph H Azar[SUP] 1 [/SUP], John P Evans[SUP] 2 [/SUP], Madison H Sikorski[SUP] 1 [/SUP], Karthik B Chakravarthy[SUP] 3 [/SUP], Selah McKenney[SUP] 1 [/SUP], Ian Carmody[SUP] 1 [/SUP], Cong Zeng[SUP] 2 [/SUP], Rachael Teodorescu[SUP] 1 [/SUP], No-Joon Song[SUP] 1 [/SUP], Jamie L Hamon[SUP] 4 [/SUP], Donna Bucci[SUP] 3 [/SUP], Maria Velegraki[SUP] 3 [/SUP], Chelsea Bolyard[SUP] 5 [/SUP], Kevin P Weller[SUP] 5 [/SUP], Sarah A Reisinger[SUP] 1 [/SUP], Seema A Bhat[SUP] 1 [/SUP], Kami J Maddocks[SUP] 1 [/SUP], Nathan Denlinger[SUP] 1 [/SUP], Narendranath Epperla[SUP] 1 [/SUP], Richard Gumina[SUP] 1 [/SUP], Anastasia N Vlasova[SUP] 6 [/SUP], Eugene Oltz[SUP] 7 [/SUP], Linda Saif[SUP] 6 [/SUP], Dongjun Chung[SUP] 8 [/SUP], Jennifer A Woyach[SUP] 1 [/SUP], Peter G Shields[SUP] 1 [/SUP], Shan-Lu Liu[SUP] 2 [/SUP], Zihai Li[SUP] 4 [/SUP], Mark P Rubinstein[SUP] 1 [/SUP]
Affiliations
- PMID: 36749632
- DOI: 10.1172/jci.insight.163434
Abstract
We assessed vaccine-induced antibody responses to the SARS-CoV2 ancestral virus and Omicron variant before and after booster immunization in 57 patients with B-cell malignancies. Over one third of vaccinated patients at the pre-booster timepoint were seronegative, and these patients were predominantly on active cancer therapies such as anti-CD20 monoclonal antibody. While booster immunization was able to induce detectable antibodies in a small fraction of seronegative patients, the overall booster benefit was disproportionately evident in patients already seropositive and not receiving active therapy. While ancestral and Omicron-reactive antibody levels among individual patients were largely concordant, neutralizing antibodies against Omicron tended to be reduced. Interestingly, in all patients, including those unable to generate detectable antibodies against SARS-CoV2 spike, we observed comparable levels of EBV and influenza reactive antibodies demonstrating that B cell-targeting therapies primarily impair de novo but not pre-existing antibody levels. These findings support rationale for vaccination prior to cancer treatment.
Keywords: COVID-19; Cancer; Immunoglobulins; Oncology.