Abstract
Coronavirus disease 2019 (COVID-19) antiviral response in a pan-tumor immune monitoring (CAPTURE) (NCT03226886) is a prospective cohort study of COVID-19 immunity in patients with cancer. Here we evaluated 585 patients following administration of two doses of BNT162b2 or AZD1222 vaccines, administered 12 weeks apart. Seroconversion rates after two doses were 85% and 59% in patients with solid and hematological malignancies, respectively. A lower proportion of patients had detectable titers of neutralizing antibodies (NAbT) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOC) versus wild-type (WT) SARS-CoV-2. Patients with hematological malignancies were more likely to have undetectable NAbT and had lower median NAbT than those with solid cancers against both SARS-CoV-2 WT and VOC. By comparison with individuals without cancer, patients with hematological, but not solid, malignancies had reduced neutralizing antibody (NAb) responses. Seroconversion showed poor concordance with NAbT against VOC. Previous SARS-CoV-2 infection boosted the NAb response including against VOC, and anti-CD20 treatment was associated with undetectable NAbT. Vaccine-induced T cell responses were detected in 80% of patients and were comparable between vaccines or cancer types. Our results have implications for the management of patients with cancer during the ongoing COVID-19 pandemic.
Highlights
The ongoing evolution of SARS-CoV-2 has led to the emergence of variants of concern (VOC) that have potentially enhanced transmission, pathogenicity and immune escape[1]
Patients with cancer have been prioritized in COVID-19 vaccination programs globally[12,13]; as they were virtually excluded from pivotal vaccine studies, data on efficacy or immune response to COVID-19 vaccines in this population are lacking
The CAPTURE study is a prospective, longitudinal cohort study evaluating the impact of cancer and anticancer treatment on the immune response to SARS-CoV-2 infection and COVID-19 vaccinations[26]
Summary
The ongoing evolution of SARS-CoV-2 has led to the emergence of VOC that have potentially enhanced transmission, pathogenicity and immune escape[1]. The CAPTURE study is a prospective, longitudinal cohort study evaluating the impact of cancer and anticancer treatment on the immune response to SARS-CoV-2 infection and COVID-19 vaccinations[26]. Data from the infection cohort (companion paper27) show that the majority of patients with solid cancer develop durable humoral responses (of at least 11 months) and have detectable T cell responses to SARS-CoV-2 infection, but patients with hematological malignancies often display a discordance between humoral and cellular arms (owing to disease-related lineage defects and anti-CD20 treatment); neutralizing activity against Alpha, Beta and Delta VOC is reduced following infection with the WT SARS-CoV-2 strain. We investigate whether humoral and cellular immunity is efficiently induced following COVID-19 vaccination in the vaccine cohort of the CAPTURE study, especially regarding VOC. This approach was implemented by the UK government during the second wave of the pandemic to maximize the number of people vaccinated with at least one dose
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