Abstract

Objective: To evaluate the safety and immunogenicity of the Pfizer-BioNTech COVID-19 vaccine in gynecologic oncology patients under chemotherapy. Methods: A prospective cohort study including gynecologic oncology women who were under chemotherapy or had completed it within 6 months at the time of the study. All patients received a two-dose schedule of the Pfizer-BioNTech COVID-19 vaccine. Results were compared with a control group of healthy women vaccinated in the same period. Results: Overall, 44 oncologic patients with a mean age of 61.3 ± 10.7 years were enrolled: 28 (63.6%) had ovarian cancer, 9 (20.4%) endometrial, and 7 (16%) cervical. The IgG antibody titer after 1 month from vaccination was low in 9 (20.5%) patients, moderate in 21 (47.7%), and high in 14 (31.8%). The 3-month titer was null in 2 (4.5%) patients, low in 26 (59.1%), moderate in 13 (29.5%), and high in 3 (6.8%). Patients ≥ 50 years reported lower 1-month (p = 0.018) and 3-month (p = 0.004) titers compared with <50 years. Patients with BMI < 30 kg/m2 had a higher 1-month titer compared with BMI ≥ 30 kg/m2 (p = 0.016). Compared with healthy women (n = 44), oncologic patients showed a lower 3-month titer (p < 0.001). None of the patients experienced serious adverse effects. Conclusions: The COVID-19 vaccine was safe and immunogenic in gynecologic oncology patients under chemotherapy. Serological monitoring and further vaccine shots should be considered to boost protection.

Highlights

  • The global cancer burden using the updated GLOBOCAN database estimated 19.3 million new cancer cases and nearly 10.0 million cancer deaths in 2020 worldwide [1]

  • The present study aimed to evaluate the safety and immunogenicity of the PfizerBioNTech COVID-19 vaccine in gynecologic oncology patients under chemotherapy treatment and to investigate the range of potential risk factors modulating the immunogenicity

  • There is only scant evidence addressing the immunogenicity and safety of available vaccines in cancer patients since immunocompromised individuals were excluded from initial registration trials

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Summary

Introduction

The global cancer burden using the updated GLOBOCAN database estimated 19.3 million new cancer cases and nearly 10.0 million cancer deaths in 2020 worldwide [1]. Managing this elevated number of cancer patients during the COVID-19 (SARS-CoV-2) pandemic represents a real clinical challenge [2,3]. The main concern about getting the vaccine is not so much related to its safety but rather to its immunogenicity, considering that either the disease itself (e.g., leukemias, lymphomas) or the treatment (e.g., chemotherapy, radiotherapy, immunotherapy, surgery) might weaken the immune system, decreasing seroconversion rates [10,19]. There are no data on whether the immune response to the SARS-CoV-2 is influenced by active cancer and ongoing or recent cancer treatments

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