Antibody response after COVID-19 vaccination lower among some patients with lung cancer
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Most patients with lung cancer — including those receiving active therapy — produced neutralizing antibodies to COVID-19 after vaccination, according to study results.
However, the findings — presented at International Association for the Study of Lung Cancer World Conference on Lung Cancer — showed lower antibody levels among individuals with lung cancer than healthy individuals.
“In addition, there is a group of patients with lung cancer who produce very low levels of neutralizing antibodies,” researcher Jorge Gomez, MD, assistant professor of medicine, hematology and medical oncology at The Tisch Cancer Institute at Mount Sinai, told Healio. “As our study matures, we hope to better understand the reasons behind the lower antibody levels. We will also be better able to understand the impact of lung cancer therapies — such as chemotherapy, immunotherapy and targeted therapy — on the immune response to SARS-CoV-2.”
Prior studies revealed mortality rates ranging from 24% to 47% among people with lung cancer who develop COVID-19.
Research has been conducted to assess antibody responses to infection and vaccination among people with hematologic malignancies; however, such data among people with lung cancer are limited. In addition, the effect of systemic lung cancer therapies on antibody response has not been established, according to study background.
Gomez and colleagues designed a prospective, control-matched longitudinal cohort study to determine whether people with lung cancer demonstrate weaker antibody response to COVID-19 infection and/or vaccination than healthy individuals.
Researchers aim to recruit 750 people with lung cancer regardless of stage, as well as 750 healthy controls matched for age, sex, ethnicity and tobacco history.
Under study protocol, researchers will obtain samples at baseline, as well as at 3, 6, 12 and 24 months, to assess quality, magnitude and duration of neutralizing antibody titers against the SARS-CoV-2 spike protein.
“We are trying to identify different factors that may help us understand why the immune response in patients with lung cancer may not be as robust as in healthy individuals,” Gomez said. “These factors might be related to cancer therapies [or] lung cancer itself, or be specific to each patient.”
At World Lung, Gomez presented data from the first 111 people (median age, 69 years; 57.6% women; 43.2% white, 27% Black, 9% Hispanic) with lung cancer enrolled in the study.
The initial analysis also included 70 controls aged older than 50 years. These included 44 people who were seronegative prior to COVID-19 mRNA vaccination, as well as 26 people who were seropositive prior to vaccination.
Seventy-two people in the lung cancer cohort had received at least one dose of COVID-19 vaccine, with twice as many receiving the Pfizer vaccine as Moderna (67% vs. 31%).
Thirty-nine people in the lung cancer cohort were fully vaccinated, defined as being at least 14 days beyond their second vaccine dose. In this group, median antibody levels were 38,400 units/mL among individuals with COVID-19-positive history (n = 4) and 6,400 units/mL among those receiving systemic cancer therapy (n = 24).
A comparison of five subgroups — individuals with cancer who had received no vaccine (n = 32), partial vaccination (n = 33) or full vaccination (n = 39), and healthy individuals who were (n = 25) or were not fully vaccinated (n = 18) — showed statistically significant differences in antibody titers (P < .001).
Researchers also reported statistically significant differences in antibody titers between fully vaccinated individuals in the cancer cohort and control cohort (P = .01), as well as between non-fully vaccinated individuals in the cancer and control cohorts (P = .01).
Results showed most patients with lung cancer achieved adequate antibody titers after vaccination, but that a subset of patients developed low antibody titers.
A comparison of antibody levels among fully vaccinated individuals with cancer showed no statistically significant differences based on sex, smoking history, age or current receipt of immunotherapy.
Gomez and colleagues are using serial samples collected over the past year to study the effect of specific cancer treatments on antibody levels. A prospective boost-vaccination study also is planned.
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Gomez J, et al. Abstract OA01.01. Presented at: International Association for the Study of Lung Cancer World Conference on Lung Cancer (virtual meeting); Sept. 8-14, 2021.
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